Parenting skills

Last update: September 2015

Topic Editor:
Richard E. Tremblay, PhD, Université de Montréal, Canada and University College Dublin, Ireland

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Table of content
Synthesis   6
     

Animal models of maternal behaviour: insights into our understanding the   9

endocrinology, neurobiology, genetics and development of mothering
EMIS AKBARI, PHD, 2KATHLEEN WONCH, MA, 2ALISON S. FLEMING, PHD, FRSC, AUGUST 2015
1

     

Parent Support Programs and Outcomes for Children   16

BARBARA DILLON GOODSON, PHD, DECEMBER 2014

     

Community-Based Parent Support Programs   22

CAROL M. TRIVETTE, PHD, CARL J. DUNST, PHD, DECEMBER 2014

     

Parent Support Programs and Early Childhood Development: Comments on   29

Goodson, and Trivette and Dunst
JANE DRUMMOND, PHD, DECEMBER 2014

     

Parenting Styles and Child Social Development   34

LEA BORNSTEIN, BA, MARC H. BORNSTEIN, PHD, DECEMBER 2014

     

The role of parents in early childhood learning   38

SUSAN H. LANDRY, PHD, DECEMBER 2014

     

Parents’ Role in Fostering Young Children’s Learning and Language   45

Development
CATHERINE S. TAMIS-LEMONDA, PHD, EILEEN T. RODRIGUEZ, PHD, DECEMBER 2014

     

The Role of Parents in Children’s School Transition   54

PHILIP A. COWAN, PHD, CAROLYN PAPE COWAN, PHD, DECEMBER 2014

     

Parent Supervision to Prevent Injuries to Young Children   60

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BARBARA A. MORRONGIELLO, PHD, BRAE ANNE MCARTHUR, PHD, OCTOBER 2018

     

Parent-Child Relationships in Early Childhood and Development of Anxiety &   69

Depression
JENNIFER L. HUDSON, PHD, DECEMBER 2014

     

Parent Management Training Interventions for Preschool-Age Children   75

ROBERT J. MCMAHON, PHD, MARCH 2015

     

Social-Contextual Determinants of Parenting   85

JAY BELSKY, PHD, DECEMBER 2014

     

Parenting Programs and Their Impact on the Social and Emotional   92

Development of Young Children
DANIEL S. SHAW, PHD, DECEMBER 2014

     

Parents’ Attitudes and Beliefs: Their Impact on Children’s Development   99

JOAN E. GRUSEC, PHD, TANYA DANYLIUK, BA, DECEMBER 2014

     

Can Changing Parental Knowledge, Dysfunctional Expectations and   104

Attributions, and Emotion Regulation Improve Outcomes for Children?
MATTHEW R SANDERS, PHD, ALINA MORAWSKA, PHD, DECEMBER 2014

     

Sources, Effects and Possible Changes in Parenting Skills: Comments on   115

Belsky, Grusec, and Sanders and Morawska
JACQUELINE J. GOODNOW, PHD, DECEMBER 2014

     

Parenting and Sleeping Problems and Universal Parenting Programs   120

HARRIET HISCOCK, MBBS, FRACP, MD, DECEMBER 2014

     

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Topic funded by:

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Synthesis

How important is it? 

Parents differ in the degree to which they respond to children’s signals and control their
behaviours. High quality caregiving, characterized by a sensitive, cognitively stimulating, and
moderately controlling approach, is crucial for children’s development and safety. Indeed, many
of the skills children acquire during the early years are fundamentally dependent on the quality of
their interactions with their parents. For instance, parents play an important role in fostering
children’s early learning (e.g., language and problem-solving abilities) and in shaping their social-
emotional skills (e.g., emotion regulation, reactivity to stress, and self-esteem). Furthermore,
parents have an influence on the development, maintenance, or cessation of children’s positive
and/or negative behaviours. The quality of parenting children receive during the early years
affects three key determinants of later success in school: their cognitive potential, their social
skills, and their behavioural functioning. Considering the fact that parenting skills can be acquired
and passed on from one generation to another, continuous efforts to improve the quality of
caregiving are important.

What do we know? 

Why parents behave the way they do? 

The caregiving approach adopted by parents is influenced by interactions between personal and
environmental factors. These include a) children’s characteristics; b) parents’ characteristics; and
c) the broader social context in which the family is living. 

Children and parents’ characteristics

While sensitive-responsive parenting is generally associated with positive emotionality in

children, irritable or aggressive children tend to receive less supportive, if not problematic
parenting. More specifically, parenting characterized by inconsistent, rigid or irritable explosive
discipline, as well as low supervision and involvement, is closely related with the development of
child conduct problems.

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However, it is important to keep in mind that parents are differentially affected by the behaviours
and temperament of their child. Parents’ level of warmth/acceptance and permissiveness/
restrictiveness is influenced by the way they interpret and react to their child’s behaviours, their
expectations about their child’s ability, and their own psychological functioning. Parents who are
able to understand the causes of their child’s distress and who are confident about their
parenting abilities tend to be more nurturing, comforting, and assertive. In contrast, parents who
believe their child has more power than them in difficult situations tend to use less effective
parenting practices by becoming either hostile or submissive. Similarly, parents who have
inaccurate beliefs or poorer understanding of developmental milestones tend to be less sensitive
to their child’s signals. Finally, parents’ own psychological functioning can influence their
caregiving approach. For example, there is emerging evidence that parents who experience
anxiety are inclined to adopt an overprotecting style of parenting. As much as responsive
parenting is fundamental for the cognitive, social, and emotional development of young children,
parenting behaviours that emphasize overprotection may promote avoidance and the
development of anxiety.   

Socio-cultural context 

Parenting practices are also influenced by the socio-cultural context. While an authoritative
parenting style (balanced levels of control and permissiveness) is normative and associated with
positive child outcomes in white middle-class families, this positive association does not prevail in
all cultural and socio-economic backgrounds. Indeed, a flexible parenting style is not necessarily
optimal for children growing up in high-risk neighbourhoods. In fact, these children may benefit
from an authoritarian parenting style (high levels of control and low levels of permissiveness) as
it has the potential to reduce the risk for negative developmental trajectories. 

What can be done? 

A large number of parent support programs exist to strengthen parenting skills and promote the
development of new competencies. Parent support programs have a common goal— to improve
the lives of children and their parents — and a shared strategy — to affect children by creating
changes in parents’ attitudes, knowledge and/or behaviour through a variety of social and
practical supports. These include case management that links families with services, education
on child development and parenting practices, and social support through relationships with
service staff and other parents. 

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With the increased recognition that parenting is influenced by a range of factors that might
compromise its functioning, several programs have extended their focus by offering support for
parents’ self-care (e.g., depression, birth-control planning), marital quality, and/or economic self-
sufficiency (e.g., improving educational, occupational, and housing resources). Ultimately, these
programs aim to give parents the knowledge and skills they need to carry out child-rearing
responsibilities effectively and provide their children with experiences and opportunities that
promote child learning and development. 

There are a number of parent support interventions that have been shown to improve behaviours
in preschool-age children, including Helping the Noncompliant Child, the Incredible Years, Parent-
Child Interaction Therapy, Triple P (Positive Parenting Program). Based on previous research
findings, parenting programs tend to be effective when they cover multiple domains, including
the child’s and family’s social ecology, target specific behaviours or developmental transitions,
offer peer support, and involve parents (e.g., through role-modelling). Continued research is
needed to evaluate child and parenting outcomes in a broader variety of cultural and
socioeconomic groups. Likewise, more research needs to be conducted on the specific role of
fathers’ cognitions and child-rearing attitudes in children’s development.

Lastly, it is essential that decision-makers reach out to vulnerable families during the preschool
years, as these families are the hardest to involve in parenting programs (obstacles due to
language, location, and/or hours of availability). By facilitating their involvement in parenting
programs, these families will have the opportunity to change some of their parenting behaviours
and beliefs, which may ultimately buffer children who are at risk of poor developmental outcomes
because of genetic vulnerability, low birth weight, low socio-economic status, or cumulative
environmental risks, among others.

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Animal models of maternal behaviour: insights
into our understanding the endocrinology,
neurobiology, genetics and development of
mothering
1
Emis Akbari, PhD, 2Kathleen Wonch, MA, 2Alison S. Fleming, PhD, FRSC
1
Atkinson Centre for Society and Child Development, University of Toronto, Toronto, Canada
2
Department of Psychology, University of Toronto, Toronto, Canada
August 2015

Introduction

New mothers experience a multitude of physiological changes that under optimal conditions may
function to prime them to respond ‘maternally’ to their infants. These perinatal changes include
enormous fluctuations in the levels of circulating hormones and changes in brain systems known
to regulate mothering in a number of species. In addition, there are changes in other brain
regions that indirectly affect mothering-related behaviours such as how rewarding mothers find
infants and their cues to be, their attitudes towards infants and parenting, their ability to be
flexible and playful, to show good memory, as well as their levels of anxiety and depression.
Included among maternal behaviours in humans are feeding or nursing, providing safety and
warmth, and expression of ‘sensitive’ and contingent interactions with their infants and, often,
positive feelings of nurturance. Under conditions of extreme stress, ill health, immaturity, and
adverse early and present experiences, these maternal behaviours and the priming effects of
physiology, are often altered or diminished.  

Optimal caregiving has been shown to affect brain, behaviour and socio-emotional development
of the offspring.1,2 Children rapidly acquire new motor, verbal, socio-emotional and cognitive skills
that are accompanied by changes in their parental needs.3 As infants transition into toddlerhood,
parents are expected to adjust their parental behaviours and strategies to not only comfort, but
also to stimulate, direct and discipline their child. Positive and responsive parenting, that includes
warmth and positive affect,4 have been shown to enhance many aspects of child development
and to help protect children from certain environmental adversities and undesirable outcomes; in
contrast, lack of parental warmth and responsivity, along with hostile-reactive, rejecting

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parenting in the absence of a social ‘buffer’ (supportive relative, friend, or professional) are
associated with behavioural problems, poorer cognitive outcomes, increased risk for child
psychopathology, depression/anxiety and other chronic illnesses.  

Subject

Understanding the experiential, physiological, and neural regulation of normative maternal

behaviour greatly informs treatment and intervention programs designed to optimize maternal
responsivity in those experiencing parenting challenges.  For example, factors such as post-
partum depression, difficult child temperament, poverty, or marital conflict, may lead to
alterations in maternal responsivity, in turn increasing the likelihood of problems in child
development. 

Problems

To understand what contributes to mothering, one can examine mothering behaviour at four
basic levels of analysis related to causality and motivation:  (1) proximal
(hormonal/neural/genetic); (2) developmental (mother’s own early experiences); (3) functional
(survival of offspring); (4) and evolutionary.  All contribute to our understanding, but none are
complete individually when trying to understand a complex reproductive behaviour. 

Research Context

Animal models of maternal behaviour have provided insights into our understanding of the
endocrinology, neurobiology, genetics and development of mothering.5,6 By also providing models
of parental-like behaviours among non-mothers (females that have not given birth), animal
studies also illustrate how parental behaviour, albeit in the absence of lactation, may develop
through simple extended exposure to young and in the absence of effects of hormones.7
Recently, studies have begun to translate what we have learned from non-human models of
mothering behaviour and examine whether similar principles govern the psychobiology of human
mothering.8 Early studies suggest that they do. This body of work uses diverse methodology,
including hormonal measures9,10 genotyping11,12 questionnaires,13,14,15 and behavioural quantification
of parenting10,16,17, all of which have demonstrated excellent validity and reliability. With advances
in human neuroimaging techniques such as fMRI and fNIRS, we have begun to ask some of the
same questions of structural and functional neuroanatomy that we have been asking in animals.18
As well, we have made considerable progress in our understanding of human mothering by

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combining insights gained by various fields including using novel statistical methods which make
it easier to model the complex interactions among multiple sources of influences on mothering.

Key Research Questions

1. What are the hormonal, neural, genetic, and experiential bases of mothering behaviour in
the animal model? What do we know about similar mechanisms in humans?

2. What are the social determinants of mothering behaviour in humans?

3. How does early life experience impact mothering behaviour?

4. What are the trans-generational effects of maternal behaviour in both animals and humans?

5. How does mothering behaviour mediate child outcomes in non-normative situations, such
as in high-risk environments? 

Recent Research Results

Around the time of birth in most mammals, changes to the hormonal milieu including fluctuating
levels of estrogen,19,20 progesterone19,20, prolactin21 and oxytocin22 trigger a cascade of neurological
adaptations that result in typical maternal behaviour.23 Numan, and colleagues,24-29 have
demonstrated that the neurobiology of mothering in rodents relies heavily on projections from the
medial preoptic area of the hypothalamus and bed nucleus of the stria terminalis, as well as
fibres from surrounding sensory, limbic and cortical systems. Both hormones and sensory input
act on these brain systems. Furthermore, studies have consistently shown that the
neurotransmitter dopamine acts on various psychobiological systems to affect the expression of
species typical maternal behaviour in both mothers who have given birth, and non-mothers who
demonstrate materal behaviours through repeated exposure to young.30-34 New mothers with
minimal experience develop an attraction to, and recognition of, their own infants, their odours,
cries and visual characteristics;35 and hence, infants and their cues become rewarding to the
mother.36 Mothers also undergo a change in their emotional states, being more anxious and more
often attentive to infants, and to threats to the infant;37,38 they show greater attentional flexibility
and working memory.  These psychological changes enhance maternal behaviour towards the
infant. The quality of mothering is also affected by her environment, her stress,39,40 and her recent
and early experiences.38,41 These environmental influences affect and interact with maternal
genes.42,43 For instance, a mother’s own experiences being mothered interact with her genes
resulting in epigenetic (environmental influences that turn genes on and off ) modification of her

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expressed mothering behaviour.11,12,17,44-46 Enhancing the quality of mothering behaviour can help
improve child outcome later in life.  This is particularly true for children in adverse circumstances.
 Responsive parenting has been shown to help buffer children who are at risk of poor
developmental outcomes because of genetic vulnerability,47 low birth weight,48 low socio-
economic status, or cumulative environmental risk.49-51

Research Gaps 

Notable gaps in research on mothering behaviour include:

1. How does parental behaviour and the brain change across the lifespan of a child? What
changes do we see from parenthood to grandparenthood?

2. Similar neurobiological systems that mediate other motivated behaviours (e.g., eating,
sexual behaviour) are active in a new mother. Is there a state of maternal satiety similar to
other motivated behaviours? Are there similar addictive properties? 

3. From rodent models, the approach/avoidance theory of maternal behaviour suggests that
neuroendocrine changes associated with parturition trigger a reduction in the aversive
response of mothers towards pups while simultaneously provoking approach behaviours.
Thus, the same neural substrates that lead a mother to respond maternally may be involved
in aversive responses to infants. Can this theory inform our understanding of parenting in
high-risk samples?

Implications for Parents, Services and Policy 

Making conceptual associations between animal and human maternal behaviours is the principal
challenge for scientists.  Consequent testing of these associations is simpler yet equally valuable.
 What elements of an animal’s maternal behaviour is unique to the animal, and what elements
are part of a basic rule that can be transferable or applied to humans are important to determine.
 The integration of animal and human literature will lead to a better comprehension of maternal
response and behaviour and will afford us more scientific understanding of its distinct and
common expression in all species that engage in it.  

References

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3. Barnard KE, Solchany JE. Mothering. In: Bornstein MH, ed. Handbook of parenting: Vol.3. Being and becoming a parent. 2nd
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17. Mileva-Seitz V, Kennedy J, Atkinson L, Steiner M, Levitan R, Matthews SG, Meaney MJ, Sokolowski MB, Fleming AS.
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infants. Genes, Brain, and Behavior 2011;10(3):325-333.

18. Barrett J, Wonch KE, Gonzalez A, Ali N, Steiner M, Hall GB, Fleming AS. Maternal affect and quality of parenting experiences
are related to amygdala response to infant faces. Social Neuroscience 2012;7(3):252-268. 

19. Liggins GC, Fairclough RJ, Grieves SA, Kendall JZ, Knox BS. The mechanism of initiation of parturition in the ewe. Recent
Progress in Hormones Research 1973;29: 111-159.

20. Challis JRG, Lye SJ. Parturition. In: Knobil E, Neil J, eds. The physiology of reproduction. New York: Raven Press;
1994:985–1031.

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 21. Amenomori Y, Chen CL, Meites J. Serum Prolactin Levels in Rats During Different Reproductive States. Endocrinology
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25. Fleming AS, Vaccarino F, Luebke C. Amygdaloid inhibition of maternal behavior in the nulliparous female rat. Physiology
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26. Fleming AS. Walsh C. Neuropsychology of maternal behavior in the rat: c-fos expression during mother-litter interactions.
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27. Fleming AS, Suh EJ, Korsmit M, Rusak B. Activation of Fos-like immunoreactivity in the medial preoptic area and limbic
structures of maternal and social interactions in rats. Behavioural Neuroscience 1994;108(4):724-734.

28. Sheehan TP, Cirrito J, Numan MJ, Numan M. Using c-Fos immunocytochemistry to identify forebrain regions that may inhibit
maternal behavior in rats. Behavioural Neuroscience 2000;114(2):337-352.

29. Sheehan T, Paul M, Amaral E, Numan MJ, Numan M. Evidence that the medial amygdala projects to the
anterior/ventromedial hypothalamic nuclei to inhibit maternal behavior in rats. Neuroscience 2001;106(2):341-356.

30. Afonso VM, King SJ, Novakov M, Burton CL, Fleming AS. Accumbal dopamine function in postpartum rats that were raised
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31. Afonso VM, King SJ, Chaterjee D, Fleming AS. Hormones that increase maternal responsiveness affect accumbal
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32. Champagne FA, Chretien P, Stevenson CW, Zhang TY, Gratton A, Meaney MJ. Variations in nucleus accumbens dopamine
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33. Hansen S, Bergvall AH, Nyiredi S. Interaction with pups enhances dopamine release in the ventral striatum of maternal
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34. Numan M, Insel TR. The Neurobiology of Parental Behaviour. Springer-Verlag: New York; 2003. 

35. Fleming AS, Grusec J, Daley D, eds. Parenting, Science, and Practice. Special Issue to Parenting Science and Practice
entitled The Arc of Parenting: From Epigenomes to Ethics. 2012; vols 3-4.

36. Strathearn L, Li J, Fonagy P, Montague PR. What's in a Smile? Maternal Brain Responses to Infant Facial Cues. Pediatrics
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38. Agrati D, Brown D, Jonas W, Meaney M, Atkinson L, Steiner M, Fleming AS. Maternal anxiety from pregnancy to 2 years
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 41. Madigan S, Wade M, Lamondon A, Jenkins J. Maternal abuse history, postpartum depression, and parenting: links with
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43. Jonas W, Mileva-Seitz V, Girard AW, Bisceglia R, Kennedy JL, Sokolowski M, Meaney MJ, Fleming AS, Steiner M; MAVAN
Research Team. Genetic variation in oxytocin rs2740210 and early adversity associated with postpartum depression and
breastfeeding duration. Genes, Brain, and Behavior 2013;12(7):681-694.

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Parent Support Programs and Outcomes for
Children
Barbara Dillon Goodson, PhD

Abt Associates Inc., USA

December 2014, 3e éd.

Introduction

Programs to support parents in their task of raising children have been in place for more than a
century, with a variety of goals for families and types of services. Today, tens of thousands of
such programs exist, most of them small, grass-roots, community-based programs that serve
only a small number of families at any one time. Parent support programs do not share a uniform
intervention, but they have a common goal – to improve the lives of children – and a shared
strategy – to affect children by creating changes in parents’ attitudes, knowledge and/or
behaviour. While the majority of parent support programs serve all families in a community, in
the last decade or so, parent support interventions have been increasingly implemented with
families whose children may be especially vulnerable to poor developmental outcomes because
of poverty or a variety of other family risk factors. Parent support programs for at-risk families
have focused on helping families reduce and cope with the stresses that threaten children’s well-
being.

Subject

There is strong consensus that parents matter in how their children develop and function. Data
from twin studies, as well as from hundreds of correlational studies, have linked multiple
dimensions of parenting behaviour to different indicators of child outcomes.1,2  Additional research
has demonstrated the relationship between parenting practices and family socio-economic status.
This body of research on the pivotal role of parenting behaviour in children’s development has
constituted the theoretical underpinning for parent support interventions. Parent support
programs seek to influence children’s outcomes by motivating changes in parents through a
variety of social and practical supports, including case management that links families with
services, education on child development and parenting practices, and social support through
relationships with service staff and with other parents. Some programs for low-income families

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are also concerned with improving the economic self-sufficiency of families and providing support
for parents in obtaining additional education, finding jobs or delaying subsequent pregnancies.

Problems

There is abundant research linking parental behaviour to child health and development. Brooks-
Gunn recently summarized the research as showing that language stimulation and learning
materials in the home are the parenting practices most strongly linked to school readiness,
vocabulary and early school achievement, while parent discipline strategies and nurturance are
most strongly linked to social and emotional outcomes such as behaviour and impulse control and
attention.3 That is, discipline practices that do not help children develop their own internalized
behaviour standards can also adversely affect children’s social and emotional functioning – their
abilities to develop sustained social relationships and to take account of the needs and feeling of
others, to control and direct their own impulses, and to focus their attention to plan and complete
tasks successfully. There is also evidence that parent support for and involvement in their
children’s school is related to children’s educational attainment by promoting school achievement.
4,5

At the same time, there is disagreement in the field about the strength of the evidence on the
effectiveness of parent support programs for child outcomes, primarily because of the scarcity of
studies with strong internal validity, i.e. reduced bias of different kinds. The question remains:
whether it is possible to change parent knowledge, attitudes and/or behaviour through parent
programs and, if so, whether these changes in parents translate into improved outcomes for
children. 

Research Context

The evidence on the effectiveness of parent support programs at producing better outcomes for
children is relatively limited, primarily because of the quality rather than the quantity of
evaluation studies. That is, only a few studies have employed strong designs, either experiments
in which families are randomly assigned to receive parent support services or to receive no
systematic services, or strong quasi-experimental designs with well-constructed comparison
groups. Also, the evidence is strongest in the domain of children’s cognitive school readiness.
This may be because there are many more standardized and normed measures available in the
cognitive domain, or it may be related to the strong interest in children’s cognitive readiness for
school and their subsequent academic achievement. Evidence of the effectiveness of parent

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support programs on children’s cognitive and social development is far from conclusive. The
absence of compelling research evidence on program impacts on children has left the door open
for differing interpretations of the evidence and differing conclusions about the effectiveness of
family support programs.  

Key Research Questions

The causal pathway from parent support programs to child outcomes has a number of links,
starting with strongly implemented programs and adequate levels of participation by parents in
the program services. Beyond these necessary but insufficient steps, it is assumed that outcomes
for children are mediated by changes that the programs create in parents. Therefore, the first
question on program impacts is whether parent support programs have been effective at
changing parents’ attitudes or behaviours. If these changes can be shown, the subsequent
research question is whether these changes in parents lead to improved outcomes for children in
the cognitive domain or in the child’s social and emotional development. A third research
question, especially difficult to answer but of strong interest for practitioners, is what types of
programs are most effective. That is, do the programs that are more effective have elements in
common, such as types of services, types of staff, methods of service delivery, etc.? The most
complex research question addresses what works for whom: Are there types of parent support
that are more effective for different types of children and families?

Recent Research Results

A comprehensive meta-analysis of the effects of parent support programs summarizes child

outcome data for parents and children from evaluations of more than 200 programs.6 The
average effects on parents varied by the outcome domain. The strongest effects were on
parenting behaviour and parenting attitudes/knowledge, where the average effect size was .24 (a
quarter of a standard deviation on the scale on which the outcome is measured). Program effects
on family functioning and parent mental health were smaller, with average effect sizes below .20.
The effect sizes were strongly influenced by a handful of programs with very large effects. Across
the program evaluations, the effect sizes for the majority of programs clustered around 0-.15 of a
standard deviation (s.d.). The larger average effect was produced by between 20 and 25% of the
programs that had effect sizes larger than .5 (which is considered to represent a moderate-to-
large effect). The parent support programs had effects for children as well. The programs looked
at a wide variety of outcomes in both the cognitive and social-emotional domains. In the domain

©2014-2021 CEDJE | PARENTING SKILLS 17

of social and emotional development, the average effect was .22; for cognitive development, it
was .29. The average effect was largest for preschool children’s programs (average = .39 s.d.).
The majority of parent support programs had very small effect sizes for child outcomes, clustered
around 0-.15 of a standard deviation. 

The fact that a small percentage of parent support programs had significant effects while most
did not begs the question of whether these effective programs had elements in common. The
meta-analysis suggests that programs with stronger effects on children’s social and emotional
development share three characteristics: (a) the program targets children with a specific need
that has been identified by the parents, such as a behavioural or conduct disorder or
developmental delay (also corroborated by Brooks-Gunna; (b) the program uses professional
rather than paraprofessional staff; or (c) the program provides opportunities for parents to meet
together and provide peer support as part of the service delivery approach. In general, case
management, i.e. helping parents identify and access needed services, was not an effective
strategy.  One possible reason for this absence of effects is that the relevant services may not be
available, for example, mental-health services or better housing.  

This meta-analysis also showed that programs that combine parent support services and early
childhood education also have larger-than-average effects on both parents and children. This
finding from the meta-analysis has been corroborated by the evidence that many of the early
childhood education interventions that have been shown to have long-term effects provide early
childhood education and family support services.7,8,9

The enhanced effects of parent support programs that combine work with parents and direct
educational services for children raise the question of which component is responsible for the
child effects – the parent support or the early childhood education. Analyses of findings from an
earlier intensive child development program for low birth weight children and their parents (the
Infant Health and Development Program) suggest that the cognitive effects for the children were
mediated through the effects on parents, and the effects on parents accounted for between 20
and 50% of the child effects.10 A recent analysis of the Chicago Child Parent Centers, an early
education program with a parent support component, examined the factors responsible for the
program’s significant long-term effects on increasing rates of school completion and decreasing
rates of juvenile arrest.11 The authors conducted analyses to test alternative hypotheses about
the pathways from the short-term significant effects on children’s educational achievement at the
end of preschool to these long-term effects, including (a) that the cognitive and language
stimulation children experienced in the centres led to a sustained cognitive advantage that
produced the long-term effects on the students’ behaviour; or (b) that the enhanced parenting
practices, attitudes, expectations and involvement in children’s education that occurred early in
the program led to sustained changes in the home environments that made them more

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supportive of school achievement and behavioural norms, which in turn produced the long-term
effects on the students’ behaviour. Structural equation modelling showed that both the cognitive
advantage gained by the children and the family support experiences were linked to long-term
program effects on children. Family factors (involvement in schools and reduced abuse and
neglect) were shown to be significant mediators of the effect of the preschool program on high
school completion, while only parent involvement in schools was a mediator of juvenile arrest
rates. Also, while both the cognitive advantage and family support explained impacts on early
child outcomes, such as school achievement, family support explained more of the effects on
juvenile delinquency and about equally explained the effects on school completion.

Conclusions

Debate continues about the effectiveness of parent support interventions on outcomes for
children. Program evaluations have shown the difficulty of producing sustained and
comprehensive changes in parents. The subsequent link between changes in parents and positive
consequences for their children’s development has been even harder to prove. The field has been
plagued by research that has low internal validity, i.e. is susceptible to bias of different kinds. The
evidence is strongest on the role of parent support services in supporting children’s cognitive
development, especially for preschool children. The data are particularly strong for programs that
combine a parent support intervention with direct educational services for children, and there is
some evidence that both components contribute to improved outcomes for children. There is less
evidence in the areas of social and emotional development; however, recent longitudinal
analyses from a program with both early childhood and parent support services have provided
new evidence linking parent support and long-term social outcomes.12,13 

Implications

The vast majority of parent support programs are designed and implemented without attention to
research or evaluation. This means that we continue to provide parent support interventions
without increasing our understanding of whether and how our work with parents can lead to
effects for children. This is particularly true for the domain of children’s social and emotional
functioning, both because of inadequate measures and because of the current policy focus on
cognitive outcomes for children that link to specific academic achievements, such as learning to
read. The critical role of parenting in the lives of children provides a strong incentive to policy-
makers and researchers to design programs that take advantage of these intimate and powerful
familiar processes. Until we more clearly understand whether and how our interventions with

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parents affect children, the policy relevance of these programs will remain in question.

References

1. Brooks-Gunn J, Markman LB. The contribution of parenting to ethnic and racial gaps in school readiness. The Future of
Children 2005;15(1):139-168. 

2. Collins WA, Maccoby EE, Steinberg L, Hetherington EM, Bornstein MH. Contemporary research on parenting: The case for
nature and nurture. American Psychologist 2000;55(2):218-232.

3. Kreider H. A conversation with Jeanne Brooks-Gunn. The Evaluation Exchange Winter 2004/2005;10(4):12-13.

4. Barnett WS, Young JW, Schweinhart LJ. How preschool education influences long-term cognitive development and school
success: A causal model. In: Barnett WS, Boocock SS, eds. Early care and education for children in poverty: Promises,
programs, and long-term results. Albany, NY: State University of New York Press; 1998:167-184.

5. Reynolds AJ, Mavrogenes NA, Bezruczko N, Hagemann M. Cognitive and family-support mediators of preschool
effectiveness: A confirmatory analysis. Child Development 1996;67(3):1119-1140.

6. Layzer JI, Goodson BD, Bernstein L, Price C. National evaluation of family support programs. Volume A: The meta-analysis.
Final report. Cambridge, Mass: Abt Associates Inc.; 2001.

7. Yoshikawa H. Long-term effects of early childhood programs on social outcomes and delinquency. The Future of Children
1995;5(3):51-75. 

8. Zigler E, Taussig C, Black K. Early childhood intervention: A promising preventative for juvenile delinquency. American
Psychologist 1992;47(8):997-1006.

9. Seitz V. Intervention programs for impoverished children: A comparison of educational and family support models. In:
Vasta R, ed. Annals of child development: A research annual, vol. 7. Philadelphia, Pa: Jessica Kingsley Publishers; 1990:73-
103.

10. Brooks-Gunn JC, McCarton CM, Casey PH, McCormick MC, Bauer CR, Bernbaum JC, Tyson J, Swanson M, Bennett FC, Scott
DT, Tonascia J, Meinert CL. Early intervention in low-birth-weight premature infants: Results through age 5 years from the
Infant Health and Development Program. JAMA -Journal of the American Medical Association 1994;262(16):1257-1262.

11. Reynolds AJ, Ou SR, Topitzes JW. Paths of effects of early childhood intervention on educational attainment and
delinquency: A confirmatory analysis of the Chicago Child-Parent Centers. Child Development 2004;75(5):1299-1328.

12. Campbell FA, Pungello EP, Miller-Johnson S, Burchinal M, Ramey CT. The Development of Cognitive and Academic Abilities:
Growth Curves from an Early Childhood Educational Experiment. Developmental Psychology 2001;37:231-242.

13. Campbell FA, Ramey CT, Pungello EP, Sparling J, Miller-Johnson S. Early Childhood Education: Young Adult Outcomes from
the Abecedarian Project. Applied Developmental Science 2002;6:42-57.

Note:

a
It is important to note that the meta-analysis of evaluations of parent support programs, like other meta-analyses, showed that
the size of the impacts of any of the parent support programs is strongly related to the type of evaluation design. The largest
average effects were reported in pre-post studies; the next largest in quasi-experimental studies; and the smallest effects were
reported for randomized studies.

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Community-Based Parent Support Programs
Carol M. Trivette, PhD, Carl J. Dunst, PhD

Orelena Hawks Puckett Institute, USA

December 2014, 3e éd.

Introduction

Community-based parent support programs differ from traditional human services parenting
programs in both form and function1 For the purposes of this review, parent support programs are
defined as community-based initiatives designed to promote the flow of resources and supports
to parents that strengthen functioning and enhance the growth and development of young
children.

The primary goal of parent support programs is to provide support and information in ways that
help parents become more capable and competent.2,3 Research now indicates that to reach this
goal, it is necessary that staff use practices that are family-centered as opposed to professionally-
centered, and capacity-building as opposed to dependency forming.4,5,6,7 The key characteristics of
family-centered practices include: treating families with dignity and respect; providing individual,
flexible and responsive support; sharing information so families can make informed decisions;
ensuring family choice regarding intervention options; and providing the necessary resources and
supports for parents to care for their children in ways that produce optimal parent and child
outcomes.8,9,10,11

Home visiting programs and community-based parenting support programs are two different
approaches to enhancing parents’ abilities to support their children’s development.12 This review
examines evidence concerning the effectiveness of community-based parent support programs.
Parent support programs that use home visiting for delivering parenting services are described
elsewhere.2,13

Subject

Parent support programs aim to support and strengthen existing parenting abilities and promote
the development of new competencies so that parents have the knowledge and skills needed to
carry out child-rearing responsibilities and provide their children with experiences and

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opportunities that promote child learning and development.14 Parenting support programs
typically include the following features: universal access for families, early support to families,
and family involvement at all levels of program operation15 Parenting programs often encompass
a variety of parenting activities, including, but not limited to, parent and child play groups, parent
information classes and support groups, parenting materials, and individualized parent supports
provided in response to particular child-rearing concerns or specific parenting questions.
Providing or helping parents gain access to other types of supports and resources, such as
medical or child care resources,  is also an important feature of these programs.16,3

Community-based parent support programs are based on the belief that when parents receive
parenting support as well as other supports and resources, they are more likely to feel better
about themselves and their parenting abilities, and in turn interact with their children in
responsive and supportive ways enhancing the development of their children.3 Bronfenbrenner,16
Cochran,17 and others18,19 have noted that parenting knowledge and skills are learned and
strengthened by the kinds of help and assistance provided by informal and formal social support
network members. The extent to which help and assistance enhances or compromises parenting
competence and confidence depends to a large degree on the ways in which help is offered and
provided.20,3,21,6 Consequently, efforts to provide supports and resources to parents need to be
done in ways that enhance rather than diminish parenting capacity. Enhancing parenting
competence and confidence is one major goal of capacity-building help-giving practices.

Capacity Building Help-Giving Practices.

Community-based parent support program staff use capacity-building helpgiving practices to

provide supports to parents. Capacity-building helpgiving practitioners help family members
acquire the skills to obtain resources, supports, and services. Capacity-building practices support
and enhance parents’ competence and confidence to promote the development of their young
children, including their social and emotional development.22,5

There are two dimensions of capacity-building helpgiving practices: relational and participatory
helpgiving.23,24,25,6 Relational practices include behaviours typically associated with effective
helpgiving (compassion, active listening, etc.) and positive staff attributions about program
participant capabilities. Participatory helpgiving practices include behaviours that involve
program participant choice and decision-making, and which meaningfully involve participants in
actively procuring or obtaining desired resources or supports.

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Problem

Enhancing and strengthening parenting capacity and the social and emotional development of
young children are important outcomes of community-based parenting programs. The
relationship between what program staff do and how parents enhance the social and emotional
development of their young children is often implicitly rather than explicitly stated by parent
support program builders. This paper includes information about the empirical evidence
concerning the relationship between capacity building  help-giving practices, parenting
competence and confidence, and the behaviour  and  development of young children, including
their social and emotional development.

Research Context

By design, most parent support programs offer individualized, multifaceted “interventions” to

parents in response to their changing concerns and needs. Although most studies were not
designed to disentangle and unpack the effects of these interventions, it is possible to do so by
paying careful attention to the characteristics of helpgiver practices to identify the most
important characteristics of parent support program practices.

Key Research Questions

The research questions to be answered are the following:

1. Does providing parent support in a family-centered capacity-building manner increase

parents’ sense of confidence and competence in their parenting ability?

2. Do parent support programs enhance parents’ abilities to interact with their young children
in ways that lead to the children’s  positive social and emotional development?

Recent Research

A number of research reviews and syntheses have been published that examined the relationship
between family-centered helpgiving practices and parent, family, and child outcomes.26,22,27,5,28,29,30,31
The studies in these reviews and syntheses used different measures of family-centered capacity-
building helpgiving, many of which assessed either or both relational and participatory helpgiving
practices. The parent, child, and family outcomes in the studies in these reviews and syntheses
included participant satisfaction with the helpgiver and his or her program, program helpfulness,
social support and resources, parent and family functioning, parenting capabilities, and child

©2014-2021 CEDJE | PARENTING SKILLS 23

behaviour and development. Several of these syntheses included measures of self-efficacy
beliefs, where the investigators examined the extent to which the relationship between
helpgiving practices and the study outcomes were mediated by belief appraisals.22,5

Capacity-building help-giving practices

Findings in the majority of research syntheses indicate capacity-building helpgiving practices are
related to a host of positive parent, family, parent—child, and child outcomes.22,27,5 Both relational
and participatory helpgiving practices were found to be related to participant satisfaction with
program and practitioner supports, program resources, informal and formal supports, parent and
family well-being, family functioning, and child behaviour and development. The nature of the
relationship between helpgiving practices and both parenting capabilities and child social-
emotional behaviour help elucidate how parent support programs influence these outcomes.

Parenting confidence, competence and enjoyment

Several research syntheses examined the ways capacity-building helpgiving practices were
related to different aspects of parenting behaviour.26,22,27,5 The measures of parenting behaviour
included parenting competence, parenting confidence, and parenting enjoyment. Both the direct
and indirect effects of helpgiving practices on parenting behaviour were examined, where the
indirect effects were determined using self-efficacy beliefs as a mediator. Results showed that
helpgiving practices had both direct and indirect effects on parenting confidence, competence,
and enjoyment, where the strength of the relationship was strongest for the indirect effects
mediated by self-efficacy beliefs. Additionally, participatory (compared to relational) helpgiving
practices had stronger direct and indirect effects on parenting behaviours.

Social-emotional behaviour and development

Findings in the same research syntheses also demonstrate a relationship between parent support
program practices and the social and emotional development of young children.26,22,27,5,28,29 The
measures of child behaviour included enhanced positive child social-emotional behaviour and
attenuated negative child social-emotional behaviour. Both relational and participatory helpgiving
practices had both direct and indirect effects on the different child behaviour outcomes. The
indirect influences of helpgiving practices on child social-emotional behaviour was mediated by
parents’ self-efficacy beliefs.

©2014-2021 CEDJE | PARENTING SKILLS 24

Conclusions

There is now a large and convincing body of evidence indicating that community-based parent
support programs operated in a family-centered manner increase parents’ sense of parenting
confidence and competence. Participatory help-giving practices that actively involve parents in
deciding what knowledge is important to them, and how they want to acquire the information
they need, have the greatest positive effect on parents’ sense of competence and confidence.22,5
Available research evidence also indicated that the social and emotional development of young
children is influenced by the ways in which program staff provided parenting support.24,32

Implications

Parent support programs can have important positive effects on both parenting behaviours and
the social and emotional development of young children. One of the key features of these
programs is not only what is offered, but how supports are provided. Capacity-building helpgiving
practices that form the basis of the interactions between staff and families ensure the
enhancement of parents’ capacities which in turn gives them the competence and confidence
necessary to interact with and promote the social and emotional development of their children.

References

1. Weissbourd B. Family resource and support programs: Changes and challenges in human services. Prevention in Human
Services 1990;9(1):69-85.

2. Comer EW, Fraser MW. Evaluation of six family-support programs: Are they effective? Families in Society 1998;79(2):134-
148.

3. Dunst CJ. Key characteristics and features of community-based family support programs. Chicago, Ill: Family Resource
Coalition, Best Practices Project; 1995.

4. Allen RI, Petr CG. Toward developing standards and measurements for family-centered practice in family support
programs. In: Singer GHS, Power LE, Olson AL, eds. Family, community, and disability: Redefining family support.
Innovations in public-private partnerships.  Baltimore, MD : Paul H. Brookes Pub. Co; 1996:57-85.

5. Dunst CJ, Trivette CM, Hamby DW. Research synthesis and meta-analysis of studies of family-centered practices. Asheville,
NC: Winterberry Press; 2008. Winterberry Monograph Series.

6. Trivette CM, Dunst CJ. Capacity-building family-centered helpgiving practices Asheville, NC: Winterberry Press; 2007:1-10 .
Winterberry Research Reports.

7. Wade CM, Milton RL, Matthews JM. Service delivery to parents with an intellectual disability: Family-centered or
professionally centered? Journal of Applied Research in Intellectual Disabilities 2007;20(2):87-98.

8. Dunst CJ. Conceptual and empirical foundations of family-centered practice. In: Illback RJ, Cobb CT, Joseph H Jr, eds.
Integrated services for children and families: Opportunities for psychological practice. Washington, DC: American
Psychological Association; 1997:75-91.

9. Dunst CJ. Family-centered practices: Birth through high school. Journal of Special Education 2002;36(3):139-147.

©2014-2021 CEDJE | PARENTING SKILLS 25

 10. King G, King S, Rosenbaum P, Goffin R. Family-centered caregiving and well-being of parents of children with disabilities:
Linking process with outcome. Journal of Pediatric Psychology 1999;24(1):41-53.

11. Shelton TL, Smith Stepanek J. Family-centered care for children needing specialized health and developmental services. 3rd
ed. Bethesda, MD: Association for the Care of Children's Health; 1994.

12. Family Resource Coalition. Guidelines for family support practice. Chicago, Ill: Family Resource Coalition, Best Practices
Project; 1996.

13. Zercher C, Spiker D. Home visiting programs and their impact on young children. In: Tremblay RE, Barr RG, Peters RDeV,
eds. Encyclopedia on Early Childhood Development [online]. Montreal, Quebec: Centre of Excellence for Early Childhood
Development; 2004:1-8. Available at: http://www.child-encyclopedia.com/Pages/PDF/Zercher-SpikerANGxp.pdf. Accessed
April 20, 2009.

14. Kagan SL, Weissbourd B, eds. Putting families first: America's family support movement and the challenge of change. San
Francisco, CA: Jossey-Bass; 1994.

15. Canadian Association of Family Resource Programs. Parenting and family supports: Moving beyond the rhetoric together.
Ottawa, Ontario: Canadian Association of Family Resource Programs; 2001. Available at:
http://www2.frp.ca/PDFDocuments/positionpaper2001.PDF.  Accessed April 20, 2009.

16. Bronfenbrenner U. The ecology of human development: experiments by nature and design. Cambridge, MA: Harvard
University Press; 1979.

17. Cochran M. Parenting and personal social networks. In: Luster T, Okagaki L, eds. Parenting: An ecological perspective.
Hillsdale, NJ: Lawrence Erlbaum Associates; 1993:149-178.

18. Bornstein MH, ed. Status and social conditions of parenting. Hillsdale, NJ: Lawrence Erlbaum Associates; 1995. Handbook of
parenting; vol 3.

19. Shonkoff JP, Phillips DA, eds. From neurons to neighborhoods: the science of early child development. Washington, DC:
National Academy Press; 2000.

20. Caplan PJ. The new don't blame mother: mending the mother-daughter relationship. New York, NY: Routledge; 2000.

21. Hewlett SA, West C. The war against parents: what we can do for America's beleaguered moms and dads. Boston, MA:
Houghton Mifflin; 1998.

22. Dunst CJ, Trivette CM, Hamby DW. Family support program quality and parent, family and child benefits. Asheville, NC:
Winterberry Press; 2006.  Winterberry Monograph Series

23. Dunst CJ, Trivette CM. Empowerment, effective helpgiving practices and family-centered care. Pediatric Nursing
1996;22(4):334-337, 343.

24. Dunst CJ, Trivette CM. Measuring and evaluating family support program quality. Asheville, NC: Winterberry Press; 2005.
Winterberry Monograph Series.

25. Trivette CM, Dunst CJ. Family-centered helpgiving practices. Paper presented at: 14th Annual Division for Early Childhood
International Conference on Children with Special Needs. December, 1998: Chicago, IL.

26. Dempsey I, Keen D. A review of processes and outcomes in family-centered services for children with a disability. Topics in
Early Childhood Special Education 2008;28(1):42-52.

27. Dunst CJ, Trivette CM, Hamby DW. Meta-analysis of family-centered helpgiving practices research. Mental Retardation and
Developmental Disabilities Research Reviews 2007;13(4):370-378.

28. King S, Teplicky R, King G, Rosenbaum P. Family-centered service for children with cerebral palsy and their families: A
review of the literature. Seminars in Pediatric Neurology 2004;11(1):78-86.

29. O'Brien M, Dale D. Family-centered services in the neonatal intensive care unit: A review of research. Journal of Early
Intervention

©2014-2021 CEDJE | PARENTING SKILLS 26

 1994;18(1):78-90.

30. Rosenbaum P, King S, Law M, King G, Evans J. Family-centred service: A conceptual framework and research review.
Physical and Occupational Therapy in Pediatrics 1998;18(1):1-20.

31. Shields L, Pratt J, Davis LM, Hunter J. Family-centred care for children in hospital. Cochrane Database of Systematic Reviews
2007;1:4811.

32. Layzer JI, Goodson BD, Bernstein L, Price C. National evaluation of family support programs: Final report. Cambridge, MA:
Abt Associates; 2001. The Meta-Analysis; vol A 

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Parent Support Programs and Early Childhood
Development: Comments on Goodson, and
Trivette and Dunst
Jane Drummond, PhD

Faculty of Nursing, University of Alberta, Canada

December 2014, 3e éd.

Introduction

Canadian policy-makers have been encouraged to subscribe to the conviction that early child
development is a determinant of national health and wealth.1,2 In a study using data from the
National Longitudinal Survey of Children and Youth (NLSCY), it was determined that about one-
third of Canadian parents use optimal parenting approaches3 and that over time, parental
responsiveness to their children declines. In Canada, parenting style is heterogeneous across
socio-economic status (SES). But low SES and problematic parenting are related to behavioural
challenges in children. The two papers commented on here originate from and are developed in
research programs that focus on child and family development. Canadian researchers who
subscribe to the population health approach would like to see these ideas developed and
rigorously implemented within health and social programs that are then integrated across sectors.
4

Trivette and Dunst have dedicated their research careers to understanding social support of
young families, and as a result have developed the tradition of family-centeredness. It is no
surprise, therefore, to find that the research presented in their review is focused on
understanding particular characteristics of family-centered help-giving practices and the links to
social emotional development in children. The link between what is done and how it is done is
proposed as important. Two key family-centered help-giving practices are isolated and examined.
5,6
Relational practices are said to include “behaviours” associated with compassion and active
listening, as well as positive staff attributions about participant capabilities that build mutual trust
and collaboration. Participatory help-giving practices include “behaviours” that involve program
participant choice and decision-making around procuring desired resources and supports.

Goodson undertakes to inform the reader about the contribution of parent support programs to a
causal pathway from parent attitudes/behaviours to child outcomes. She makes it clear that the

©2014-2021 CEDJE | PARENTING SKILLS 28

review is carried out in a research context in which the quality but not the quantity of evaluation
studies is limited, measurement is typically focused on children’s cognitive gains (not socio-
emotional gains), and assumptions are made about the rigour of the program implementation
and the adequacy of family retention in the programs.

Research and Conclusions

In the paper by Trivette and Dunst, parents’ capacity to promote child social-emotional
development is operationalized as confidence/competence. They report four major findings. First,
parent support programs improve parental competence/confidence and parental beliefs that child-
initiated interactions are most important in parent-child interactions.7,8 Second, although general
parent support programs support social-emotional development of children, parent support that is
directed at parental emotional and educational/economic development has an enhanced impact
on child social-emotional development.9 Third, participatory help-giving practices contribute the
most to parents’ judgment of their children’s emotional competence.7 Fourth, group approaches
to parental support have a more powerful effect on child social-emotional competence than home-
visiting approaches.9

Goodson refers to the same meta-analysis used by Trivette and Dunst in their paper9 and also to
the longitudinal work of Reynolds and colleagues.10,11 Four findings are reported. First, parent
support programs have less of an effect on social-emotional competence than on cognitive gains.
Second, programs with stronger effects on social-emotional competence have three
characteristics: children with specific needs are targeted, professionals deliver the service, and
parents meet together to provide peer support. Third, programs that provide both direct early
childhood education and parent support services have larger-than-average effects. Fourth, family
support has a stronger effect than cognitive gain on juvenile delinquency (social-emotional
competence), while their effect is about equal on high school completion (cognitive competence).

I am familiar with the literature on family support, family-centered practice, and parent support
and have no argument with the positions taken by the authors of these two papers. My
colleagues and I have focused our research program on parent support of vulnerable groups and
have found, through the use of randomized control trials, that systematic interventions directed
at parenting behaviours improve parental contingency in low-income parents and in adolescent
mothers.12,13 Similarly, we have found that systematic intervention on family problem-solving
behaviour, what Trivette and Dunst call participatory help-giving practice, also improves

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contingency of parent-child interactions.14  

In my opinion, more research is required on those areas of assumption made by Goodson, i.e. on
the rigour of the parent support program implementation and on the adequacy of family retention
in those programs. Just as there is a gap between controlled interventions and clinical
applications in child and adolescent psychotherapy,15,16 the transition from efficacious parent
support approaches to effective community program practice needs to be carefully implemented
and tracked.17

Implications for Services, Development and Policy

Trivette and Dunst imply that family-centered help-giving practices must form the basis of
interactions between parent support-providers and families. Goodson, on the other hand, is keen
to have researchers, service-providers and policy-makers attend to the need for rigorous
implementation and evaluation study of parent support programs that target socio-emotional
development in children. These implications are self-evident and fall naturally from a review of
the literature in the latter case and from the career focus of the researchers in the former case.

A challenge faced by Canadian health and social-service providers is to promote parenting,3 but in
a proactive and cost-effective manner. A consistent negative association exists between family
vulnerability due to socio-economic and related factors and engagement/retention rate in health,
social, educational, leisure and cultural activities.18,19,20,21 Barriers include service fragmentation;
narrowness of mandate; power differential created by provider expertise; and difficulty in access
because of location, language and hours of availability. The combination of family and service
barriers results in reduced opportunities for effective access to preventive parenting programs
and in increased use of secondary-level services (e.g. emergency medical services, child
emergency social services, police involvement) by vulnerable families, with the obvious increase
in costs.

Because the issues facing vulnerable families are rooted in an array of social, economic and
political conditions that extend beyond the control of any one service sector, government and
community systems must collaborate to coordinate programs. Collaborations are necessary when
organizations share a common purpose, and when that common purpose addresses a meta-level
problem,22 such as parenting in vulnerable families. Collaboration occurs when a group of
autonomous stakeholders, sharing a problem domain, interact using shared rules, norms and
structures to address issues related to that domain.23 Inherent in collaboration is the notion that

©2014-2021 CEDJE | PARENTING SKILLS 30

the outcomes achieved are more effective, efficient and/or sustainable than what would have
been achieved if organizations were working alone.24,25,26,27,28 Researchers28,29,30 have found that
collaboration and integration of services for vulnerable populations are more effective, efficient
and less costly than narrowly focused initiatives. Concerted efforts are required to create
collaboration across sectors with the goal of improving parent support to Canadian families.

References

1. Keating DP, Hertzman C, eds. Developmental health and the wealth of nations: Social, biological, and educational dynamics
. New York, NY: Guilford Press; 1999.

2. Raphael D, ed. Social determinants of health: Canadian perspectives. Toronto, Ontario: Canadian Scholar’s Press; 2004.

3. Willms JD, ed. Vulnerable children: Findings from Canada's National Longitudinal Survey of Children and Youth. Edmonton,
Alberta: University of Alberta Press; 2002.

4. Browne GB. Early childhood education and health. In: Raphael D, ed. Social determinants of health: Canadian perspectives.
Toronto, Ontario: Canadian Scholar’s Press; 2004:125-137.

5. Dunst CJ, Trivette CM. Empowerment, effective helpgiving practices and family-centered care. Pediatric Nursing
 1996;22(4):334-337, 343.

6. Trivette CM, Dunst CJ. Family-centered helpgiving practices. Communication présentée à: 14th Annual Division for Early
Childhood International Conference on Children with Special Needs; Décembre, 1998; Chicago, Ill.

7. Dunst CJ, Trivette CM. Parenting supports and resources, helpgiving practices, and parenting competence. Asheville, NC:
Winterberry Press; 2001.

8. Walker TB, Rodriguez GG, Johnson DL, Cortez CP. Avance parent-child education program. In: Smith S, ed. Two generation
programs for families in poverty: A new intervention strategy. Westport, Conn: Ablex Publishing; 1995:67-90. Advances in
applied developmental psychology; vol 9.

9. Layzer JI, Goodson BD, Bernstein L, Price C. National evaluation of family support programs: Final report. Cambridge, Mass:
Abt Associates; 2001.

10. Reynolds AJ, Mavrogenes NA, Bezruczko N, Hagemann M. Cognitive and family-support mediators of preschool
effectiveness: A confirmatory analysis. Child Development 1996;67(3):1119-1140.

11. Reynolds AJ, Ou S-R, Topitzes JW. Paths of effects of early childhood intervention on educational attainment and
delinquency: A confirmatory analysis of the Chicago Child-Parent Centers. Child Development 2004;75(5):1299-1328.

12. Fleming D, McDonald L, Drummond J, Kysela GM. Parent training: can intervention improve parent-child interactions? 
Exceptionality Education Canada. Sous presse.

13. Letourneau N, Drummond J, Fleming D, Kysela GM, McDonald L, Stewart M. Supporting parents: Can intervention improve
parent-child relationships? Journal of Family Nursing 2001;7(2):159-187.

14. Drummond J, Fleming D, McDonald L, Kysela GM. Randomized controlled trial of a family problem-solving intervention. 
Clinical Nursing Research 2005;14(1):57-80.

15. Lonigan CJ, Elbert JC, Johnson SB. Empirically supported psychosocial interventions for children: An overview. Journal of
Clinical Child Psychology 1998;27(2):138-145.

16. Weisz JR, Donenberg GR, Han SS, Weiss B. Bridging the gap between laboratory and clinic in child and adolescent
psychotherapy. Journal of Consulting and Clinical Psychology 1995;63(5):688-701.

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 17. Hoagwood K, Hibbs E, Brent D, Jensen P. Introduction to the special section: Efficacy and effectiveness in studies of child
and adolescent psychotherapy. Journal of Consulting and Clinical Psychology 1995;63(5):683-687.

18. Bischoff RJ, Sprenkle DH. Dropping out of marriage and family therapy: a critical review research. Family Process
 1993;32(3):353-375.

19. Britton JA, Gammon MD, Kelsey JL, Brogan DJ, Coates RJ, Schoenberg JB, Potischman N, Swanson CA, Stanford JL, Brinton
LA. Characteristics associated with recent recreational exercise among women 20 to 44 years of age. Women and Health
 2000;31(2-3):81-96.

20. Lipman EL, Offord DR, Boyle MH. What if we could eliminate child poverty? The theoretical effect on child psychosocial
morbidity. Social Psychiatry and Psychiatric Epidemiology 1996;31(5):303-307.

21. Ross DP, Roberts P. Income and child well-being: A new perspective on the poverty debate. Ottawa, Ontario: Canadian
Council on Social Development; 1999. Disponible sur le site: http://www.ccsd.ca/pubs/inckids/index.htm. Accessed August

26, 2005.

22. Chisholm RF. On the meaning of networks. Group and Organization Management 1996;21(2):216-235.

23. Harris E, Wise M, Hawe P, Finlay P, Nutbeam D. Working together: Intersectoral action for health. Sydney, Australia:
Commonwealth Department of Human Health and Services, Australian Centre for Health Promotion; 1995.

24. Browne G, Roberts J. The Integration of Human Services Measure. Hamilton, Ontario: McMaster University and Affiliated
Health and Social Service Agencies; 2002.

25. Browne G, Byrne C, Roberts J, Gafni A, Watt S, Haldane S, et al. Benefiting all the beneficiaries of social assistance: The 2-
year effects and expense of subsidized versus nonsubsidized quality child care and recreation. National Academies of
Practice Forum: Issues in Interdisciplinary Care 1999;1(2):131-142.

26. Huxham C, Vangen S. Leadership in the shaping and implementation of collaboration agendas: How things happen in a
(not quite) joined-up world. Academy of Management Journal 2000;43(6):1159-1175.

27. Lasker RD, Weiss ES, Miller R. Partnership synergy: A practical framework for studying and strengthening the collaborative
advantage. Milbank Quarterly 2001;79(2):179-205.

28. Organization for Economic Cooperation and Development. Strategic governance and policy-making: Building policy
coherence. Paris, France: OECD; 2000.

29. Browne G, Byrne C, Roberts J, Gafni A, Whittaker S. When the bough breaks: Provider-initiated comprehensive care is more
effective and less expensive for sole-support parents on social assistance. Social Science and Medicine 2001;53(12):1697-
1710.

30. Browne G, Roberts J, Byrne C, Gafni A, Weir R, Majumdar B. Translating research. The costs and effects of addressing the
needs of vulnerable populations: Results of 10 years of research. Canadian Journal of Nursing Research 2001;33(1):65-76.

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Parenting Styles and Child Social Development
Lea Bornstein, BA, Marc H. Bornstein, PhD

University of Pennsylvania, USA, National Institute of Child Health and Human Development, USA
December 2014, 3e éd.

Introduction

During the first years of life – thought by many to be a unique period of human development –
parents assume special importance. As parents guide their young children from complete
infantile dependence into the beginning stages of autonomy, their styles of caregiving can have
both immediate and lasting effects on children’s social functioning in areas from moral
development to peer play to academic achievement. Ensuring the best possible outcome for
children requires parents to face the challenge of balancing the maturity and disciplinary
demands they make to integrate their children into the family and social system with maintaining
an atmosphere of warmth, responsiveness and support. When parent conduct and attitude during
the preschool years do not reflect an appropriate balance on these spectra, children may face a
multitude of adjustment issues. What parenting styles best achieve this balance?

Subject

There are probably almost as many opinions on what constitutes “good parenting” as there are
people asked. New parents often receive advice and guidance on how to parent from their
parents and experts, as well as from peers and popular culture. Developing an appropriate
parenting style during the first years of a child’s life is a challenging proposition for new parents,
especially when not all sources agree. Research on effective parenting styles can help guide
parents to a proper balance of sensitivity and control.

Problems

A major obstacle in family systems research is the question of relevance: Can researchers draw
conclusions about parenting style that bridge cultural and socioeconomic gaps?  Much research
shows that the authoritative and flexible parenting style is optimal for the white, middle-class
child from a nuclear family, but the same may not be true for other children growing up in other
circumstances and situations. Allowing children flexibility and freedom may result in positive

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outcomes when children live in safe areas and their peers are less likely to engage in dangerous
behaviour, but in high-risk neighbourhoods, higher degrees of parental control might be
necessary. Before policy-makers and clinicians can set guidelines or make recommendations
regarding appropriate parenting behaviour, the extent to which the research conclusions apply to
different ethnic/racial/cultural and socioeconomic groups must be evaluated. Furthermore, the
positive and negative child outcomes associated with different types of parenting styles in
preschool children may not necessarily apply to children at later stages of development. Longer-
term outcomes must also be factored into policy-making and advising parents.

Research Context

Contemporary studies of parenting styles in large part expand on several concepts put forward in
Diana Baumrind’s formative research in the 1960s, which outlined a three-group classification
system. Since the advent of this type of research, generally conducted through direct observation
and by questionnaires and interviews with parents and children, classification has been based on
evaluations along two broad dimensions of parenting styles: control/demandingness (claims
parents make on a child relating to maturity, supervision and discipline) and responsiveness
(actions that foster individuality, self-regulation and self-assertion by being attuned and
supportive). Contemporary researchers typically classify parenting styles in four groups:
authoritarian parenting, characterized by high levels of control and low levels of responsiveness;
indulgent permissive parenting, characterized by low levels of control and high levels of
responsiveness; authoritative parenting, characterized by high levels of both control and
responsiveness; and neglectful parenting, characterized by lack of both control and
responsiveness. 

Recent Research Results

Research has generally linked authoritative parenting, where parents balance demandingness
and responsiveness, with higher social competencies in children. Thus, children of authoritative
parents possess greater competence in early peer relationships, engage in low levels of drug use
as adolescents, and have more emotional well-being as young adults. Although authoritarian and
permissive parenting styles appear to represent opposite ends of the parenting spectrum, neither
style has been linked to positive outcomes, presumably because both minimize opportunities for
children to learn to cope with stress.  Too much control and demandingness may limit children’s
opportunities to make decisions for themselves or to make their needs known to their parents,

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while children in permissive/indulgent households may lack the direction and guidance necessary
to develop appropriate morals and goals. Research has also uncovered significant associations
between parenting styles across generations; bad parenting appears to be “passed on” as much
as good parenting.

Even though these kinds of results appear to be robust, their applicability across cultures and
environments is questionable.  Many studies focus on white, middle-class children and families,
but children with different ethnic/racial/cultural or socioeconomic backgrounds may fare better
under different types of guidance. Recent controversy concerns the outcomes of different
parenting styles for child social development in low-SES, high-risk, inner-city families. While some
research has suggested that more authoritarian parenting styles may be necessary in high-risk
areas, other research has shown continued benefits of authoritative parenting. Factoring into this
research is the idea that parenting may actually “matter less” among low-SES families due to the
greater force of environmental factors, such as financial difficulties and higher crime rates.

Ethnic and cultural differences must also be taken into account in studying the effects of
parenting styles on child social development. It is difficulty to escape social pressures that judge
some parenting styles to be better, usually those that reflect the dominant culture. Authoritarian
parenting, which is generally linked to less positive child social outcomes, tends to be more
prevalent among ethnic minorities. In Asian ethnic families, authoritarian parenting is linked to
positive social outcomes and academic success, due in part to parenting goals and training
specific to Asian-origin families.

Although parenting quality inevitably adjusts, improves or declines as children mature and
parents face new and different challenges, some level of stability in parenting style over long
periods of time obtains.

Conclusions

Information and education on optimal parenting styles and early establishment of effective
practices are both important to a child’s social adjustment and success.  In many situations,
adoption of a flexible and warm authoritative parenting style is most beneficial for a child’s social,
intellectual, moral and emotional growth. However, research in the area of parent-child
interaction must continue to expand to evaluate not only outcomes in a broader variety of
ethnic/racial/cultural and socioeconomic groups, but also outcomes in children of different ages

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so that families in all types of situations can reap the full benefits of research.

Implications for the Policy and Services Perspective

The development of personality, morals, goals and problem-solving that occurs during the first
years of life is critical and developmentally unlike any other time in the life course. It is important
for family policy-makers and family support service workers to aid new parents in adopting
appropriate parenting techniques and strategies to ensure that children receive guidance that will
best allow them to succeed in later life. However, research into the broad applicability of certain
types of parenting techniques must continue so that policy-makers can tailor advice and
guidelines to optimize outcomes for every child.

References

1. Bornstein MH. Handbook of Parenting. 2nd ed. Mahwah, NJ: Erlbaum; 2002.

2. Darling N, Steinberg L. Parenting style as context: An integrative model. Psychological Bulletin 1993;113(3):487-496.

3. Grusec JE, Hastings PD. Handbook of socialization: Theory and research. New York, NY: Guilford Press; 2006.

4. Maccoby EE, Martin JA. Socialization in the context of the family: Parent-child interaction. In: Hetherington EM, ed.
Socialization, personality, and social development. New York, NY: Wiley; 1983:1-101. Mussen PH, ed. Handbook of child
psychology. 4th ed; vol 4.

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The role of parents in early childhood learning
Susan H. Landry, PhD

Children’s Learning Institute; University of Texas Health Science Center, USA

December 2014, Éd. rév.

Introduction

Children’s development of the cognitive and social skills needed for later success in school may
be best supported by a parenting style known as responsive parenting.1 Responsiveness is an
aspect of supportive parenting described across different theories and research frameworks (e.g.
attachment, socio-cultural) as playing an important role in providing a strong foundation for
children to develop optimally.2-4 Parenting that provides positive affection and high levels of
warmth and is responsive in ways that are contingently linked to a young child’s signals
(“contingent responsiveness”) are the affective-emotional aspects of a responsive style.5 These
aspects, in combination with behaviours that are cognitively responsive to the child’s needs,
including the provision of rich verbal input and maintaining and expanding on the child’s
interests, provide the range of support necessary for multiple aspects of a child’s learning.6

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Acceptance of the child’s interests with responses that are prompt and contingent to what the
child signals supports learning, in part, by facilitating the child’s development of mechanisms for
coping with stress and novelty in his or her environment.2 With repeated positive experiences, a
trust and bond develop between the child and parent that in turn allow the child to ultimately
internalize this trust and then generalize their learning to new experiences. This sensitive support
promotes the child’s continued engagement in learning activities with his or her parent.7,8
Thus, these affective-emotional behaviours communicate the parent’s interest and acceptance,
fostering self-regulation and cooperation, critically important behaviours for effective learning to
occur. From a socio-cultural viewpoint, cognitively responsive behaviours (e.g. maintaining versus
redirecting interests, rich verbal input) are thought to facilitate higher levels of learning because
they provide a structure or scaffold for the young child’s immature skills, such as developing
attentional and cognitive capacities.9 Responsive behaviours in this framework promote joint
engagement and reciprocity in the parent-child interaction and help a child learn to assume a
more active and ultimately independent role in the learning process.10 Responsive support for the
child to become actively engaged in solving problems is often referred to as parental scaffolding,
and is also thought to be key for facilitating children’s development of self-regulation and
executive function skills, behaviours that allow the child to ultimately assume responsibility for
their well-being.11,12 

Subject

Responsive parenting is one of the aspects of parenting most frequently described when we try to
understand the role the environment plays in children’s development.  Research shows it has the
potential to promote normal developmental trajectories for high-risk children, such as those from
low-income backgrounds and/or those with very premature births.13 In contrast, unresponsive
parenting may jeopardize children’s development, particularly those at higher risk for
developmental problems.14 The critical importance of responsive parenting is highlighted by
recent evidence identifying links between high levels of early responsive parenting and larger
hippocampal volumes for normally developing preschool aged children. Increased volume in this
brain region is associated with more optimal development of a number of psychosocial factors
(e.g., stress reactivity).15 Links between early responsive parenting and increased volume in the
hippocampal region also suggest that the early developmental period is an important time to
facilitate responsive parenting practices, especially in high risk families, in order to enhance the
parent-child relationship. Given the potential importance of responsive parenting, more specific
knowledge of the types of behaviours that are most important for supporting particular areas of a
child’s learning could further our understanding of how to facilitate effective parenting practices.

©2014-2021 CEDJE | PARENTING SKILLS 38

Problem

Despite the central role for responsive parenting in different research frameworks, much of what
we know about this parenting style comes from descriptive studies.  This means that we can only
infer the importance of responsive parenting. To assume a causal influence of responsive
parenting on child outcomes would require data from experimental studies with random
assignment. A strong body of experimental studies that demonstrate how greater degrees of
responsive parenting promote higher levels of learning could provide a clearer understanding of
the mechanism by which responsive behaviours promote a child’s learning. Fortunately, there is
growing evidence from interventions targeting the facilitation of responsive parent practices that
show positive results and some evidence that when responsive behaviours are increased children
showed at least short-term increases in cognitive, social, and emotional skills.16,17 However, many
questions still need to be addressed including whether there is specificity between particular
responsive behaviours and the support they provide for certain areas of child development as
well as whether there are sensitive periods of early development when particular types of
responsive behaviours are most helpful.

Research Context

Young children’s acquisition of problem solving, language and social-emotional skills is facilitated
by interactions with their parents. There is some evidence that the mechanism by which
responsiveness supports a child’s development may be dependent on consistency across
development in this parenting style.13,18 As the child and parent are part of a broader social
context, many factors may support or impinge on a parent’s consistent use of responsive
behaviours.  Personal factors that may compromise a parent’s responsiveness include depression,
perception of the parent’s own child-rearing history as negative, or beliefs and attitudes that
detract from a parent’s sense of importance in his or her child’s life.19 However, other factors,
such as higher levels of social support from friends and family, can buffer some of these negative
social-personal factors13 as well as predict which parents move from a non-responsive to a
responsive style with intervention.20 This is an encouraging finding, as parenting interventions can
be developed to provide a level of social support mothers from high-risk social backgrounds need
in order to develop responsive parenting styles.21

Key Research Questions

1. Do increases in parent responsiveness behaviours result in increases in young children’s

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 learning? 

2. Can interventions targeting responsive parenting work for different types of high risk
parents?

3. Do increases in the various aspects of responsiveness explain the positive changes in

different aspects of cognitive and social development? 

4. Is there an optimal time in the child’s development when responsiveness is particularly

important, or is consistency across development necessary for more optimal learning to
occur?

5. Is parental responsiveness equally effective, or does its effectiveness vary for children with
varying characteristics (e.g., socio-economic status, ethnicity, biological risk factors)?

Recent Research Results

A recent random assignment intervention study examined whether mothers’ responsive

behaviours could be facilitated and whether such behaviours would boost young children’s
learning.6 To also examine the most optimal timing for intervention (e.g. across infancy versus
the toddler/preschool period versus both), families from the intervention and non-intervention
groups were re-randomized at the end of the infancy phase, to either receive the responsiveness
intervention in the toddler/preschool period or not.22 The intervention was designed to facilitate
mothers’ use of key behaviours that provided affective-emotional support and those that were
cognitively responsive, as both types of support were expected to be necessary to promote
learning. After the infancy phase, mothers receiving the intervention showed strong increases in
all responsiveness behaviours and their infants showed higher levels and faster growth rates in a
range of skills. For example, independent problem-solving during toy play showed greater
increases for infants whose mothers received the intervention compared to infants whose
mothers did not receive the intervention.  Affective-emotional and cognitively responsive
behaviours together mediated the effect of the intervention on children’s learning, demonstrating
that the effectiveness of responsiveness can best be understood if defined as a broad construct.
In addition, different aspects of children’s learning were specifically improved by certain specific
responsive behaviours. For instance, children’s cooperation was best improved by mothers’
increased use of contingent responsiveness and verbal encouragement and by their less frequent
restriction of the children’s activities, while children’s use of words was best improved by
mothers’ more frequently maintaining children’s attention on their interests and labelling objects
or actions. 

Examination of evidence for the most optimal timing of an intervention showed that it depended
upon factors such as the type of support a responsive behaviour provided and the degree to

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which it was linked to a child’s developmental needs. For example, behaviours such as warm
sensitivity (from an attachment framework) were best facilitated during the infancy phase, while
those that were more complex, as they had to be responsive to the child’s changing
developmental picture (e.g., contingent responsiveness), required both intervention phases. The
effects of the intervention also generalized to positively influence parent and child behaviours
during a shared book reading activity, even though this activity was not a specific focus of the
intervention.23 The intervention worked equally well with children who were or were not at high
biological risk.13,22 This supports the notion that responsiveness facilitates learning through
parental sensitivity and willingness to meet young children’s individual needs. Finally,
interventions targeting responsive parenting practices also show similar positive effects for
parents of varying risk factors (e.g., teen versus adult parents).24

Research Gaps

Recent findings from experimental studies demonstrate that some areas of a child’s learning are
best supported by specific responsiveness behaviours or combinations of these. Now research is
needed to further delineate this specificity between particular types of responsive support and
particular developmental goals.

Expanding our understanding of how responsive parenting looks and works across different family
and child characteristics would add to the development of a more highly specified model of
responsive parenting.  Finally, determination of what supports need to be in place to assist
parents with their attempts to be responsive could enhance the effectiveness of responsive
parent interventions.

Conclusions

Responsive parenting, according to many descriptive studies and fewer experimental studies, is
an important process for supporting young children’s learning.  There is now support for a causal
role of responsive parenting, as greater gains in the parental behaviours associated with a
responsive style were responsible for the effect of several parenting interventions on greater
gains in young children’s learning.6,22,24 Also, recent evidence for normally developing children
showing links between early high levels of responsive parenting and increased volume in brain
regions responsible for regulation of stress suggests the critical importance of this parent practice
in early development.15 

As both normal and high-risk children benefited from responsiveness that provided affective-
emotional and cognitively responsive support, the effectiveness of responsiveness seems best
understood when it is defined as a broad construct. Recent evidence shows that certain
responsive behaviours may provide different types of support for children’s learning and this

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support may vary depending on a child’s developmental needs. There are many new research
avenues that need to be explored and questions addressed in recent studies that require further
examination.

Implications

The importance of responsive parenting for young children’s well-being has many policy
implications. Policy and practice decision-makers need to pay particular attention to parents who
are most at risk: they need find ways to facilitate change in parents’ behaviours, taking into
consideration factors such as parent beliefs, social support, mental health status, in order to
maximize effectiveness. Synthesis of relevant research should guide new investments in parent
programs and the development of research initiatives concerning responsive parenting.
Developmental science is frequently not well integrated into policy or program application. Given
the critically important role of early experience in brain development, policy-makers have an
interest in making sure that young children’s environments (e.g. home, child care) are of high
enough quality to promote positive outcomes. When new investments are made in publicly
funded services for children and families, there is often a greater emphasis on accountability.
This should serve to encourage a greater consideration of research-based evidence that can
better assure program effectiveness. 

References

1. Bornstein MH, Tamis-Lemonda CS. Maternal responsiveness and cognitive development in children. In:  Bornstein MH, ed.
Maternal responsiveness: Characteristics and consequences. San Francisco, CA: Jossey-Bass;1989:49-61.

2. Ainsworth M, Blehar M, Waters E, Wall S. Patterns of attachment: A psychological study of the Strange Situation. Hillsdale,
NJ: Erlbaum; 1978. 

3. Grusec JE, Goodnow JJ. Impact of parental discipline methods on the child's internalization of values: A reconceptualization
of current points of view. Developmental Psychology 1994;30(1):1-19.

4. Rogoff B. Apprenticeship in Thinking. New York, NY: Oxford University Press; 1990.

5. Stroufe LA. Infant-caregiver attachment and patterns of adaptation in preschool: The roots of maladaptation and
competence. In: Perlmutter M, ed. Minnesota Symposia in Child Psychology. Hillsdale, NJ: Erlbaum; 1983:41-83. Vol. 16.

6. Landry SH, Smith KE, Swank PR. Responsive parenting: Establishing early foundations for social, communication, and
independent problem solving. Developmental Psychology 2006;42(4):627-642.

7. Maccoby EE, Martin JA. Socialization in the context of the family: Parent-child interactions. In: Mussen PH, Hetherington EM,
eds. Handbook of child psychology. 4th ed. New York, NY: Wiley; 1983:1-101. Socialization, personality, and social
development; vol.  4.

8. Baumrind D. Rearing competent children. In: Damon W, ed. Child development today and tomorrow. San Francisco, CA:
Jossy-Bass; 1989:349-378.

9. Tomasello M, Farrar JM. Joint attention and early language. Child Development 1986;57(6):1454-1463.

©2014-2021 CEDJE | PARENTING SKILLS 42

 10. Vygotsky LS. Mind in society: The development of higher psychological processes. Cambridge, United Kingdom: Harvard
University Press; 1978.

11. Bernier A, Carlson SM, Whipple N. From external regulation to self-regulation: Early parenting precursors of young
children’s executive functioning. Child Development 2010;81:326-339.

12. Hammond SI, Muller U, Carpendale JIM, Bibok MB, Liebermann-Finestone DP. Developmental Psychology 2012;48(1):271-
281.

13. Landry SH, Smith KE, Swank PR, Assel MA, Vellet S. Does early responsive parenting have a special importance for
children's development or is consistency across early childhood necessary? Developmental Psychology 2001;37(3):387-
403.

14. Landry SH, Smith KE, Miller-Loncar CL, Swank PR. Predicting cognitive-linguistic and social growth curves from early
maternal behaviors in children at varying degrees of biological risk. Developmental Psychology 1997;33(6): 1040-1053.

15. Luby JL, Barch DM, Belden A, Gaffrey MS, Tillman R, Casey B, Tomoyuki N, Suzuki H, Botteron KN. Maternal support in early
childhood predicts larger hippocampal volumes at school age. Proceedings of the National Academy of Science
2012;109(8):2854-5849.

16. Van Zeijl J, Mesman J, Van IJzendoorn MH, Bakermans-Kraneburg MJ, Juffer F, …, Alink LRA. Attachment-based intervention
for enhancing sensitive discipline in mothers of 1- to 3-year-old children at risk for externalizing behavior problems: A
randomized controlled trial. Journal of Consulting and Clinical Psychology 2006;74:994-1005.

17. Dunst CJ, Kassow DZ. Caregiver sensitivity, contingent social responsiveness, and secure infant attachment. Journal of
Early and Intensive Behavior Intervention  2008;5:40-56.

18. Bradley RH, Caldwell BM, Rock S. Home environment and school performance: A ten year followup and examination of
three models of environmental action. Child Development 1988;59(4):852-867.

19. Belsky J, Hertzog C, Rovine M. Causal analyses of multiple determinants of parenting: Empirical and methodological
advances. In: Lamb M, Brown A, Rugoff B, eds. Advances in Developmental Psychology. Hillsdale, N.J.: Lawrence Erlbaum
Associates;1986:153-202. Vol 4.

20. Guttentag C, Pedrosa-Josic C, Landry SH, Smith KE, Swank PR. Individual variability in parenting profiles and predictors of
change: Effects of an intervention with disadvantaged mothers. Journal of Applied Developmental Psychology 2006;
27(4):349-369.

21. Dieterich SE, Landry SH, Smith KE, Swank PR. Impact of community mentors on maternal behaviors and child outcomes.
Journal of Early Intervention 2006; 28(2):111-124.

22. Landry SH, Smith KE, Swank PR, Guttentag C. A responsive parenting intervention: The optimal timing across early
childhood for impacting maternal behaviors and child outcomes. Developmental Psychology 2008;44(5):1335-1353.

23. Landry SH, Smith KE, Swank PR, Zucker T, Crawford AD, Solari EF. The effects of a responsive parenting intervention on
parent-child interactions during shared book reading. Developmental Psychology.  2012;48(4), 366-392

24. Guttentag CL, Landry SH, Williams JM, Baggett KM, Noria CW, Borkowski  JG, Swank PR, Farris JR, Crawford AD, Lanzi RG,
Carta JJ, Warren SF, Ramey SL. “My baby & me”: Effects of an early comprehensive parenting intervention on at-risk
mothers and their children. Developmental Psychology 2014;50(5), 1482-1496.

Note:

First edition of this paper was financed by the Canadian Council on Learning - Early Childhood Learning Knowledge

Centre

©2014-2021 CEDJE | PARENTING SKILLS 43

Parents’ Role in Fostering Young Children’s
Learning and Language Development
Catherine S. Tamis-LeMonda, PhD, Eileen T. Rodriguez, PhD

New York University, USA

December 2014, 3e éd.

Introduction

During the first years of life, children undergo major developmental changes across a range of
domains. In particular, the entry into “formal language” is one of the most heralded
achievements of early development. Language enables children to share meanings with others,
and to participate in cultural learning in unprecedented ways. Moreover, language is foundational
to children’s school readiness and achievement. For these reasons, a vast body of research has
been dedicated to understanding the social-contextual factors that support children’s early
language and learning. This work is also central to practitioners, educators and policy makers
who seek to promote positive developmental outcomes in young children.

Subject

Developmental scholars have long been interested in documenting the social experiences that
help explain within- and between-group variation in children’s early language and learning.1,2 This
work is anchored in the writings of scholars such as Bruner3,4 and Vygotsky,5 who posited that
learning occurs in a socio-cultural context in which adults and primary caregivers support or
“scaffold” young children to higher levels of thinking and acting. According to this view, children
who experience sensitive, cognitively stimulating home environments early in development are at
an advantage in the learning process.

Problem

Research into the factors that promote positive language growth and learning in young children is
central to addressing achievement gaps that exist in children from different ethnic, language,
racial, and socioeconomic backgrounds. Children enter school with different levels of skill, and
these initial differences often affect children’s subsequent language growth, cognitive
development, literacy and academic achievement.6,7,8 Children who exhibit delays at the onset of

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schooling are at risk for early academic difficulties and are also more likely to experience grade
retention, special education placement, and failure to complete high school.9,10,11

These delays are particularly evident in children living in poverty. Children from low-income
households lag behind their peers in language skills from early on,2,12 and have been shown to
develop vocabularies at slower rates than their peers from more economically advantaged
households.7 Smaller receptive and productive vocabularies, in turn, predict children’s later
reading and spelling difficulties in school.8,13 

Research Context

The demographic profiles of minority and immigrant populations in the U.S. and Canada have
changed dramatically over the past decade ̶  a shift that has generated research on the
widespread disparities that exist in children’s school readiness across ethnic, racial and
socioeconomic lines.14,15,16,17,18 Because group disparities in learning exist prior to kindergarten,
researchers and practitioners alike seek to understand the role of children’s early home
environment in the learning process.19,20,21,22,23

Research Questions

Inquiry into the role of the home environment on young children’s language and learning can be
classified under two broad questions:

1. Which aspects of parenting matter for children’s early language and learning, and why?

2. What factors enable parents to provide a supportive environment to their young children?

Recent Research Results

Which aspects of parenting matter, and why?

Three aspects of parenting have been highlighted as central to children’s early language and
learning: (1) the frequency of children’s participation in routine learning activities (e.g., shared
bookreading, storytelling); (2) the quality of caregiver-child engagements (e.g., parents’ cognitive
stimulation and sensitivity/responsiveness); and (3) the provision of age-appropriate learning
materials (e.g., books and toys).24

Early and consistent participation in routine learning activities, such as shared book reading,

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storytelling, and teaching about the letters of the alphabet, provide children with a critical
foundation for early learning, language growth and emergent literacy.25,26,27,28 Routine activities
provide young children with a familiar structure for interpreting others’ behaviors and language,
anticipating the temporal sequencing of events, and drawing inferences from new experiences.29,30
Moreover, engagement in learning activities expands children’s vocabularies and conceptual
knowledge.31 In particular, shared bookreading, as well as the sharing of oral stories, facilitate
young children’s vocabulary growth, phonemic skills, print concept knowledge, and positive
attitudes toward literacy.25,27,32,33,34,35

A plethora of studies also indicate that the quality of parent-caregiver interactions plays a
formative role in children’s early language and learning. In fact, the amount and style of language
that parents use when conversing with their children is one of the strongest predictors of
children’s early language. Children benefit from exposure to adult speech that is varied and rich
in information about objects and events in the environment.7,36,37 Additionally, parents who
contingently respond to their young children’s verbal and exploratory initiatives (through verbal
descriptions and questions) tend to have children with more advanced receptive and productive
language, phonological awareness, and story comprehension skills.38,39,40,41

Finally, the provision of learning materials (e.g., books, toys that facilitate learning) has been
shown to support young children’s language growth and learning.42,43,44 Learning materials provide
opportunities for caregiver-child exchanges about specific objects and actions, such as when a
parent and child pretend to cook a meal. In such instances, materials serve as a vehicle for
communicative exchanges around a shared topic of conversation. Specifically, exposure to toys
that enable symbolic play and support the development of fine motor skills has been shown to
relate to children’s early receptive language skills, intrinsic motivation and positive approaches to
learning.45,46 In addition, children’s familiarity with storybooks has been linked to their receptive
and expressive vocabularies and early reading abilities.26,27

What factors predict positive parenting?

Researchers agree that parenting is multiply determined by characteristics of both parents and
children. In terms of parent characteristics, parent age, education, income, and race/ethnicity (to
name a few) have all been shown to relate to the three aspects of parenting discussed above. For
example, compared to older mothers, teen mothers display lower levels of verbal stimulation and
involvement, higher levels of intrusiveness, and maternal speech that is less varied and complex.
47,48

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 Mothers with fewer years of education read to their children less frequently25,49 and demonstrate
less sophisticated language and literacy skills themselves,50 which affects the quantity and quality
of their verbal interactions with their children.2 Parental education, in turn, relates to household
income: poverty and persistent poverty are strongly associated with less stimulating home
environments,51 and parents living in poverty have children who are at risk for cognitive,
academic, and social-emotional difficulties.52,53 Finally, Hispanic and African American mothers
are, on average, less likely to read to their children than White, non-Hispanic mothers;54 and
Spanish-speaking Hispanic families have fewer children’s books available in the home as
compared to their non-Hispanic counterparts.25 These racial and ethnic findings are likely
explained by differences in family resources across groups, as minority status is often associated
with various social-demographic risks.

Child characteristics, such as gender and birth order (as two of many examples), have also been
linked to early measures of language and learning. For example, girls tend to have a slight
advantage over boys in the early stages of vocabulary development,55,56,57 and studies have
documented that families spend substantially more time in literacy-related activities with girls
than with boys.58 Firstborn children have slightly larger vocabularies on average than their later-
born peers.59 Further, mothers differ in their language, engagement and responsiveness toward
their first- and laterborn children, with input favoring firstborns.60

Research Gaps

In light of evidence that children from low-income and minority backgrounds are more likely to
exhibit delays in language and learning at school entry, additional work is needed to understand
why these differences exist, and how to best support parents in their provision of positive home
environments for their children. Future research should investigate the ways in which multiple
aspects of the home learning environment jointly contribute to developmental outcomes in
children. Moreover, studies on “school readiness” should begin at the earliest stages of infancy,
as this is the period when foundational language and knowledge develops. In this regard,
research on the language development and school readiness of children from language minority
households should focus on how in- and out-of-home language experiences jointly contribute to
children’s proficiency in both English and their native language. Finally, most research on the
social context of children’s language and learning is focused on children’s interactions with
mothers. Given the rich social networks that comprise infants’ and toddlers’ environments, future

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studies should examine the literacy opportunities offered by multiple members of young
children’s social worlds, including fathers, siblings, extended family members, and childcare
providers.

Conclusions

There exists irrefutable evidence for the importance of children’s early language and learning for
later school readiness, engagement and performance. Children’s experiences at home are critical
to early language growth and learning. In particular, three aspects of the home literacy
environment promote children’s learning and language: learning activities (e.g., daily book
reading), parenting quality (e.g., responsiveness), and learning materials (e.g., age-appropriate
toys and books). Additionally, parents with more resources (e.g., education, income) are better
able to provide positive learning experiences for their young children. Finally, children also play a
key role in their own learning experiences, as exemplified by links between child characteristics
and parenting behaviors. Children affect parents just as parents affect children; it is therefore
critical to acknowledge the transactional nature of children’s early language and learning
experiences.61

Implications

Research on children’s early learning environments is relevant to policy makers, educators, and
practitioners who seek to promote the positive language development and learning of young
children. Intervention and preventive efforts should target multiple aspects of children’s early
language and learning environments, including supporting parents in their provision of literacy-
promoting activities, sensitive and responsive engagements, and age-appropriate materials that
facilitate learning. Moreover, these efforts should begin early in development, as children are
likely to benefit most from supportive home environments during the formative years of rapid
language growth and learning.22,62,63 Finally, interventions with parents that aim to support
children’s learning should attend to the cultural context of early development when working with
parents from different backgrounds, and also consider the broader social context of parenting by
attending to the barriers created by poverty and low parental education.

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Note:

This paper was financed by the Canadian Council on Learning - Early Childhood Learning Knowledge Centre

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The Role of Parents in Children’s School Transition
Philip A. Cowan, PhD, Carolyn Pape Cowan, PhD

University of California, Berkeley, USA

December 2014, 2e éd.

Introduction

The prevailing explanatory model of children’s successful transition from preschool to elementary
school assumes that major risk and protective factors lie primarily within the child in terms of
cognitive and emotional “readiness” to enter kindergarten.1 Consistent with this assumption,
most intervention efforts involve school-based attempts to improve children’s cognitive and self-
regulation skills. Investigations of the social contexts and relationships that affect children’s
transition to school have only begun to emerge. Surprisingly, despite the general
acknowledgment that parent-child relationships constitute central contexts for children’s
development,2 there has been little attention to the roles parents play in children’s transition to
elementary school, and almost none to planning or evaluating interventions addressed to parents
of preschoolers. We attempt to address these gaps.

Subject

In most studies of children’s development, “parent” means mother, and parenting is studied in
isolation from other family and social contexts in which parent-child relationships develop. We
present a multidomain model of children’s development that locates mother-child and father-
child relationships within a system of relationships inside and outside the family, paying special
attention to the quality of the relationship between the parents. We then describe the results of
preventive interventions based on our conceptual model in the form of a couples group led by
trained mental health professionals.

Problems

Challenges for the young pre-schooler about to enter kindergarten have been well documented.3,4,5
What makes this an especially important developmental transition period is the consistent
evidence for a “trajectory hypothesis” in both middle-class and low-income samples: how children
fare academically and socially in early elementary school is a strong predictor of their academic,

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social, and mental health outcomes throughout high school.6,7,8 These findings imply that
interventions to improve the child’s relative standing at school entrance could have long-term
payoff.

Research context and research gaps

Research claiming to demonstrate the importance of parent-child relationships in children’s

school adaptation has a number of important gaps. We lack longitudinal studies that trace family
trajectories across the school transition. Information about fathers’ potential role in their
children’s transition is extremely sparse. Only a handful of studies examine other aspects of the
family system context (e.g., the couple relationship) that may affect how children fare. Finally,
outside of early school-based interventions that focus on children’s readiness, we have very little
evidence concerning family-based interventions during the pre-school period that could help
children meet the new challenges of entering school successfully.

Key research questions

What do we know from current research about parents’ role in shaping children’s transition to
school? What do the findings tell us about interventions that might provide children with a “leg
up” as they make the elementary school transition?

Recent research results

Concurrent correlations

It has been well-established in countless studies that parents who are warm, responsive to
children’s questions and emotions, provide structure, set limits and make demands for
competence (authoritative parents, in Baumrind’s terms) have children who are more likely to
succeed in the early years of school and get along successfully with peers.9,10,11 The problem with
these studies is that they do not establish antecedent-consequent connections.

Longitudinal studies

Only a few studies, including two of our own, assess families during the preschool period and
again after the child has entered elementary school.8,12,13 The basic finding is of considerable
consistency across the transition in terms of mothers’, fathers’, and children’s characteristics;
both mothers’ and fathers’ authoritative parenting style during the preschool period explains

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significant variance in children’s academic achievement and externalizing or internalizing
behaviour with peers two and three years later.

The multidomain context of parenting

Our findings support a family systems risk model14 that explains children’s cognitive, social and
emotional development using information about five kinds of family risk or protective factors: (1)
Each family member’s level of adaptation, self-perceptions,  mental health and psychological
distress; (2) The quality of both mother-child and father-child relationships; (3) The quality of the
relationship between the parents, including communication styles, conflict resolution, problem-
solving styles and emotion regulation; (4) Patterns of both couple and parent-child relationships
transmitted across the generations; and (5) The balance between life stressors and social
supports outside the immediate family. Most studies of children’s development focus on one or at
most two of the five family risk and protective domains. We have shown that each domain,
especially the quality of the couple relationship, contributes uniquely to predicting children’s
academic and social competence, and their internalizing and externalizing problem behaviours in
early elementary school.15 Consistent with prevention science, then, we have identified a set of
factors that can be targeted in interventions to lower the probability that children will have
difficulties, and increase the probability that they will display both intellectual and social
competence in early elementary school.

Family-based parenting interventions

Over the past 35 years we have conducted two randomized clinical trials in which some couples
were randomly chosen to participate in couples groups led by trained mental health
professionals, while others were not. The male-female co-leaders met with the couples weekly for
at least 4 months.

In the Becoming a Family Project,12 we followed 96 couples with interviews, questionnaires and
observations over a period of five years from mid-pregnancy to their first child’s completion of
kindergarten. Some of the expectant couples, randomly chosen, were offered participation in a
couples group that met with their co-leaders for 24 weeks over 6 months. Each group session
included some open time to discuss personal events and concerns in their lives and a topic that
addressed one of the aspects of family life in our conceptual model. We found that, while there
was a decline in satisfaction as a couple in new parents without the intervention, the new parent
couples who participated in an ongoing couples group maintained their level of satisfaction over

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the next five years until their children had finished kindergarten. Five years after the couples
groups ended, the quality of both the couple- and parent-child relationships measured when the
child was 3-1/2 was significantly correlated with the children’s adaptation to kindergarten (child
self-reports, teacher ratings and tested achievement).

A second intervention study, the School Children and their Families Project16 followed another 100
couples from the year before their first child entered kindergarten until the children were in 11th
grade. There were three randomly-assigned conditions – an opportunity to use our staff as
consultants once a year (the control group), a couples group that emphasized parent-child
relationships during the open-ended part of the evenings (the more traditional approach), or a
couples group that focused more on the relationship between the parents during the open-ended
parts. When the families were assessed during kindergarten and 1st grade, parents who had been
in a group emphasizing parent-child relationships had improved in the aspects of parenting we
observed in our project playroom, with no improvement in the control participants. By contrast,
parents who had participated in a group in which the leaders focused more on parents’ issues as
a couple showed decreased conflict as a couple when we observed them, and their parenting
became more effective.

Both intervention variations affected the children. The children of parents in the parenting-
focused groups improved in positive self-image, and were less likely to show shy, withdrawn,
depressed behaviour at school. Children of parents in the couple-focused groups were at an
advantage in terms of higher scores on individually administered achievement tests, and lower
levels of aggressive behaviour at school. The interventions continued to have a significant impact
on the families over the next 10 years in terms of both self-reported and observed couple
relationship quality and behaviour problems in the students. The impact of the couple-focused
groups was always equal to or greater than the impact of the parenting-focused groups.17

Conclusions

In sum, we have shown through correlational studies that the quality of the parent-child and
couple relationships is related to the children’s early school adaptation. Through intervention
studies, we see that changing the tone of couple and parent-child relationships has a long-term
causal impact on children’s adaptation to school.

Implications

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Our emphasis on family relationships as important contexts for children’s abilities to cope with
the demands of elementary school admittedly poses a challenge for education policy makers and
school personnel. We are suggesting reaching out to parents before children enter school and
proposing that children will benefit from an enhanced relationship between their parents. It has
been our experience during years of consulting to preschool and elementary school staff that
very few have training in communicating with parents, and none are trained to provide
interventions that might enhance co-parenting or couple relationships.

An obvious alternative would be to hire trained family educators, social workers, nurses or clinical
psychologists to do the outreach and lead groups for couples. Of course this would be costly.
What is as yet unknown is the balance between benefits and costs. If the cost of dealing with
behaviour problem children to the school and society is greater than the cost of these family-
based interventions, perhaps it is time to consider such an approach.

References  

1. Rimm-Kaufman S., School transition and school readiness: An outcome of early childhood development. In: Tremblay RE,
Barr RG, Peters RdeV, eds. Encyclopedia on Early Childhood Development [online]. Montreal, Quebec: Centre of Excellence
for Early Childhood Development; 2004:1-7. Available at: http://www.child-encyclopedia.com/pages/PDF/Rimm-
KaufmanANGxp.pdf. Accessed March 4, 2009.

2. Bornstein MH, ed. Handbook of Parenting. 2nd ed.  Mahwah, N.J.: Erlbaum; 2002.

3. Pianta RC, Cox MJ, National Center for Early Development & Learning (U.S.), eds. The transition to Kindergarten. Baltimore,
MD: P.H. Brookes Pub;1999.

4. Cowan PA, Heming G. How children and parents fare during the transition to school. In: Cowan PA, Cowan CP, Ablow JC,
Johnson VK, Measelle JR, eds. The Family Context of Parenting in Children's Adaptation to Elementary School. Mahwah, NJ:
L. Erlbaum Associates; 2005. Monographs in parenting series.

5. Sameroff AJ, Haith MM, eds. The Five to Seven Year Shift: The Age of Reason and Responsibility. Chicago, IL: The University
of Chicago Press; 1996. The John D. and Catherine T. MacArthur Foundation series on mental heath and development.

6. Entwisle DR, Alexander KL. Facilitating the transition to first grade: The nature of transition and research on factors
affecting it.The Elementary School Journal 1998;98(4):351-364.

7. Kellam SG, Simon MB, Ensminger ME. Antecedents in first grade of teenage drug use and psychological well-being: A ten-
year community-wide prospective study. In: Ricks DF, Dohrenwend BS, eds. Origins of psychopathology: Research and
public policy. Cambridge, NY: Cambridge University Press; 1983.

8. Cowan PA, Cowan CP, Ablow JC, Johnson VK, Measelle JR, eds. The Family Context of Parenting in Children's Adaptation to
Elementary School. Mahwah, NJ: L. Erlbaum Associates; 2005. Monographs in parenting series.

9. Baumrind D. New directions in socialization research.American Psychologist 1980;35(7):639-652.

10. Steinberg L. We know some things: Parent-adolescent relationships in retrospect and prospect.Journal of Research on
Adolescence 2001;11(1):1-19.

11. Parke RD, Buriel R. Socialization in the family: Ethnic and ecological perspectives. In: Damon W, ed. Handbook of Child
Psychology. 5th ed. New York : J. Wiley; 1998: 463-552. Eisenberg N, ed. Social, Emotional, and Personality Development;

©2014-2021 CEDJE | PARENTING SKILLS 57

 vol 3.

12. Cowan CP, Cowan PA. When Partners Become Parents : the Big Life Change for Couples. Mahwah, NJ: Lawrence Erlbaum
Associates; 1999.

13. Barth JM, Parke RD. The impact of the family on children's early school social adjustment. In: Sameroff AJ, Haith MM, eds.
The Five to Seven Year Shift: The Age of Reason and Responsibility. Chicago, IL: The University of Chicago Press; 1996: 329-
361 The John D. and Catherine T. MacArthur Foundation series on mental heath and development.

14. Cowan PA, Cowan CP. Interventions as tests of family systems theories: Marital and family relationships in children's
development, and psychopathology.Development and Psychopatholology 2002;14:731-760.

15. Cowan PA, Cowan CP. Five-domain models: Putting it all together. In: Cowan PA, Cowan CP, Ablow JC, Johnson VK, Measelle
JR, eds. The Family Context of Parenting in Children's Adaptation to Elementary School. Mahwah, NJ: L. Erlbaum Associates;
2005. Monographs in parenting series.

16. Cowan CP, Cowan PA, Heming G. Two variations of a preventive intervention for couples: effects on parents and children
during the transition to elementary school. In: Cowan PA, Cowan CP, Ablow JC, Johnson VK, Measelle JR, eds. The Family
Context of Parenting in Children's Adaptation to Elementary School. Mahwah, NJ: L. Erlbaum Associates; 2005. Monographs
in parenting series.

17. Cowan PA, Cowan CP. Group Interventions for parents of preschoolers: 10-year impact on family functioning and teen’s
adaptation. Paper presented at: SRA Biennal Meeting; March 23-26, 2006; San Francisco, California.

Note:

This paper was financed by the Canadian Council on Learning - Early Childhood Learning Knowledge Centre

©2014-2021 CEDJE | PARENTING SKILLS 58

Parent Supervision to Prevent Injuries to Young
Children
Barbara A. Morrongiello, PhD, Brae Anne McArthur, PhD

University of Guelph, Canada

October 2018, Éd. rév.

Introduction

Caregivers must assume responsibility for the safety of infants, toddlers and preschoolers
because children at these developmental stages have a limited capacity to appraise risk and
differentiate unsafe from safe situations. Historically, research on child safety has focused on
determining what safety practices caregivers adopt, why they do so, and how to motivate them
to enact better safety practices.1-6 More recently research has shifted to examine caregiver
supervision practices, how these influence young children’s risk of injury, and what messaging
approaches are best to motivate caregivers to improve their supervision practices. These issues
are addressed in this article.

Subject

For young children (< 6 years) researchers have defined supervision in terms of specific
behaviours that indicate attending to the child (watching, listening).7 Proximity is particularly
important for the safety of younger children under 6 years of age because they often do
unpredictable things, and quickly, which increases exposure to and interactions with injury
hazards.8

Problems

Epidemiology studies reveal that young children are frequently injured when in their homes,9,10
which is surprising given an adult caregiver should be present and responsible for children at
these young ages. Two essential questions are: how are caregivers typically supervising and what
constitutes ‘adequate supervision’ for ensuring a child’s safety? Examining how patterns of
supervision differentially influence children’s risk of injury is an essential first step for determining
what constitutes adequate supervision.

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Research context

Historically, progress in exploring links between supervision and injury risk had been hampered
by the difficulty of measuring supervision in scientifically rigorous ways. Asking parents to report
on how they might supervise in different circumstances may or may not accurately reflect how
they will do so in real life circumstances.11,12 Studies that have used direct observations (e.g.,
parents with children in public places like parks) and self-monitoring techniques (i.e., parents
record their own supervisory practices at home throughout the day) have substantially advanced
our understanding of factors that influence supervisory practices and how these practices impact
children’s risk of injury.13-15 Another popular testing approach to study supervision involves the use
of ‘contrived hazards’ – hazards that appear real but that have been modified to pose no real risk
of injury in laboratory settings.16,17 With this approach one creates a ‘simulated’ risk situation, and
supervisors’ reactions can be unobtrusively videotaped, providing a more accurate index of
‘typical’ supervision practices. These observation-based methods are time- and labour- intensive
but have yielded substantial insights regarding links between supervision and child injury risk.

Key Research Questions

1. How often are children routinely ‘out of view’ of supervisors when at home? Are there
parent and/or child attributes that influence children’s supervision needs?

2. What patterns of supervision do caregivers show when at home with young children? Are
some patterns more effective than others to prevent children from being injured?

3. Are siblings effective supervisors? What factors influence their effectiveness?

Research Findings

In research on how caregivers routinely supervise it was found that when young children (< 6
years) are at home with mothers they are supervised (in view, attended to) more than
unsupervised (i.e., parent does not know where child is or what the child is doing – for at least 5
minutes). Nonetheless, young children are completely out of view of supervisors about 20% of
their awake time, and the extent of supervision is poorer when they are out of view (e.g.,
intermittently listening in but not watching).18,19 Thus, in the course of their daily lives, parents
routinely supervise in ways that can elevate children’s risk of injury by allowing them to be out of
view. Time children spend out of view of supervisors generally increases with children’s age
because parents assume older children know and will follow safety rules better than younger

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children.20 When sex differences emerge, girls are more closely supervised than boys during the
preschool years, which may partly explain why boys routinely experience more injuries than girls.
21,22

Mothers who score higher in conscientiousness and those with children having behavioural
attributes that are likely to increase risk behaviours (i.e., impulsivity, sensation seeking), keep
their children in view more of the time.14 Thus, parents adjust their level of supervision based on
both parent and child attributes. Importantly, research has shown that children who scored high
in behavioural intensity (i.e., show high activity and intense reactions to new situations and
events) had a history of more medically-attended injuries when parents reported reduced
supervision but not when parents reported high levels of supervision (see Figure 1).23 Thus, close
supervision can counteract the elevated risk of injury typically found for temperamentally-difficult
children.24,25 On the other hand, the child attribute of inhibitory control (e.g., child can exercise
self-control and resist doing things prohibited by a caregiver) serves a protective function and
scoring high in this trait predicts a history of fewer medically-attended injuries even under
conditions of reduced supervision, whereas for children low in inhibitory control higher levels of
supervision are needed to prevent injuries (see Figure 1).23 Hence, whether lower levels of
supervision lead to increased risk of injury depends, in part, on the child’s behavioural attributes.
Risk of injury to children, therefore, reflects an interaction of many factors, including child
characteristics x supervision practices x level of environmental risk.26

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Figure 1. Supervision moderates the relation between child behaviour characteristics and injury. For High

Intensity Behaviour, high scores predicted injury when parents showed low and moderate levels of supervision (p

< .05) but not when they showed high levels of supervision. A similar pattern of significant differences was found

for low scores in Inhibitory Control.

At time points when children acquire new developmental milestones (e.g., start to walk), which
often occurs unexpectedly for parents, injury rates show temporary peaks.27 Thus, when children
behave unpredictably and parents have not had sufficient time to adjust the level of supervision
those children need in order to ensure their safety, then children more frequently get injured,
especially at younger ages and in high-hazard contexts like farms.28

Studies of young children have documented that lax supervision is associated with greater risk
taking, more medically-attended injuries, and more severe injuries.29 Moreover, particular
patterns of supervision differentially relate to frequency of injury, highlighting the importance of
closely supervising children, particularly boys.14 As shown in Figure 2, injury rates for boys and
girls differed significantly when mothers used the strategy of intermittently going to check on the
child, with boys experiencing more injuries than girls. In fact, injury rates for boys when mothers
intermittently listened in were as high as when mothers left their sons unsupervised, and rates
for girls were as low as when mothers provided direct and close supervision; just the threat that a
parent might appear to check on what the child was doing was sufficient to deter girls from taking
risks, but not boys. Hence, anything less than constant watchful supervision was associated with
high injury rates among boys. Generally, the research has shown that boys engage in more risk
taking than girls and they are less compliant with parent requests to avoid hazards. Hence, boys
require more frequent and effortful supervision practices than girls to ensure their safety.14,16

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 Proportions of injuries occuring to boys and girls as a function of level of supervision

Image not found or type unknown

Figure 2. Proportion of injuries for boys (n = 428 total) and girls (n = 137 total) as a function of supervision pattern.

Sibling supervision in which an older child in the family (e.g., 5-12 years) looks after a younger
one (e.g., < 5 years) occurs often when children are at home together.30 This supervision
arrangement elevates risk of injury for young children compared to parent supervision.31,32
Research examining the supervisory practices of older siblings compared with mothers revealed
that supervisees were allowed to engage in more risk behaviours when supervised by older
siblings than by mothers.33 Moreover,  the behaviours of both the sibling supervisors (i.e., less
effective supervision) and young supervisees (i.e., non-compliant) contribute to increase risk of
injury to the young child.34,35  Importantly, a rigorous evaluation of an online training program
(Safe Sibs) reveals that siblings can learn to be more effective supervisors when given the proper
resources and practice experiences.36 

Research Gaps

Most research examining supervision and its impact on injury risk has focused on mothers, but
fathers also often supervise young children at home. A few studies have compared mothers’ with
fathers’ beliefs about the need for supervision of their young children37 and reactions to their
toddler’s risk taking behaviours38 and found no differences, however, more extensive research is
needed. It might be, for example, that differences in supervision between mothers and fathers

©2014-2021 CEDJE | PARENTING SKILLS 63

vary depending on a child’s developmental level or behavioural attributes.

Surprisingly, despite how often supervision is mentioned as a risk factor for injury in the pediatric
literature, there is only one proven effective intervention program that addresses parent
supervision. The Supervising for Home Safety program incorporates a number of messaging
approaches that were shown to be effective to change parental beliefs about injuries and
supervision.39 The program has proven effective when delivered in a 1:1 format (e.g., home
visiting programs) or a parenting group context.40,41 Extending this program to meet the needs of
high-risk parent populations is an important next step because in the child maltreatment area
inadequate supervision is a cornerstone in defining neglectful parenting.42,43  Hence, interventions
that can improve supervision behaviours for parents showing supervisory neglect are sorely
needed.

Conclusions

Developments in defining and measuring supervision have paved the way for research on
caregiver supervision, including studying how this factor influences young children’s risk of injury.
Research has confirmed past speculation that poor supervision can elevate risk of injury to
children, but the findings also highlight variation in this process depending on parent and child
characteristics, as well as level of environmental risk. The evidence indicates that mothers and
fathers are more similar than different in supervising young children and that sibling supervision
is more lax than parent practices which contributes to elevated injury risk for young supervisees
when supervised by older siblings.

Implications 

An important aspect of raising young children is preventing unintentional injuries. Supervision is a

strategy that has been shown to achieve this goal. The supervision needs of children, however,
are influenced by a multitude of factors, including child characteristics (age, sex, behavioural
attributes), parent characteristics (conscientiousness, beliefs about injuries) and level of
environmental risk. Such complexity suggests that it may not be realistic to aim to develop
specific ‘supervision guidelines’ that can apply broadly. Developing interventions that target
caregiver supervision beliefs and behaviours and can be broadly applied, therefore, is essential.
The Supervising for Home Safety program meets this need and the focus now has to be on
program dissemination to counteract parents’ commonly held belief that childhood injuries are

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‘accidents’ and to enhance their motivation for and self-efficacy beliefs that they can more
closely supervise their children.44 In addition, the Safe Sibs program can address the need to train
children to be more effective supervisors of younger children. This is essential given that
supervision by siblings is a common occurrence and without training these older siblings increase
risk of injury to younger children.

References

1. Dershewitz RA, Williamson JW. Prevention of childhood household injuries: A controlled clinical trial. American Journal of
Public Health 1977;67(12):1148-1153.

2. Gallagher SS, Hunter P, Guyer B. A home injury prevention program for children. Pediatric Clinics of North America
1985;32(1):95-112.

3. Gielen AC, McDonald EM, Wilson ME, Hwang WT, Serwint JR, Andrews JS, Wang MC. Effects of improved access to safety
counseling, products, and home visits on parents’ safety practices: Results of a randomized trial. Archives of Pediatrics and
Adolescent Medicine 2002;156(1):33-40.

4. Kendrick D, Barlow J, Hampshire A, Stewart-Brown S, Polnay L. Parenting interventions and the prevention of unintentional
injuries in childhood: Systematic review and meta-analysis. Child: Care, Health, and Development 2008;34(5):682-695.

5. Towner E, Dowswell T, Mackereth C, Jarvis S. What works in preventing unintentional injuries in children and young
adolescents? An updated systematic review. London, UK: National Institute for Health and Clinical Excellence; 2001.

6. Morrongiello BA, Kiriakou S. Mothers’ home-safety practices for preventing six types of childhood injuries: What do they do,
and why? Journal of Pediatric Psychology 2004;29(4):285-297.

7. Morrongiello BA. Caregiver supervision and child-injury risk: I. Issues in defining and measuring supervision; II. Findings and
directions for future research. Journal of Pediatric Psychology 2005;30(7):536-552.

8. Gitanjali S, Brenner R, Morrongiello BA, Haynie D, Rivera M, Cheng T. The role of  supervision in child injury risk: Definition,
conceptual, and measurement issues. Journal of Injury Control & Safety Promotion 2004;11(1):17-22.

9. Rivera FP. Developmental and behavioral issues in childhood injury prevention. Journal of Developmental and Behavioral
Pediatrics1995;16(5):362-370.

10. Shannon A, Brashaw B, Lewis J, Feldman W. Nonfatal childhood injuries: A survey at the Children’s Hospital of Eastern
Ontario. Canadian Medical Association Journal 1992;146(3): 361–365.

11. Pollack-Nelson C, Drago DA. Supervision of children aged two through six years. Injury Control and Safety Promotion.
2002;9(2):121-126

12. Simon HK, Tamura T, Colton K. Reported level of supervision of young children while in the bathtub. Ambulatory Pediatrics
2003;3(2):106-108.

13. Garling A, Garling T. Mothers’ supervision and perception of young children's risk of injury in the home. Journal of Pediatric
Psychology 1993;18(1):105-114.

14. Morrongiello BA, Ondejko L, Littlejohn A. Understanding toddlers’ in-home injuries: II. Examining parental strategies and
their efficacy for managing child injury risk. Journal of Pediatric Psychology 2004;29(6):433-446.

15. Peterson L, DiLillo D, Lewis T, Sher K. Improvement in quantity and quality of prevention measurement of toddler injuries
and parental interventions. Behavior Therapy 2002;33(2):271-297.

16. Morrongiello BA, Dawber T. Toddlers’ and mothers’ behaviors in an injury-risk situation: Implications for sex differences in

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 childhood injuries. Journal of Applied Developmental Psychology 1998;19(4):625-639.

17. Cataldo MF, Finney JW, Richman GS, Riley AW, Hook RJ, Brophy CJ, Nau PA. Behaviors of injured and uninjured children and
their parents in a simulated hazardous setting. Journal of Pediatric Psychology 1992;17(1):73-80.

18. Morrongiello BA, Corbett M, McCourt M, Johnston N. Understanding unintentional injury-risk in young children I. The nature
and scope of caregiver supervision of children at home. Journal of Pediatric Psychology 2006;31(6):529-539.

19. Morrongiello BA, Corbett M, McCourt M, Johnston N. Understanding unintentional injury risk in young children II. The
contribution of caregiver supervision, child attributes, and parent attributes. Journal of Pediatric Psychology
2006;31(6):540-551.

20. Morrongiello BA, Midgett C, Shields R. Don’t run with scissors: Young children’s knowledge of home safety rules. Journal of
Pediatric Psychology 2001;26(2):105-115.

21. Morrongiello BA,  Rennie H. Why do boys engage in more risk-taking than girls? The role of attributions, beliefs, and risk-
appraisals. Journal of Pediatric Psychology 1998;23(1):33-43.

22. Rivera FP, Bergman AB, LoGerfo JP, Weiss NS. Epidemiology of  childhood injuries. II. Sex differences in injury rates.
American Journal of Diseases of Children 1982;136(2):502-506.

23. Morrongiello BA, Klemencic N, Corbett M. Interactions between child behavior patterns and parent supervision: Implications
for children’s risk of unintentional injury. Child Development 2008;79(3):627-638.

24. Schwebel DC, Brezausek CM, Ramey SL, Ramey CT. Interactions between child behavior  patterns and parenting:
Implications for children's unintentional injury risk. Journal of Pediatric Psychology 2004;29(2):93-104.

25. Schwebel DC, Speltz M, Jones K, Bardina P. Unintentional injury in preschool boys with and without early onset of disruptive
. Journal of Pediatric Psychology 2002;27(8):727-737.

26. Morrongiello BA. The role of supervision in child-injury risk: Assumptions, issues, findings, and future directions. Journal of
Pediatric Psychology 2005;30:S36-S52.

27. Agran P, Winn D, Anderson C, Trent R, Walton-Haynes L, Thayer S. Rates of pediatric injuries by 3-month intervals for
children 0 to 3 years of age. Pediatric 2003;111(6 Pt 1):683-692.

28. Morrongiello BA, Pickett W, Berg RL, Linneman JG, Brison RJ, Marlenga B. Adult  supervision and pediatric injuries in the
agricultural worksite. Accident Analysis and Prevention 2008;40(3):1149-1156.

29. Morrongiello BA, Corbett M, Brison RJ. Identifying predictors of medically-attended injuries to young children: Do child and
parent attributes matter? Injury Prevention 2009;15(4):50-55.

30. Morrongiello BA, Walpole B, McArthur BA. Brief Report: Young children’s risk of unintentional injury: A comparison of
mothers’ and fathers’ supervision beliefs and reported practices. Journal of Pediatric Psychology 2009;34(10):1063-1068.

31. Morrongiello BA, Dawber T. Parental influences on toddlers’ injury-risk behaviors: Are sons and daughters socialized
differently? Journal of Applied Developmental Psychology 1999;20(2):227-251.

32. Morrongiello BA, MacIsaac T, Klemencic N. Older siblings as supervisors: Does this influence young children’s risk of
unintentional injury? Social Science & Medicine 2007;64(4):807-817.

33. Nathans AB, Neff M, Goss CH, Maier RV, Rivara FP. Effect of an older sibling and birth interval on the risk of childhood
injury. Injury Prevention 2000;6(3):219-222.

34. Rauchschwalbe R, Brenner RA, Smith GS. The role of bathtub seats and rings in infant drowning deaths. Pediatrics
1997;100(4):E1.

35. Morrongiello BA, Schmidt S, Schell S. Caregiver supervision and injury risk: A comparison of mothers’ and older siblings’
reactions to risk taking by a younger child member of the family. Social Science and Medicine 2010; 71: 958-965.

36. Morrongiello BA, Schell S, Schmidt S. “Please keep an eye on your younger sister”: Sibling supervision and young children’s

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 risk of injury. Injury Prevention 2011; 16:398-402.

37. Morrongiello BA, Schell S. “You have to listen to me because I’m in charge”: explicit instruction improves sibling
supervision. Journal of Pediatric Psychology 2013; 38:342-350.

38. Schell S, Morrongiello BA. Can older siblings learn to be better supervisors? An RCT evaluating the effectiveness of Safe
Sibs- on online training program to improve children’s supervision knowledge and behavior. Journal of Pediatric Psychology
2015; 40:756-767.

39. Morrongiello BA, Zdzieborski D, Sandomierski M, Lasenby-Lessard J. Video messaging: What works to persuade mothers to
supervise young children more closely in order to reduce injuries? Social Science & Medicine 2009;68(6):1030-1037.

40. Morrongiello BA, Zdzieborski D, Sandomierski M, Munroe K. A randomized controlled trial (RCT) evaluating the efficacy of
the Supervising for Home Safety Program: Impact on mothers’ supervision practices. Accident Analysis & Prevention 2013;
50:587-595.

41. Morrongiello BA, Hou S, Bell M, Walton K, Fillion A, Haines, J. Supervising for Home Safety program: A randomized
controlled trial testing community-based group delivery. Journal of Pediatric Psychology 2017; 42: 768-778.

42. Budd KS, Holdsworth MJ. Issues in clinical assessment of minimal parenting competence. Journal of Clinical Child Psychology
1996;25(1):2-14.

43. Coohey C. Defining and classifying supervisory neglect. Child Maltreatment 2003;8(2):145-156.

44. Morrongiello BA, Dayler L. A community-based study of parents’ knowledge, attitudes and beliefs related to childhood
injuries. Canadian Journal of Public Health 1996;87(6):383-388.

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Parent-Child Relationships in Early Childhood and
Development of Anxiety & Depression
Jennifer L. Hudson, PhD

Centre for Emotional Health, Department of Psychology, Macquarie University, Australia

December 2014, 2e éd.

Introduction

Parents play a substantial role in shaping children’s emotional health, particularly in early
childhood.1 To better understand the impact of the parent-child relationship on the development
of anxiety and depression in young children, research has focused on three main constructs 1)
the degree to which a parent may be overprotective and/or critical, 2) parental modelling of
anxiety and 3) the security of the child’s attachment to his or her caregivers.

Subject

One of the key factors involved in the maintenance of anxiety disorders is the degree to which
the child avoids feared situations. Parenting behaviours, such as overprotection, that serve to
accommodate or enhance avoidant strategies are likely to impact on the maintenance and
development of anxiety disorders.2 Overprotective and overinvolved parenting is likely to lead to
reduced opportunities for the child to approach new and potentially fearful situations. By reducing
these opportunities, it is theorised that the child is less able to habituate to the perceived threat
in these situations, less able to learn to accurately detect threat in new situations and less likely
to learn they can cope with difficult situations. Another parenting style that has received
attention with respect to the development of emotional health problems is critical parenting.
Critical parenting has been consistently associated with depression and, to a lesser extent,
anxiety.3-5 It is hypothesized that parents who criticise and minimise the child’s feelings,
undermine the child’s emotion regulation and increase their sensitivity to emotional health
problems such as anxiety and depression.

Parental modelling of fearful behaviour and avoidant strategies is also likely to increase a child’s
risk of developing later emotional health problems.6 An anxious parent may be more likely to
model anxious behaviour or may provide threat and avoidant information to their child,
increasing the child’s risk of anxiety disorder. It is theorised that the impact of an anxious parent,

©2014-2021 CEDJE | PARENTING SKILLS 68

as well as an overprotective and critical parent, may be exacerbated in the context of a child with
an inhibited temperament.2

Finally, an insecure parent-child attachment has also been identified as a risk factor for the
development of anxiety disorders.7 Attachment is defined as the intimate emotional bond that
forms between a child and caregiver and different patterns of attachment have been identified.8
An insecure, in contrast to a secure, attachment is one in which the child experiences the
caregiver as unpredictable or does not experience comfort from the relationship. Attachment
theorists propose that an insecure attachment occurs when the caregiver is unresponsive and
insensitive to the child’s needs. It is an insecure attachment that has been associated with
anxiety and depression.7,9-11 It has been proposed that children with an insecure attachment are
not able to develop adequate emotion regulation skills or a positive sense of self.

Problems

A significant problem arising in this area of study is the accurate assessment of the parent-child
relationship. Early research examining overprotective and critical parenting focused on
retrospective reports from adults with anxiety and depression, leading to potentially biased
reports.12 More recently, researchers have used observational methods to assess parental
overprotection and negativity.13 Observational methods however, are not without problems, as
parents may behave more positively when being observed in a research laboratory or at home.

Research Context

The majority of studies examining the relation between parenting behaviour and emotional
disorders are cross-sectional in design thus limiting their ability to test causality. A few
longitudinal studies, along with a small number of experimental studies, have recently emerged
allowing an improved estimate of the causal impact of parenting behaviour on emotional health.
The majority of this research focuses on school-aged children with few studies investigating
parent interactions with younger children.

Key Research Questions

1. What parenting behaviours are associated with anxiety and depression in early childhood?

2. Is there a causal relationship between parenting behaviours and anxiety and depression in
early childhood?

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 3. Is the impact of parenting behaviours greater for children with an inhibited temperament?
In other words, do these parenting behaviours increase the risk of emotional health
problems in all children or only in children already at risk for anxiety (e.g., inhibited
children)?

Recent Research Results

Longitudinal studies have recently emerged showing that overprotective parenting in early
childhood is associated with later anxiety disorders.14 For example, Hudson and Dodd15 followed a
group of inhibited and uninhibited children from the age of 4 years. In this study, children’s
anxiety at age 9 was predicted by the child’s anxiety and inhibition at age 4 but also by the
mother’s anxiety and the mother’s overprotective behaviour: Greater maternal anxiety and
maternal over-involvement predicted greater child anxiety.  This finding has also been
demonstrated in a number of other studies. In this study, the security of a child’s attachment and
maternal negativity did not predict later anxiety. Although these findings provide support for the
relation between parenting and later psychopathology, these effects are only likely to be small. In
support of this, a meta-analysis reported that overall parenting accounts for 4% of variance in
anxiety in school aged children and 8% in child depression.5

Although theoretical models propose that parenting behaviours should interact with a child’s
temperament to increase risk, there has been minimal support for this type of interaction.
Instead, the findings to date suggest that this relationship may in fact be additive, that is, the
parenting behaviour may increase risk for all children not just children with an inhibited
temperament.15 In contrast, Rubin and colleagues16 showed that mother’s observed intrusive
behaviour and derisive comments moderated the relation between toddler inhibited
temperament and social reticence at preschool.

With regards to parental modelling, there have been a number of studies demonstrating that
parent anxiety can be transmitted through modelling and verbal transmission of threat and
avoidant information.17,18 In one experimental study, young infants showed increased fearfulness
and avoidance of a stranger following exposure to a socially-anxious mother-stranger interaction.19
In this study, the effect was stronger for children with an inhibited temperament.

Research Gaps

The majority of research to date has focused almost exclusively on mothers. Knowledge about

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the role of fathers in the development of anxiety and depression in early childhood is limited.
Fathers may in fact play a unique role in preventing the development of emotional health
problems through encouraging risk-taking and encouraging ‘rough and tumble’ play. Further
research investigating the role of fathers is needed.

Although some longitudinal research has emerged, further research is needed to assess the
causal role of these parenting behaviours in the development of emotional health problems as
well as the possible interactions between temperament and parenting. One of the difficulties of
research examining the transmission of anxiety from parent to child is to examine the impact of
parenting or parental modelling independent of the influence of shared genes.

Conclusions

Parenting has a small but significant impact on the development of anxiety and depression in
young children. The most consistent evidence for this relationship has come from research
examining maternal overprotection and child anxiety. Research has demonstrated a clear link
between maternal overprotection and anxiety disorders in young children. Evidence for the
causal nature of this relationship has started to emerge but further research is still needed to
better understand the intricacies of this relationship and, particularly, its bidirectional nature.
Theories propose that certain parenting behaviours should have a greater impact in the presence
of an inhibited child but the empirical evidence for this has yet to be convincing.

Another body of research has demonstrated that parents can have an impact on their child
through modelling anxiety. The degree to which a parent behaves in an anxious manner by either
showing fearful or avoidant behaviours or by communicating threat to the child has been shown
empirically, in a number of experimental studies, to impact on subsequent child emotion and
behaviour. Longitudinal research which shows the impact of this modelling, over and above the
influence of shared genes is needed.

The security of a child’s attachment with their parent has been linked to later psychopathology.
Given the overlap with other constructs (such as the child’s temperament, other parenting
behaviours) the degree to which attachment independently predicts child outcome is uncertain.

Implications for Parents, Services and Policy

Understanding which parenting behaviours increase a child’s risk for later emotional health

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problems has direct implications for early intervention. The findings to date suggest that reducing
overprotective parenting and reducing parent anxiety (and hence anxious modelling and verbal
transmission of threat and avoidance) would be important in preventing later emotional health
problems. Theoretical models predict that parenting strategies should be aimed at parents of
inhibited children, however empirical evidence has yet to fully support this notion and would
suggest that all parents should be taught to use strategies to increase a child’s autonomy (rather
than overprotective strategies). Still, there remains an argument for specifically targeting parents
of at-risk children. With risk being so far identified as additive (rather than multiplicative),
overprotective parenting increases an inhibited child’s already high-risk status. For a child who is
uninhibited, the increased risk conferred by an overinvolved parent may be inconsequential.
Thus, targeting parents of inhibited preschool children may prove to be a more beneficial
approach. 

References

1. Gar NS, Hudson JL, Rapee RM. Family Factors and the Development of Anxiety Disorders. Psychopathology and the family.
New York, NY: Elsevier Science; US; 2005:125-145.

2. Hudson JL, Rapee RM. From Temperament to Disorder: An Etiological Model of Generalized Anxiety Disorder. In: Heimberg
RG, Turk CC, Menin DS, eds. Generalized Anxiety Disorder: Advances in Research and Practice. New York: Guildford Press;
2004.

3. Wood JJ, McLeod BD, Sigman M, Hwang W-C, Chu BC. Parenting and childhood anxiety: Theory, empirical findings, and
future directions. Journal of Child Psychology and Psychiatry. Jan 2003;44(1):134-151.

4. McLeod BD, Wood JJ, Weisz JR. Examining the association between parenting and childhood anxiety: A meta-analysis. 
Clinical Psychology Review Vol 27(2) Mar 2007, 155-172; 2007.

5. McLeod BD, Weisz JR, Wood JJ. Examining the association between parenting and childhood depression: A meta-analysis. 
Clinical Psychology Review. Dec 2007;27(8):986-1003.

6. Rapee R. Family Factors in the Development and Management of Anxiety Disorders. Clin Child Fam Psychol Rev.
2012/03/01 2012;15(1):69-80.

7. Warren SL, Huston L, Egeland B, Sroufe L. Child and adolescent anxiety disorders and early attachment. Journal of the
American Academy of Child & Adolescent Psychiatry. May 1997;36(5):637-644.

8. Ainsworth MDS, Blehar MC, Waters E, Wall S. Patterns of attachment: A psychological study of the strange situation.
Hillsdale, NJ: Erlbaum; 1978.

9. Shamir-Essakow G, Ungerer JA, Rapee RM. Attachment, Behavioral Inhibition, and Anxiety in Preschool Children. Journal of
Abnormal Child Psychology. 2005;33(2):131-143.

10. Bogels SM, Brechman-Toussaint ML. Family issues in child anxiety: Attachment, family functioning, parental rearing and
beliefs. Clinical Psychology Review. Nov 2006;26(7):834-856.

11. Muris P, Mayer B, Meesters C. Self-reported attachment style, anxiety, and depression in children. Social Behavior &
Personality. 2000;28(2):157-162.

12. Rapee RM. Potential role of childrearing practices in the development of anxiety and depression. Clinical Psychology Review

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 . 1997;17(1):47-67.

13. Hudson JL, Rapee RM. Parent-child interactions and anxiety disorders: An observational study. Behaviour Research and
Therapy. Dec 2001;39(12):1411-1427.

14. Edwards SL, Rapee RM, Kennedy S. Prediction of anxiety symptoms in preschool-aged children: examination of maternal
and paternal perspectives. Journal of Child Psychology and Psychiatry. 2010;51(3):313-321.

15. Hudson JL, Dodd HF. Informing Early Intervention: Preschool Predictors of Anxiety Disorders in Middle Childhood. PLoS ONE.
2012;7(8):e42359.

16. Rubin KH, Burgess KB, Hastings PD. Stability and Social-Behavioral consequences of toddlers' inhibited temperament and
parenting behaviors. Child Development, 2002; 73 (2): 483-495.

17. Field A, Lawson J. Fear information and the development of fears during childhood: Effects on implicit fear responses and
behavioural avoidance. Behaviour Research and Therapy. Nov 2003;41(11):1277-1293.

18. Gerull FC, Rapee RM. Mother knows best: The effects of maternal modelling on the acquisition of fear and avoidance
behaviour in toddlers. Behaviour Research & Therapy. Mar 2002;40(3):279-287.

19. de Rosnay M, Cooper PJ, Tsigaras N, Murray L. Transmission of social anxiety from mother to infant: An experimental study
using a social referencing paradigm. Behaviour Research and Therapy. 2006;44(8):1165-1175.

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Parent Management Training Interventions for
Preschool-Age Children
Robert J. McMahon, PhD

Simon Fraser University and Child & Family Research Institute, Canada
March 2015, 3e éd. rév.

Introduction

There is a substantial and growing body of evidence concerning the important role that familial
risk factors play in facilitating young children’s entry and progression along the “early-starter”
pathway of conduct problems. This pathway is characterized by three elements: the onset of
conduct problems (such as developmentally excessive levels of aggression, noncompliance, and
other oppositional behaviour) in the preschool and early school-age years; a high degree of
continuity throughout childhood and into adolescence and adulthood; and a poor prognosis.1,2 The
most comprehensive family-based formulation for the early-starter pathway has been the
coercion model developed by Patterson and his colleagues.3,4 The model describes a process of
“basic training” in conduct-problem behaviours that occurs in the context of an escalating cycle
of coercive parent-child interactions in the home, beginning prior to school entry. The proximal
cause for entry into the coercive cycle is thought to be ineffective parental management
strategies, particularly in regard to child compliance with parental directives during the preschool
period. Types of parenting practices that have been closely associated with the development of
child conduct problems include inconsistent discipline, irritable explosive discipline, low
supervision and involvement, and inflexible rigid discipline.5 As this process of ineffective parent
management continues over long periods, significant increases in the rate and intensity of child
coercive behaviours occur as family members are reinforced by engaging in aggressive
behaviours. Coercive interactions with siblings can also play a role in the development and
maintenance of conduct problems.6 Other family risk factors that may have direct or indirect
effects on parenting practices include maladaptive social cognitions, personal (e.g., antisocial
behaviour, substance use, maternal depression) and interparental (e.g., marital problems)
distress, and greater social isolation (e.g., insularity).1,7

Subject 

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Parent Management Training (PMT) can be defined as an approach to treating child behaviour
problems by using “procedures in which parents are trained to alter their child’s behavior in the
home. The parents meet with a therapist or trainer who teaches them to use specific procedures
to alter interactions with their child, to promote prosocial behavior, and to decrease deviant
behavior.”8 PMT has been applied to a broad array of child problems and populations, but it has
been primarily employed in the treatment of preadolescent (i.e., preschool- to school-age)
children who exhibit overt conduct-problem behaviours such as temper tantrums, aggression, and
excessive noncompliance, and it is in this area that PMT has the greatest empirical support. This
article will focus on PMT interventions for preschool-age (three to five years old) children who
engage in excessive levels of overt conduct problems. 

The underlying assumption of social learning–based PMT models is that some sort of parenting
skills deficit has been at least partly responsible for the development and/or maintenance of the
conduct-problem behaviours. The core elements of the PMT model include the following
approaches: First, intervention is conducted primarily with the parents, with relatively less
therapist-child contact. Second, therapists refocus parents’ attention away from conduct-problem
behaviour toward prosocial goals. Third, the content of these programs typically includes
instruction in the social learning principles underlying the parenting techniques. Parents are
trained in defining, monitoring, and tracking child behaviour; in positive reinforcement
procedures, including praise and other forms of positive parent attention and token or point
systems; in extinction and mild punishment procedures, such as ignoring, response cost, and
time out in lieu of physical punishment; in giving clear instructions or commands; and in problem
solving. Finally, in the PMT approach, therapists make extensive use of didactic instruction,
modelling, role playing, behavioural rehearsal, and structured homework exercises to promote
effective parenting.8-10

Problems 

Despite the increasing emphasis on the use of evidence-based practice in this area,11,12 the
overwhelming majority of commercially available family-based interventions have never been
evaluated in a systematic and rigorous manner. Yet these programs are widely used, and their
numbers increase each year. 

The picture is more positive with respect to social learning-based PMT interventions. However,
although the short-term efficacy of PMT in producing changes in both parent and child behaviours

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has been demonstrated repeatedly (see below), PMT is not effective with all families. First, as
with other types of treatment for children, dropouts occur, with average rates approximating 28
percent.13 Second, for families that do stay engaged, PMT interventions have demonstrated their
generalizability (e.g., to the home, over time, to other children in the family) and social validity
(i.e., whether therapeutic changes are “clinically or socially important” for the client14) to varying
degrees ― some quite impressively, others to a moderate degree, and others not at all.12 

Third, although there are some data about various child and family characteristics that predict
outcome (e.g., socioeconomic disadvantage, severity of child behaviour, maternal adjustment
problems, treatment barriers), there has been a relative dearth of attention paid to a) the actual
processes of change that are induced by PMT and b) whether there are certain subgroups (e.g.,
based on child gender or minority status or family socioeconomic status) for whom PMT is more
or less effective.15-17

Research Context

In the past 45 years, hundreds of studies focusing on PMT with children with conduct problems
have appeared.10-12,15-18 Study designs have ranged from case descriptions, single-case designs,
and simple pre- to post-treatment evaluations to large-scale, randomized controlled trials with
various control and alternative treatment comparison conditions. In general, the methodological
sophistication of many of these evaluations is quite high.7,11,15-16

Key Research Questions 

1. What is the evidence for the efficacy, generalization, and social validity of PMT interventions
with young children?

2. What are the mechanisms by which changes in child behaviour are achieved? 

3. Is PMT differentially efficacious a) for various subgroups of children, parents, or families and
b) as a function of the form and type of the PMT intervention itself?  If not, are subgroup-
specific interventions needed to improve the intervention? 

4. What is the best way to disseminate evidence-based PMT interventions to the broader
community (locally and internationally) so that they are employed with reasonable fidelity
but with allowance for necessary site-specific adaptations?

Research Results 

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Efficacy, generalization, and social validity

PMT interventions with preadolescent (including those age five years and younger) children have
been the focus of the largest and most sophisticated body of intervention research with children
with conduct problems, and present the most promising results. PMT interventions have been
successfully utilized in the clinic and home settings, have been implemented with individual
families or with groups of families, and have involved some or all of the instructional techniques
listed above. Self-administered PMT interventions can be effective with certain families, although
other families may require more intensive interventions.16,19 Immediate treatment outcome has
been quantified by changes in parental behaviour (e.g., less directive, controlling, and critical,
and more positive), child behaviour (e.g., less physically and verbally aggressive, more compliant,
and less destructive), and parental perceptions of the children’s adjustment, with effect sizes
ranging from medium for parent behaviour and adjustment to medium to large for child
behaviour.16,20-22 One meta-analytic study23 found that teaching parents to interact positively with
their children and requiring parents to practice with their child during treatment sessions were
associated with more positive parenting and child outcomes. Emotion communication skills also
were associated with positive parenting outcomes, and teaching parents to use time out correctly
and to respond consistently to the child were associated with positive child outcomes. Recent
reviews11,12 have identified a number of PMT interventions that have a strong evidence base for
improving conduct-problem behaviour in preschool-age children, including Helping the
Noncompliant Child,24 the Incredible Years,25 Parent-Child Interaction Therapy,26 Parent
Management Training-Oregon,27 and Triple P (Positive Parenting Program).28

Generalization of positive intervention effects to the home, over significant follow-up periods (up
to 14 years post-treatment and longer), to untreated siblings, and to untreated behaviours has
been demonstrated for many of these interventions as well. The social validity (e.g., consumer
satisfaction, improvement to the normative range) of these effects has also been documented.
For example, in their meta-analytic review of parent training, Serketich and Dumas22 reported
that 17 of 19 intervention groups dropped below the clinical range after treatment on at least one
measure, and 14 groups did so on all measures. Furthermore, the five PMT programs noted above
have been positively evaluated in comparison with no-treatment, waiting-list, and/or attention-
placebo control conditions, as well as with alternative family-based treatments29 and available
community mental health services.30

Mechanisms

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Changes in parenting behaviour have now been shown in several studies to mediate the effects
of PMT with young children with conduct problems.15 This is a critical finding that goes to the core
of PMT, as improvement in parenting behaviour is hypothesized to be the central mechanism by
which change in child behaviour occurs. However, it is important to note that the majority of
studies reviewed did not find support for parenting behaviour as a mediator.15

Moderation

In general, there has been a dearth of attention paid to the extent to which PMT may be
differentially efficacious with different subgroups of children, parents, and families, or as a
function of different aspects of PMT (e.g., treatment delivery mode). Candidates as possible
moderators of efficacy include child characteristics such as severity of the child’s conduct-
problem behaviour, extent of comorbid problems (e.g., ADHD, anxiety/depression, callous-
unemotional (CU) traits), age, gender, and minority status. Examples of parent and family
characteristics that might serve as potential moderators include personal and marital adjustment,
single-parent status, and family socioeconomic status. A meta-analytic study that examined
moderators of PMT found that less severe child conduct problems, single-parent status, economic
disadvantage (i.e., low socioeconomic status), and group-administered (as opposed to
individually-administered) PMT resulted in poorer child behaviour outcomes in PMT.16
Interestingly, child age was not a significant moderator. Lundahl et al.16 reported that among
disadvantaged families, individual PMT was associated with more positive child and parent
behavioural outcomes than group PMT. Child gender does not appear to moderate PMT outcomes,
although the research is limited. 

One area of current research interest is the extent to which PMT is efficacious with a subgroup of
children with early starting conduct problems who also display CU traits (or limited prosocial
emotions in the DSM-531). CU traits are characterized by a lack of regard for others’ feelings,
deficient guilt associated with wrongdoing, restricted emotionality, and a lack of concern about
performance, and are associated with a significantly poorer prognosis than for other children with
early starting conduct problems.32 Children with conduct problems and elevated levels of CU traits
do not respond as well to traditional PMT interventions as do other children with conduct
problems. In a recent review, CU traits were associated with poorer outcomes from PMT in 81% (9
of 11) of the studies.33 However, it is also the case that these children do respond to PMT, but to a
lesser degree than other children. Furthermore, two studies have documented decreases in CU
traits (in addition to decreases in conduct problems) as a function of PMT.34,35 It has been

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suggested that additional emphasis be placed on the promotion of parental warmth and positive
reinforcement in PMT interventions with these children.33

Effectiveness/dissemination

Large-scale effectiveness trials of PMT as well as cross-cultural dissemination studies are

becoming increasingly more common. These research efforts provide essential information on
transporting these interventions to real-world settings and the feasibility of utilizing PMT
interventions with diverse populations. Michelson et al.36 meta-analysis demonstrated that PMT
worked when conducted in “real-world” settings, as indicated by a) clinic-referred samples, b)
non-specialist therapists, c) routine settings, and d) as part of a routine service. Cross-cultural
effectiveness trials of the Incredible Years, Triple P, and Parent Management Training-Oregon
programs have been conducted  in Europe, Asia, Australia, and North America.30,37-40 Triple P is
currently being implemented in more than 20 countries.28 Efforts to establish PMT in developing
countries are also currently underway.41  

Conclusions

A PMT approach to intervention for young children with conduct problems is arguably the
intervention of choice, given the substantial empirical support for efficacy, generalization, and
social validity. There is also increasing empirical support for the premise that change in parental
behaviour is a key mechanism in producing child behaviour change. Meta-analytic research
suggests that the efficacy of PMT for child behaviour change is less for economically
disadvantaged and single-parent families and for children with CU traits; greater when
administered to children with more severe conduct problems and to individual families rather
than in groups; and is comparable in efficacy for boys and girls and for majority and minority
samples. Large-scale effectiveness and dissemination trials, many of them in international
settings, are providing important information concerning the feasibility of implementing PMT
interventions in the real world.

Implications 

As a first step, it is critical that policy-makers choose PMT programs that have an adequate
empirical base. Reference to key reviews7,11,12 can be a useful starting point for the identification of
potential PMT interventions. 

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With respect to delivery systems, group-based PMT can be a cost-effective alternative to working
with individual families in some instances, although PMT with individual families may be more
efficacious, especially with economically disadvantaged families. In some cases, self-administered
PMT may be sufficient. Guidelines for the selection of particular modes of PMT are needed. 

Interest in interventions for the prevention of conduct problems has burgeoned over the past 25
years, stimulated partly by increased knowledge about the early-starter pathway of conduct
problems. PMT may have significant preventive effects, especially if it is applied during the
preschool period,42 or is a component of broader preventive interventions for school-age children
at risk for conduct problems.43,44 An integrative review of 26 reviews and meta-analyses (1,075
studies) published between 1990 and 2008 found that PMT interventions had a larger effect size
than either child focused or school/community based interventions (ds = .56,.41, and .28,
respectively).45 If PMT can play a role in the prevention of conduct problems, that will have
important implications for reducing the need for ongoing interventions throughout the
developmental period and adulthood.

One of the more compelling reasons for the utilization of PMT on a large scale is its potential
economic benefit. Children with early starting conduct problems are likely to incur significant
economic consequences. It has been estimated that the potential value of saving a single youth
from a criminal career ranges from $3.2 to $5.5 million.46 The empirical support for PMT, the
availability of manuals (which assists in standardized use and dissemination) for many PMT
programs and multiple-level delivery systems, and its potential for preventive effects are all
conducive to significant economic savings. When analyzed as part of a cost-benefit study
conducted by the Washington State Institute of Public Policy,47 benefit-to-cost ratios ranged from
1.20 to 5.63 for the Incredible Years, Parent-Child Interaction Therapy, and Triple P (i.e., for every
dollar spent, savings ranged from $1.20 to more than $5).

Despite this very positive evaluation of PMT as an intervention for young children with conduct
problems, there are a number of areas that warrant continued and increased attention. These
include: a) development of treatment selection guidelines; b) continued emphasis on
identification and elaboration of the processes of family engagement and change in PMT;48 c)
examination of strategies for enhancing outcome and generalization of effects, especially with
respect to underserved groups; d) the role of PMT as a preventive intervention; and e) greater
attention to the conceptual, empirical, and pragmatic issues that are involved in large-scale
dissemination.49 Incorporating innovative technologies in the design, delivery, and enhancement

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of PMT (e.g., via the internet and smartphone apps) is particularly promising.50 

References

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30. Taylor TK, Schmidt F, Pepler D, Hodgins C. A comparison of eclectic treatment with Webster-Stratton’s parents and
children’s series in a children’s mental health center: A randomized controlled trial. Behavior Therapy 1998;29(2):221-240.

31. American Psychiatric Association. Diagnostic and statistical manual of mental disorders 5th ed. (DSM-5). Washington, DC:
American Psychiatric Publishing; 2013.

32. Frick PJ, Ray JV, Thornton LC, Kahn RE. (2014). Can callous-unemotional traits enhance the understanding, diagnosis, and
treatment of serious conduct problems in children and adolescents? A comprehensive review. Psychological Bulletin
2014;140(1):1-57.

33. Hawes DJ., Price MJ, Dadds MR. Callous-unemotional traits and the treatment of conduct problems in childhood and
adolescence: A comprehensive review. Clinical Child and Family Psychology Review 2014;17(3):248-267.

34. McDonald R, Dodson MC, Rosenfield D, Jouriles EN. Effects of a parenting intervention on features of psychopathy in
children. Journal of Abnormal Child Psychology 2011;39(7):1013-1023.

35. Somech LY, Elizur Y. Promoting self-regulation and cooperation in pre-kindergarten children with conduct problems: A
randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry 2012;51(4):412-422.

36. Michelson D, Davenport C, Dretzke J, Barlow J, Day C. Do evidence-based interventions work when tested in the ‘‘real
world?’’ A systematic review and meta-analysis of parent management training for the treatment of child disruptive
behavior. Clinical Child and Family Psychology Review 2013;16(1):18-34.

37. Scott S, Spender Q, Doolan M, Jacobs B, Aspland H. Multicentre controlled trial of parenting groups for childhood antisocial
behaviour in clinical practice. British Medical Journal 2001;323(7306):194-197.

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 38. Leung C, Sanders MR, Leung S, Mak R, Lau J. An outcome evaluation of the implementation of the Triple P-Positive
Parenting Program in Hong Kong. Family Process 2003;42(4):531-544. 

39. Ogden T, Amlund Hagen K. Treatment effectiveness of parent management training in Norway: A randomized controlled
trial of children with conduct problems. Journal of Consulting and Clinical Psychology 2008;76(4):607-621.

40. Zubrick SR, Ward KA, Silburn SR, Lawrence D, Williams AA, Blair E, Robertson D, Sanders MR. Prevention of child behavior
problems through universal implementation of a group behavioral family intervention. Prevention Science 2005;6(4):287-
304.

41. Mejia A, Calam, C, Sanders MR. A review of parenting programs in developing countries: Opportunities and challenges for
preventing emotional and behavioral difficulties in children. Clinical Child and Family Psychology Review 2012;15(2):163-
175.

42. Reid JB. Prevention of conduct disorder before and after school entry: Relating interventions to developmental findings.
Development and Psychopathology 1993;5(1-2):243-262.

43. Conduct Problems Prevention Research Group. Impact of early intervention on psychopathology, crime, and well-being at
age 25. American Journal of Psychiatry 2015;172(1):59-70.

44. Tremblay RE, Vitaro F, Bertrand L, LeBlanc M, Beauchesne H, Boileau H, David L. Parent and child training to prevent early
onset of delinquency: The Montreal longitudinal-experimental study. In: McCord J, Tremblay RE, eds. Preventing antisocial
behavior: Interventions from birth through adolescence. New York, 

45. Beelmann A, Raabe T. The effects of preventing antisocial behavior and crime in childhood and adolescence: Results and
implications of research reviews and meta-analyses. European Journal of Developmental Science 2009;3(3):260-281.

46. Cohen MA, Piquero AR. New evidence on the monetary value of saving a high risk youth. Journal of Quantitative Criminology
2009;25(1):25-49.

47. Lee S, Aos S, Drake E, Pennucci A, Miller M, Anderson L. Return on investment: Evidence-based options to improve
statewide outcomes, April 2012 (Document No. 12-04-1201). 2012; Olympia: Washington State Institute for Public Policy.

48. Nock MK, Ferriter C. Parent management of attendance and adherence in child and adolescent therapy: A conceptual and
empirical review. Clinical Child and Family Psychology Review 2005;8(2):149-166. 

49. Turner KMT, Sanders MR. Dissemination of evidence-based parenting and family support strategies: Learning from the
Triple P – Positive Parenting Program system approach. Aggression and Violent Behavior 2006;11(2):176-193. 

50. Jones DJ, Forehand R, Cuellar J, Kincaid C, Parent J., Fenton N, Goodrum N. Harnessing innovative technologies to advance
children’s mental health: Behavioral parent training as an example. Clinical Psychology Review 2013;33(2):241-252.

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Social-Contextual Determinants of Parenting
Jay Belsky, PhD

University of California, Davis, USA

December 2014, Éd. rév.

Introduction

By tradition, students of socialization have directed their primary energies toward understanding
processes whereby parents’ child-rearing strategies and behaviours influence children’s
development. An abundance of mostly correlational (but some experimental) evidence
underscores parenting practices that, in general, promote child well-being. In the infant-toddler
years, these take the form of sensitive-responsiveness, which is known to foster attachment
security,1 and mutually-positive parent-child relations, which themselves promote child
cooperation, compliance and conscience development.2 In the preschool through adolescent
years, authoritative (vs. neglectful) parenting that mixes high levels of warmth and acceptance
with firm control and clear and consistent limit-setting fosters prosocial orientation, achievement
striving, and positive peer relations.3,4,5 Across childhood and adolescence, then, parenting that
treats the child as an individual, respecting developmentally-appropriate needs for autonomy,
and which is not psychologically intrusive/manipulative or harshly coercive contributes to the
development of the kinds of psychological and behavioural “outcomes” valued in the western
world.

Research Question

The fact that not all parents engage in such generally growth-promoting child-rearing raises a
fundamental question: Why do parents parent the way they do? Whereas the earliest work on this
topic emphasized the socio-economic status of parents and the way in which (maltreating)
parents were themselves reared, subsequent work, guided principally by Belsky’s6 process model
of the determinants of parenting, highlights social-contextual factors and forces that shape
parenting.7 These include (a) attributes of children; (b) the developmental history of parents and
their own psychological make-up; and (c) the broader social context in which parents and this
relationship are embedded. 

Research Results

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Virtually all the work to be considered derives from correlational (and sometimes longitudinal)
studies linking some putative determinant with some feature of parenting. As such, most of the
work fails to account for the fact that parenting, like so much of behavioural functioning, is itself
heritable.8,9 Thus, findings to be summarized linking social-contextual “determinants” and
parenting “outcomes” illuminate potential causal processes rather than confirm them. 

Characteristics of children

It has long been presumed that hard-to-manage, negatively emotional and demanding children
are not only more likely to develop behaviour problems, especially of the externalizing variety,
but do so because of the hostile-intrusive or even detached-uninvolved parenting they evoke. A
number of investigations do link infant or child negativity/difficulty with less supportive, if not
problematic parenting,10,11 and greater sensitive-responsiveness and warmth on the part of
parents with  greater  positive emotionality,11 prosocial behaviour12,13 and social competence14 on
the part of children. Pike and associates15 found, in fact, that more negative, irritable or
aggressive adolescents received more negative parenting even after accounting for heritability.
Such results are in line with experiments manipulating negative child behaviour to investigate its
causal effect on parenting.16 Such experimental efforts to document truly causal effects have not
been undertaken with positive child behaviour. All this is not to say, however, that variation in
parenting is exclusively – or even primarily – a function of child temperament/behaviour, only that
it makes a contribution, especially when considered in the context of other sources of influence.7

Characteristics of parents

Research on the etiology of child maltreatment called attention to the role of child-rearing history
in shaping parenting. What has become clear, however, is that the intergenerational transmission
of parenting, whether maltreating or growth-promoting, is by no means inevitable.7,17,18
Nevertheless, in the main, both harsh19,20,21,22 and supportive parenting23,24,25 tend to be transmitted
down generational lines, in the case of mothers, fathers or both.

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Psychological attributes of parents also influence the way parents manage their children.26
Indeed a meta-analysis of 30 studies focused on the Big 5 personality characteristics involving
almost 6,000 parent-child dyads revealed that higher levels extraversion, agreeableness,
conscientiousness and openness to experience and lower levels of neuroticism were related to
greater warmth and behavioural control on the part of parents, whereas higher levels of
agreeableness and lower levels of neuroticism were related to the provision of more support for
autonomy;27 somewhat similar results emerged in a related meta-analysis that also examined the
influence of parental psychological problems on parenting.28

There is reason to believe that these personality characteristics shape parenting by influencing
the emotions parents experience and/or the attributions they make about the causes of child
behaviour (e.g., crying is caused by tiredness or by a desire to manipulate the parent).7,29
The possibility must be entertained, as well, that these processes are themselves a product of
how parents were raised by their own parents.6,30 

The social context: marital/partner relationships

Evidence dating back to at least the 1930s linking troubled marriages and child behaviour
problems led to the hypothesis that while some of the association between marital processes and
child functioning is direct and unmediated via parenting,31 some of it derives from the effect of
marriage on parenting.6,32,33,34 

One way in which marriages affect parenting involves emotions, be they positive or negative,
spilling over from one relationship to affect the other,10 though compensatory mechanisms also
seem to be at work in some families, with problems in the marriage fostering more sensitive and
involved parenting.35 In some cases this probably reflects efforts to protect the child from marital
stress,36 though in other cases it may reflect developmentally inappropriate enmeshment,
whereby adults use the parent-child relationship to meet unmet emotional needs.37 Anger in the
marriage can also promote parental withdrawal,38 something that children can perceive as
rejection. But it is also the case that spousal withdrawal from partner conflict can engender
hostile and intrusive parenting.38,39,40 The fact that marriage-parenting linkages are so varied
probably explains why simple marriage-parenting correlations are not always as strong as might
be expected.23,36

Conclusion

Almost 25 years ago now Belsky6 argued that parenting is multiply determined by a variety of
factors and forces and that weakness or strength in any one was unlikely to determine how

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parents behaved, as the positive contribution of the latter buffered the undermining effect of the
former. Thus, what was most important to understanding why parents parented the way they did
was the accumulation of stresses and supports or, in developmental-psychopathology
terminology, risk and protective factors.41 Therefore, while the cited evidence calls attention to
some of the social-contextual determinants of parenting, these need to be considered “in
context,” i.e. in the context of other determinants, only some of which have been discussed.

New theory and research also warns against over interpreting the findings summarized here and
the general conclusions drawn regarding social-contextual forces shaping parental behaviour.
And this is because differential-susceptibility theory, along with ever-emerging evidence
consistent with it, stipulates that individuals vary in their susceptibility to environmental effects.
42,43,44
What this implies with regard to the determinants of parenting is that not all parents will
prove equally affected by characteristics of their children and/or the marital/partner
relationship—and so much more. Perhaps the most compelling evidence to this effect comes from
Dutch research indicating that the anticipated effects of daily hassles on sensitive parenting was
most pronounced in parents with a combination of genes leading to the least efficient
dopaminergic system functioning (COMT val/val or val/met, DRD4-7Repeat). Indeed, and
consistent with the differential-susceptibility hypothesis, more daily hassles were associated with
less sensitive parenting, whereas lower levels of daily hassles were associated with more
sensitive parenting, but only among such parents, not those who did not fit this genetic profile.45
One implication of this observation and differential-susceptibility thinking more generally is that
evidence cited highlighting effects of child behaviour and marital/partner relationships on
parenting likely over- and under-estimates such effects, as it fails to take into consideration
variation in susceptibility on the part of parents. Thus, the research over estimates effects in the
case of those less susceptible and under estimates effects for those more susceptible, clearly
implying that future work needs to consider variation in susceptibility to better illuminate the
determinants of parenting. 

Implications

The most important implication of the notion that parenting is multiply determined  is that there
should be no single way to promote growth-fostering parenting, especially among those who
prove highly susceptible to the contextual regulation of their parenting.  In some cases, the best
way may be to promote marital relationships; in other cases, it may be to shape how parents
think about the causes of child behaviour. And in still others, it may be to enable parents to better
regulate their negative emotions. Of course, if it can be done well, there is no reason not to target
multiple avenues of potential influence. 

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References

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16. Brunk MA, Henggeler SW. Child influences on adult controls: An experimental investigation. Developmental Psychology
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17. Belsky, J., Conger, R., Capaldi, D.M. (2009). The Intergenerational Transmission of Parenting: Introduction to the Special
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18. Conger, R.D., Belsky, J., & Capaldi, D.M. (2009). The Intergenerational Transmission of Parenting: Closing Comments for the
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19. Capaldi DM, Pears KC, Patterson GR, Owen LD. Continuity of parenting practices across generations in an at-risk sample: A
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 20. Conger RD, Neppl T, Kim KJ, Scaramella L. Angry and aggressive behavior across three generations: A prospective,
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21. Bailey, J.A., Hill, K.G., Oesterle, S., Hawkins, J.D. & The Social Development Research Group. (2009). Parenting practices
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22. Neppl, T.K., Conger, R.D., Scaramella, L.V., & Ontai, L.L. (2009) Intergenerational continuity in parenting behavior.
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23.    Belsky J, Fearon RMP. Exploring marriage-parenting typologies and their contextual antecedents and developmental
sequelae. Development and Psychopathology 2004;16(3):501-523.

24. Chen ZY, Kaplan HB. Intergenerational transmission of constructive parenting. Journal of Marriage and the Family
2001;63(1):17-31. 

25. Kerr, D.C.R., Capaldi, D.M., Pears, K.C., & Owen, L.D. (2009). A Prospective Three Generational Study of Fathers’
Constructive Parenting: Influences from Family of Origin, Adolescent Adjustment, and Offspring Temperament.
Developmental Psycholog, 45, 1257-1275.

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27. Prinzie, P., Stams, G.J., Dekovic, M., Reigntjes, A.H. & Belsky, J. (2009). The Relations Between Parents’ Big Five Personality
Factors and Parenting: A Meta-analytic Review. Journal of Personality and Social Psychology, 97, 351-362.

28. McCabe, J.E. (2014). Maternal personality and psychopathology as determinants of parenting behavior: A quantitative
integration of two literatures. Psychological Bulletin, 140, 722-750.

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31. Serbin L, Karp J. Intergenerational studies of parenting and the transfer of risk from parent to child. Current Directions in
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32. Wilson BJ, Gottman JM. Marital conflict, repair, and parenting. In: Bornstein MH, ed. Handbook of parenting: Social
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33. Belsky J. Early human experience: A family perspective. Developmental Psychology 1981;17(1):3-23.

34. Macfie, J., Houts, R. M., Pressel, A. S., & Cox, M. J. (2008). Pathways from infant exposure to marital conflict to
parent–toddler role reversal. Infant Mental Health Journal, 29, 297–319.

35. Emery RE. Family violence. American Psychologist 1989;44(2):321-328.

36. Cox MJ, Paley B. Families as systems. Annual Review of Psychology 1997;48:243-267.

37. Grych JH. Marital relationships and parenting. In: Bornstein MH, ed. Handbook of parenting: Social conditions and applied
parenting. Vol. 4. 2nd ed. Mahwah, NJ: Lawrence Erlbaum Associates; 2002:203-225.

38. Margolin G, Oliver PH, Medina AM. Conceptual issues in understanding the relation between interparental conflict and child
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Interparental conflict and child development: Theory, research, and applications. New York, NY: Cambridge University
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39. Lindahl KM, Malik NM. Observations of marital conflict and power: Relations with parenting in the triad. Journal of Marriage
and the Family 1999;61(2):320-330.

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 40. Katz LF, Woodin EM. Hostility, hostile detachment, and conflict engagement in marriages: Effects on child and family
functioning. Child Development 2002;73(2):636-652.

41. Cicchetti D, Toth SL. Perspectives on research and practice in developmental psychopathology. In: Sigel IE, Renninger KA,
eds. Handbook of child psychology: Child psychology in practice. Vol.4. 5th ed. New York, NY: John Wiley and Sons;
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45. van Ijzendoorn, M. H., Bakermans-Kranenburg, M. J., & Mesman, J. Dopamine system genes associated with parenting in
the context of daily hassles. Genes, Brain, and Behavior 2008;7(4):403-410.

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Parenting Programs and Their Impact on the
Social and Emotional Development of Young
Children
Daniel S. Shaw, PhD

University of Pittsburgh, USA

December 2014, 2e éd.

Introduction

Modifying parenting attitudes and behaviours has been a central focus of many programs
designed to improve the social and emotional development of young children. The impetus for
focusing on parenting is based on common sense and a large body of research demonstrating
associations between parenting in early childhood and a number of later socio-emotional
outcomes.1,2 Even before formal research studies were initiated on the effects of early
socialization practices in relation to children’s later psychosocial outcomes, many community-
based programs focused on parenting because of young children’s physical and psychological
dependence on caregivers. This emphasis on parenting has been bolstered since the 1940s, when
research on the effects of early parenting was formally initiated.3,4 Since then a plethora of
studies, including those utilizing genetically informed designs, have found associations between
caregiving behaviours in early childhood and later child outcomes.5 A number of parenting
dimensions have been associated with various types of child adjustment. On the positive side,
early caregiving characterized as sensitive, responsive, involved, proactive and providing
structure has been associated with positive socio-emotional adjustment. Conversely, parenting in
early childhood (from birth to five years) characterized as neglectful, harsh, distant, punitive,
intrusive and reactive has been associated with various types of maladjustment. In general,
parenting programs for young children have varied based on the theoretical orientation of the
intervention model (e.g. social learning,6 attachment7), the developmental status of the child (e.g.
prenatal, infancy, preschool-age), and the breadth of child behaviours targeted for intervention
(e.g. externalizing problems, social and cognitive outcomes). Some programs are held with
groups of parents,6 others work with individual parents and are typically home-based,8 while
others incorporate parenting as part of a school- or daycare-based program.9,10

Subject

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In the last 20 years, parenting programs initiated in early childhood have been increasingly
targeted at families whose children are at increased risk for poor social and emotional outcomes.
During the prenatal and infant periods, families have been identified on the basis of
socioeconomic risk (parental education, income, age8,11) and/or other family (e.g. maternal
depression) or child (e.g. prematurity and low birth weight12) risks; whereas with preschoolers a
greater emphasis has been placed on the presence of child disruptive behaviour, delays in
language/cognitive impairment and/or more pervasive developmental delays.6 With an increased
emphasis on families from lower socioeconomic strata, who typically face multiple types of
adversity (e.g. low parental educational attainment and work skills, poor housing, low social
support, dangerous neighbourhoods), many parenting programs have incorporated components
that provide support for parents’ self-care (e.g. depression, birth-control planning), marital
functioning and/or economic self-sufficiency (e.g. improving educational, occupational and
housing resources).8,13,14 This trend to broaden the scope of “parenting” programs mirrors recent
findings on early predictors of low-income children’s social and emotional skills. For children living
in poverty, although parenting has been shown to be a consistent predictor of later child
functioning, other factors in the child’s social environment have been found to contribute
independent variance to children’s adjustment, effects that are not accounted for by parenting.15
Such factors include parental age, well-being, history of antisocial behaviour, social support
within and outside the family, and beginning around age three to four in Canada’s most
impoverished communities, neighbourhood quality.16

Challenges, Research Context and Key Research Questions

Although scores of parenting programs for young children have been and are currently being
used in communities throughout North America, in only a relatively few cases has their long-term
efficacy been tested using comparison groups, much less with a randomized control trial (RCT).17,18
Thus, drawing firm conclusions about their effectiveness in improving young children’s social and
emotional outcomes is limited to a few investigators who have used more rigorous methods. Even
in cases where appropriate comparison groups have been utilized, there are a couple of
important caveats worthy of mention. First, in studies in which parents are the sole informant on
child outcomes following intervention, there is a potential for reporting bias, as parents might be
more invested in the intervention condition and motivated to report improvements in child
functioning than parents in control groups. Second, early studies that were limited to parenting
per se and that did not address other issues in the child and his/her ecology (e.g. child verbal

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skills, family’s socioeconomic context and parental well-being) found rather modest effect sizes
that tended to dissipate over time and across context (e.g. average effect sizes below .20, little
long-term generalization to child behaviour at school19). Third, and related to parenting programs
expanding to incorporate ecological factors (e.g. parental well-being, economic self-sufficiency), it
is becoming increasingly difficult to unpack the effects of specific components of multifaceted
interventions. While ideally it should remain a goal to identify and attribute changes in child
behaviour to specific changes in parenting, this aim might become less realistic to achieve as
more parenting programs apply a multisystemic perspective to targeting the multifaceted needs
of families from high-risk environments.

Recent Research Results

Rather than provide a systematic and exhaustive review of the literature, the goal is to identify
promising work and themes across studies that might lead to similar positive outcomes in future
work. As noted earlier, because of the relative dearth of studies that have randomly assigned
families to a family-based intervention, it is not a difficult task to pare down the number of
methodologically elite projects. In terms of how the design of a study might compromise the
credibility of its findings, it is important to note that effect sizes of parent support programs tend
to be consistently higher for those studies using less rigorous designs (e.g. pre-post studies
without control groups) and consistently lower for randomized studies.19 Despite these caveats,
there are emerging themes that characterize many successful programs.

Specificity does matter. Parenting programs that address specific types of child
behaviour (e.g. developmental disabilities, child conduct problems) or target specific
developmental transitions (e.g. becoming a parent, the “terrible twos”) seem to be more
successful than those that treat a wide range of problem behaviours or a wide age range of
young children.6,8,14

Covering multiple domains. Successful programs tend to emphasize parenting and

factors that might compromise its functioning, including consistent caregiving in other
contexts (e.g. preschool, daycare), and maternal well-being, the family’s economic
independence and marital quality.6,8,14

Careful training of interventionists. The most successful programs tend to devote

enormous efforts to initial training of staff and maintenance of intervention fidelity over
time.6,8 There is also some support for the use of professional staff over para-professionals,19

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 but some of this research is confounded by the quality of staff training in these studies (i.e.
the studies that tend to use professionals also tend to have more intensive training and
follow-up).

Interventionist’s ability to engage parents. Successful programs have developed ways

to maximize parents’ investment by emphasizing the importance of young children’s
development and linking it to parenting skills and parents making healthful decisions about
their own well-being.6,8,14 In addition to covering multiple domains of family life, successful
programs generally include repeated and intensive contact with parents ranging from
several months to one or two years.

Two prime examples of successful programs with young children include the programmatic work
of Olds and colleagues8,20,21 and Webster-Stratton.6,22 Despite differences in their theoretical
emphasis, timing of the intervention (prenatal period and infancy versus preschool to early school
age) and their structure (home-based, one-on-one contact versus meeting in a group format at a
clinic), the two programs share the four commonalities described above. Olds’ model engages
mothers during pregnancy and immediately following the delivery of their infant to promote
maternal health and quality of the infant-parent relationship. It has now been validated in RCTs
with three large cohorts of children at heightened risk for maladaptive outcomes.8,20,21 While
including a component to improve the quality of the mother-infant relationship (79% lower rate of
child maltreatment in intervention vs. control group), the intervention also stresses changes in
maternal health-related behaviours during pregnancy (i.e. smoking, drinking alcohol) and in
health and lifestyle choices during the child’s early years (e.g. 43% lower rates of subsequent
pregnancy, 84% higher participation in work force). Group differences have been found in several
domains at age 15, with youth in the intervention group demonstrating significantly fewer arrests
and convictions than adolescent offspring in the control group. Results from an initial study
conducted in rural New York have been followed up in Memphis and Denver, communities that
are more urban and more ethnically diverse families than the original cohort. Early follow-up
results from the Memphis sample suggest similar but more muted effects on children’s problem
behaviour (i.e. maternal but not teacher reports show intervention effects) and maternal
functioning (e.g. fewer subsequent pregnancies and a lower rate of pregnancy-induced
hypertension) up to age six. Importantly, the intervention targets multiple issues at a time of
developmental transition, including the mother’s health behaviours, the quality of the
environment parents are generating for the child (e.g. maternal work skills, number of
subsequent children born in the next couple of years), and parenting skills.

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The programmatic work of Webster-Stratton and colleagues is also notable. Whereas Olds’ work
has focused on the challenges of becoming a parent (i.e. program limited to first-time parents),
Webster-Stratton has targeted the late preschool period and the transition to formal schooling,
when children’s emotion regulation skills are becoming more stable and tested in the context of
full-day school settings.6,22 A central focus of Webster-Stratton’s program is parent management
training to promote child social competence and prevent the development of conduct problems.
In service of this goal, parents learn to observe their child’s behaviour in an objective,
unemotional manner and to implement appropriate consequences in response to disruptive
behaviour. Webster-Stratton conducts parent-training sessions in groups using carefully refined
videotapes, where parents can observe ways to manage children’s behaviour and simultaneously
learn from group leaders and other parents’ experiences. Although begun primarily as a
parenting intervention, the scope of the program has expanded to include a teacher-based
classroom management component and a child-based component to improve regulation
strategies and school readiness. In repeated RCTs with samples ranging from clinically referred
middle-class preschoolers to low-income Head Start preschoolers at risk for psychosocial
adjustment, significant improvements have repeatedly been found one to two years following the
intervention in promoting children’s prosocial adjustment and reducing children’s problem
behaviours.

Conclusions and Implications

Recent innovations in the scope of parenting programs are promising. Initial parenting programs
have evolved to incorporate findings from developmental psychopathology that highlight the
influence of child and parent attributes, as well as family and community factors that might
compromise parenting and child psychosocial development. Greater methodological care is also
becoming more normative in evaluating the efficacy of individual parenting programs, including
the increasing use of RCTs. Substantively, the data suggest that parenting programs that also
encompass the child’s and family’s social ecology, including contexts outside the home where the
child spends significant time, are more likely to be associated with lasting improvements in child
outcomes. The work of Olds and Webster-Stratton exemplifies the progress that has been made
in the field. These model programs also suggest the need to re-evaluate the appropriateness of
using the term “parenting programs” to describe the scope of successful family-based
interventions for young children. Clearly, the most promising strategies incorporate parenting as
a central foundation, but model programs also incorporate additional components to address

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critical aspects of the child’s and parents’ social context. These additions to traditional parenting
programs appear to be key ingredients for maximizing children’s potential for positive social and
emotional development within and outside the home.

References

1. Renken B, Egeland B, Marvinney D, Mangelsdorf S, Sroufe A. Early childhood antecedents of aggression and passive-
withdrawal in early elementary school. Journal of Personality 1989;57(2):257-281.

2. Shaw DS, Gilliom M, Ingoldsby EM, Nagin DS. Trajectories leading to school-age conduct problems. Developmental
Psychology 2003;39(2):189-200.

3. Baldwin AL, Kalhorn J, Breese FH. Patterns of parent behaviour. Psychological Monographs 1945;58(3).

4. Baumrind D. The development of instrumental competence through socialization. Minnesota Symposia on Child Psychology
1972;7:3-46.

5. Collins WA, Maccoby EE, Steinberg L, Hetherington EM, Bornstein MH. Contemporary research on parenting: The case for
nature and nurture. American Psychologist 2000;55(2):218-232.

6. Webster-Stratton C, Hammond M. Treating children with early-onset conduct problems: A comparison of child and parent
training interventions. Journal of Consulting and Clinical Psychology 1997;65(1):93-109.

7. Lieberman AF, Weston DR, Pawl JH. Preventive intervention and outcome with anxiously attached dyads. Child
Development 1991;62(1):199-209.

8. Olds DL. Prenatal and infancy home visiting by nurses: From randomized trials to community replication. Prevention
Science 2002;3(3):153-172.

9. Campbell FA, Ramey CT, Pungello EP, Sparling J, Miller-Johnson S. Early childhood education: Young adult outcomes from
the Abecedarian Project. Applied Developmental Science 2002;6(1):42-57.

10. Schweinhart LJ. Significant benefits: The High/Scope Perry Preschool Study through age 27. Ypsilanti, Mich: High/Scope
Press; 1993.

11. Brooks-Gunn J, McCormick MC, Shapiro S, Benasich A, Black GW. The effects of early education intervention on maternal
employment, public assistance, and health insurance: the Infant Health and Development Program. American Journal of
Public Health 1994;84(6):924-931.

12. Brooks-Gunn JC, McCarton CM, Casey PH, McCormick MC, Bauer CR, Bernbaum JC, Tyson J, Swanson M, Bennett FC, Scott
DT, Tonascia J, Meinert CL. Early intervention in low-birth-weight premature infants: Results through age 5 years from the
Infant Health and Development Program. JAMA -Journal of the American Medical Association 1994;272(16):1257-1262.

13. Gross D, Fogg L, Tucker S. The efficacy of parent training for promoting positive parent-toddler relationships. Research in
Nursing and Health 1995;18(6):489-499.

14. Shaw DS, Dishion TJ, Supplee LH, Gardner F, Arnds K. A family-centered approach to the prevention of early-onset
antisocial behaviour: Two-year effects of the family check-up in early childhood. Journal of Consulting and Clinical
Psychology. In press.

15. Shaw DS, Bell RQ, Gilliom M. A truly early starter model of antisocial behavior revisited. Clinical Child and Family
Psychology Review 2000;3(3):155-172.

16. Kohen DE, Brooks-Gunn J, Leventhal T, Hertzman C. Neighborhood income and physical and social disorder in Canada:
Associations with young children's competencies. Child Development 2002;73(6):1844-1860.

17. Reynolds AJ, Ou S-R, Topitzes JW. Paths of effects of early childhood intervention on educational attainment and

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 delinquency: A confirmatory analysis of the Chicago Child-Parent Centers. Child Development 2004;75(5):1299-1328.

18. Yoshikawa H. Long-term effects of early childhood programs on social outcomes and delinquency. The Future of Children
1995;5(3):51-75. Available at: http://www.futureofchildren.org/usr_doc/vol5no3ART3.pdf. Accessed March 6, 2006.

19. Layzer JI, Goodson BD, Bernstein L, Price C. National evaluation of family support programs. Final report. Volume A: The
meta-analysis. Cambridge, Mass: Abt Associates; 2001. Available at:
http://www.acf.hhs.gov/programs/opre/abuse_neglect/fam_sup/reports/famsup/fam_sup_vol_a.pdf. Accessed March 6, 2006.

20. Eckenrode J, Zielinski D, Smith E, Marcynyszyn LA, Henderson CR Jr, Kitzman H, Cole R, Powers J, Olds DL. Child
maltreatment and the early onset of problem behaviors: Can a program of nurse home visitation break the link?
Development and Psychopathology 2001;13(4):873-890.

21. Olds D, Hill P, Robinson J, Song N, Little C. Update on home visiting for pregnant women and parents of young children.
Current Problems inPediatrics 2000;30(4):107-141.

22. Baydar N, Reid MJ, Webster-Stratton C. The role of mental health factors and program engagement in the effectiveness of
a preventive parenting program for Head Start mothers. Child Development 2003;74(5):1433-1453.

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Parents’ Attitudes and Beliefs: Their Impact on
Children’s Development
Joan E. Grusec, PhD, Tanya Danyliuk, BA

University of Toronto, Canada

December 2014, Éd. rév.

Introduction

Why do parents behave the way they do when raising children? One answer is that they are
modelling the behaviour of their own parents, having learned how to parent in the course of
being parented. Another is that they are behaving in accord with information about appropriate
parenting  acquired through books, Web sites, or informal and formal advice. Yet another major
determinant of their behaviour lies in their general attitudes as well as specific beliefs, thoughts,
and feelings that are activated during parenting: These have a  powerful impact on behaviour,
even if parents are distressed by or unaware of that impact. Researchers interested in children’s
development have explored parenting attitudes, cognitions, and the resulting emotions (such as
anger or happiness), because of their influence on parenting behaviour and on the subsequent
impact of that parenting behaviour on  children’s socioemotional and cognitive development.

Subject

Child-rearing attitudes are cognitions that predispose an individual to act either positively or
negatively toward a child. Attitudes most frequently considered involve the degree of warmth and
acceptance or coldness and rejection that exists in the parent-child relationship, as well as the
extent to which parents are permissive or restrictive in the limits they set for their offspring.
Researchers have also studied more situation-specific thoughts or schemas – filters through
which parents interpret and react to events,, particularly ambiguous ones. These include
cognitions such as beliefs about parenting abilities, expectations about what children are capable
of or should be expected to do, and reasons why children have behaved in a particular way.

Problems

The influence of attitudes on parenting behaviours has been a favourite topic of investigation,
with research suggesting that linkages are generally of a modest nature.1 In part, this is because

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reported attitudes do not always have a direct impact on parenting actions which are often
directed by specific features of the situation. For example, parents might endorse or value being
warm and responsive to children, but have difficulty expressing those feelings when their child is
misbehaving. As a result of this realization the study of parent cognitions has been widened to
include more specific ways of thinking. 

Research Context

The study of parent attitudes, belief systems, and thinking has taken place along with changing
conceptions of child-rearing. These changes have emphasized the bidirectional nature of
interactions, with children influencing parents as well as parents influencing children.2
Accordingly, an interesting extension of research on attitudes and cognitions has to do with how
children’s actions affect parents’ attitudes and thoughts, although little work has been done in
this area.

Key Research Questions

1. Which parental attitudes result in the best child outcomes?

2. How do negative/positive thoughts and cognitions hinder/facilitate child development?

3. How can parents’ harmful attitudes be modified?

Recent Research Results

A large body of research on attitudes indicates that parental warmth together with reasonable
levels of control combine to produce positive child outcomes. Although not strong, as noted
above, the results are consistent. Researchers have noted that what is seen to be a reasonable
level of control varies as a function of sociocultural context.3  Attitudes toward control are
generally more positive in non Anglo-European cultures, with these attitudes having less
detrimental effects on children’s development because they are more normative and less likely to
be interpreted as rejecting or unloving.3,4 In accord with the realization that children’s behaviour
affects that of their parents, researchers have found that, whereas parent attitudes affect child
behaviour, this relation shifts as the child grows, with adolescent behaviour having an impact on
parenting style and attitudes.5

Research on more specific cognitions also highlights the importance of parent thinking on child
outcomes. As an example, parents look for reasons why both they and their children act the way
the do. These attributions can make parenting more efficient when they are accurate. They can
also interfere with effective parenting when they lead to feelings of anger or depression (a

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possibility if children’s bad behaviour is attributed to a bad disposition or an intentional desire to
hurt, or the parent’s failure or inadequacy). These negative feelings distract parents from the task
of parenting, and make it more difficult for them to react appropriately and effectively to the
challenges of socialization.6 

Specific cognitions have been assessed both with respect to their impact on children’s
socioemotional development and on their cognitive development. For example, Bugental and
colleagues have studied mothers who believe their children have more power than they do in
situations where events are not going well.7 These mothers are threatened and become either
abusive and hostile or unassertive and submissive. They send confusing messages to their
children, with the result that children stop paying attention to them as well as showing a
decrease in cognitive ability.8 This view of the power relationship takes its toll on mothers’ ability
to problem-solve and therefore to operate effectively in their parenting role. Similarly, mothers of
infants who are low in self-efficacy, that is, do not believe they can parent effectively, give up on
parenting when the task is challenging and become depressed. They are cold and disengaged in
interactions with their babies.9 Furthermore, parents who trust that their child’s course of
biological development will proceed in a natural and healthy way are able to adjust better to their
parenting role and less likely to develop a coercive parenting style.10

Other aspects of parent thinking include the ability to take the perspective of the child. Mothers
who recognize what is distressing for their children have children who are better able to cope with
their own distress11 and parents who can accurately identify their children’s thoughts and feelings
during conflicts are better able to achieve satisfactory outcomes for those conflicts.12  “Mind-
mindedness,” the ability of parents to think of children as having mental states as well as being
accurate in their assessment of these mental states, has been linked to children’s secure
attachment,13 with a positive link between mothers who describe their children using positive
mental descriptors and mothers’ sensitivity.14

Research Gaps 

Little has been done to see how fathers’ cognitions and attitudes affect child development. There
has been some investigation of  how mothers and fathers differ in their parental cognitions and
parenting style: Mothers report higher endorsement of progressive parenting attitudes,
encouraging their children to think and verbalize their own ideas and opinions, whereas fathers
endorse a more authoritarian approach.15 What is unknown is the extent to which these
differences in attitudes affect child outcomes.  Another gap has to do with the direction of effect
between parent and child, that is, how children affect their parents’ cognitions and attitudes. 

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Conclusions

The study of parent cognitions, beliefs, thoughts, and feelings can expand our knowledge of child
development.  Child-rearing cognitions influence parents to act either positively or negatively
towards their children.  These beliefs have been considered good predictors of parenting
behaviour because they indicate the emotional climate in which children and parents operate and
the health of the relationship. In sum, parents observe their children through a filter of conscious
and unconscious thoughts, beliefs, and attitudes, and these filters direct the way they perceive
their children’s actions. When the thoughts are benign, they direct positive actions. When the
thoughts are accurate they will usually lead to positive actions.  When they are distorted and
distressing, however, they distract parents from the task at hand as well as leading to negative
emotions and attributions that ultimately impair effective parenting.

Implications for Policy and Services

Most intervention programs for parents involve teaching effective strategies for managing
children’s behaviour. But problems can also arise when parents engage in maladaptive thinking.
Mothers at a higher risk of child abuse, for example, are more likely to attribute negative traits to
children who demonstrate ambiguous behaviour, and see this behaviour as intentional.16 Bugental
and her colleagues have administered a cognitive retraining intervention program for parents
which aims to alter such biases. They found that mothers who participated in the program
showed improvement in parenting cognitions, diminished levels of harsh parenting, and greater
emotional availability. In turn, children, two years after their mothers participated in the program,
displayed lower levels of aggressive behaviour as well as better cognitive skills than those whose
mothers had not undergone such cognitive retraining.17,18,19 These findings, then, clearly underline
the important role played by parental beliefs in the child-rearing process.

References

1. Holden GW, Buck MJ. Parental attitudes toward childrearing. In: Bornstein MH, ed. Handbook of Parenting. Volume 3: Being
and Becoming a Parent. 2 ed. Mahwah, NJ: Lawrence Erlbaum Associates; 2002:537-562.nd

2. Kuczynski L, ed. Handbook of dynamics in parent child relations. Thousand Oaks, Calif: Sage Publications; 2003.

3. Chen X, Fu R, Zhao S. Culture and socialization. In: Grusec JE, Hastings PD, Eds. Handbook of Socialization. New York:
Guilford Press; 2014:451-472.

4. Rothbaum F, Trommsdorff G. Do roots and wings complement or oppose one another? The socialization of relatedness and
autonomy in cultural context. In: Grusec JE, Hastings PD, Eds. Handbook of Socialization. New York: Guilford Press;
2007:461-489. 

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 5. Kerr M, Stattin H, Özdemir M.  Perceived parenting style and adolescent adjustment: Revisiting directions of effects and the
role of parental knowledge. Dev Psychol. 2012;48:1540-1553.

6. Bugental DB, Brown M, Reiss C. Cognitive representations of power in caregiving relationships: Biasing effects on
interpersonal interaction and information processing. J Fam Psychol. 1996;10:397-407.

7. Bugental DB, Lyon JE, Lin EK, McGrath EP, Bimbela A. Children “tune out” in response to ambiguous communication style of
powerless adults. Child Dev. 1999;70:214-230.

8. Bugental DB, Happaney K. Parental attributions. In: Bornstein MH, ed. Handbook of parenting. Volume 3: Being and
becoming a parent. 2nd ed. Mahwah, NJ: Lawrence Erlbaum Associates; 2002:509-535.

9. Teti DM, Gelfand DM. Behavioral competence among mothers of infants in the first year: The mediational role of maternal
self-efficacy. Child Dev. 1991;62:918-929.

10. Landry R, Whipple N, Mageau G, et al.  Trust in organismic development, autonomy support and adaptation among
mothers and their children. Motiv Emotion. 2008;32:173-188.

11. Vinik J, Almas A, Grusec JE.  Mothers’ knowledge of what distresses and what comforts their children predicts children’s
coping, empathy, and prosocial behavior.  Parent Sci Pract. 2011;11:56-71.  

12. Hastings P, Grusec JE. Conflict outcome as a function of parental accuracy in perceiving child cognitions and affect. Soc Dev
 1997;6:76-90.

13. Bernier A, Dozier M. Bridging the attachment transmission gap: The role of maternal mind-mindedness. Int J of Behav Dev
. 2003;27:355-365.

14. McMahon CA, Meins E. Mind-mindedness, parenting stress, and emotional availability in mothers of preschoolers. Early
Child Res Q. 2012;27:245-252.  

15. Bornstein MH, Putnick DL, Lansford JE. Parenting attributions and attitudes in cross-cultural perspective. Parent Sci Pract.
 2011;11:214-237.

16. McCarthy R, Crouch J, Skowvonski, et al. Child physical abuse risk moderates spontaneously inferred traits from ambiguous
child behaviors. Child Abuse Neglect. 2013;37:1142-1151.

17. Bugental DB, Ellerson PC, Lin EK, Rainey B, Kokotovic A, & O'Hara N. A cognitive approach to child abuse prevention. 
Psychol Violence. 2010;1: 84-106.

18. Bugental DB, Corpuz R, Schwartz A. Parenting children’s aggression: Outcomes of an early intervention. Devel Psychol
. 2012;48:1443-1449.

19. Bugental DB, Schwartz A, Lynch C. Effects of an early family intervention on children's memory: The mediating effects of
cortisol levels. Mind, Brain, Educ. 2010;4:159-170.

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Can Changing Parental Knowledge, Dysfunctional
Expectations and Attributions, and Emotion
Regulation Improve Outcomes for Children?
Matthew R Sanders, PhD, Alina Morawska, PhD

University of Queensland, Australia

December 2014, 3e éd.

Introduction

The broader parent training literature has increasingly incorporated explicit consideration of
cognitive and affective elements of the parenting role in explanations of parenting difficulties and
in descriptions of how to intervene successfully with parents.1,2 To some extent, the notion that
parents need to understand what is age-appropriate to develop reasonable expectations of
children has been assumed. However, the evidence supporting the idea that early childhood
parenting programs that explicitly target cognitive and affective changes result in better
outcomes than more behaviourally skills-based programs is less clear. The present paper
examines the conceptual and empirical basis for strategies such as increasing parents’
knowledge of development norms, reducing age- inappropriate expectations or dysfunctional
attributions, and increasing parents’ capacity to regulate their own emotions.

Subject

The strongest potentially modifiable risk factor contributing to the development of behavioural
and emotional problems in children is the quality of parenting a child receives. Evidence from
behaviour genetics research and epidemiological, correlational, and experimental studies shows
that parenting practices have a major influence on children’s development.3

Problems

While the research has examined parental knowledge as a risk factor for poorer child
development across a range of domains, a clear understanding of the mechanisms by which
parental knowledge impacts on children’s development and behaviour is lacking. Furthermore,
studies that have specifically assessed for changes in parenting knowledge have been limited
methodologically and have not delineated the processes by which parental knowledge changes,

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and whether in fact the change in knowledge is associated with changes in child development
and behaviour or whether other factors mediate the effect.

Similarly, there is currently no clear explication of the link between parental knowledge,
parenting behaviour, parental mood and parenting efficacy, and especially how these change as
a function of intervention. While the literature supports the idea that parenting knowledge,
competence and efficacy are not necessarily related,4 the processes that underpin the
development of discrepancies between the cognitive, affective and skills domains are unclear. For
example, how do parents feel or believe they are competent in their role as a parent, when
objective evidence suggests poor parenting skills and low knowledge about children’s
development?

The emphasis in the literature, and particularly in relation to parenting behaviours, has been on
children’s externalizing behaviour, non-compliance and psychopathology, and several models of
coercive family processes leading to child externalizing behaviour have been delineated and
supported.5 There is a paucity of research examining child competencies, both in terms of
behaviour and developmental competencies (social, cognitive, emotional) and how parenting
behaviours, parental knowledge, mood and self-efficacy interact with and impact on these
competencies. As a result, while a number of interventions have been demonstrated to change
parenting skills and child behaviour,1 in general these studies have not focused on outcomes in
terms of parental knowledge of children’s development.

Research Context

A number of intra-organismic factors influence child development; however, many of the skills
children acquire are fundamentally dependent on their interactions with their care-givers and the
broader social environment. In addition to intrinsic factors, such as low birth weight, prematurity,
and fetal alcohol exposure, a range of environmental risk factors have been identified as
contributing to poor child developmental outcomes. For example, poverty has been identified as
a risk factor for lower child cognitive test scores and more child behaviour problems.6 The effects
of poverty are mediated and moderated through poor neighbourhoods, poor schools, poor basic
services, greater environmental health risks, and via the stress these cause for the parent,
impacting on the parent-child relationship.7,8 In general, risk factors in the care-giving
environment are transmitted through the child’s experiences in their primary care-giving
relationship.9

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Key Research Questions

1. What are the mechanisms by which parental knowledge impacts on children’s development
and behaviour?

2.  Is a change in parent knowledge associated with changes in children’s development or do

other factors mediate the effect?

3. What is the link among parental knowledge, parenting behaviour, parental mood and
parenting efficacy, and how do these change as a function of intervention?

4. How do parenting interventions impact on children’s developmental competencies?

5. How can the impact of parenting interventions be strengthened?

Recent Research Results

The family environment is one of the most important potential contributors to children’s
development. Bradley10 concluded that in general, correlations between Home Observation for
Measurement of the Environment (HOME) Inventory scores, which include the provision of
learning materials, language and learning stimulation, variety in experience and active
stimulation, and measures of children’s developmental status and intelligence, are low to
moderate (.2 to .6) during the first two years and moderate (.3 to.6) from three to five years of
age. Similarly, Jackson and Schemes11 found that preschool children whose mothers were more
warm and supportive and provided cognitive stimulation at home had better language abilities as
rated by their school teachers. More specifically, when parents are more supportive and less
authoritarian, their children’s verbal and intelligence scores are higher, when examined
prospectively.12,13 Similarly, small to medium effect sizes have been found through meta-analysis
for the relationship between mother-child attachment and children’s peer relations,14 and there is
evidence that attachment style predicts differing trajectories in terms of the child’s emotion
regulation.15

Parental knowledge of child development has often been mentioned as a factor related to child
development outcomes. It can be defined as understanding of “developmental norms and
milestones, processes of child development, and familiarity with caregiving skills.”16 Parental
knowledge is thought to provide a global cognitive organization for adapting to or anticipating
developmental changes in children.17 Mothers who are knowledgeable respond more sensitively
to their child’s initiations,18 while mothers with inaccurate expectations about their child’s

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development tend to be more harsh.19,20,21 Studies have indicated that when mothers have higher
knowledge of infant and child development, they show higher levels of parenting skills,16,22,23 their
children have higher cognitive skills,16,24 and there are fewer child behaviour problems.16
Furthermore, a positive association has been found between parental self-efficacy and parenting
competence when knowledge of child development is high. However, mothers who report high
parental self-efficacy but low knowledge are least sensitive in their interactions with their infants.4

In general, there is scant research on parents’ knowledge and particularly on the link between
parental knowledge and other skills, such as behaviour management skills, parenting efficacy,
parental mood and parenting conflict. In addition, the majority of research has focused on high-
risk samples, specifically adolescent mothers and/or low birth weight and premature infants. A
number of studies have examined whether parenting and family interventions increase parental
knowledge, and there is evidence that this is the case.25,26,27,28 However, in general these studies
have been uncontrolled, with small sample sizes, examining very high risk samples, and with no
examination of the mechanism of action between increased knowledge and potential child
outcomes.

Parents’ beliefs about child development and the nature and causes of their child’s behaviour
have also been examined as factors related to child developmental outcomes. There is evidence
that parents’ inaccurate beliefs or overestimation of their child’s performance actually undermine
the child’s performance,29,30,31 and that expectations have an effect on parenting behaviours.32 For
example, adolescent mothers who reported more positive, more realistic and more mature
expectations about parenting, children and the parent-child relationship had children with better
coping skills, as rated through observation.17 Realistic expectations about child abilities have been
related to greater child socio-emotional and cognitive competencies.33 However, this association
may work indirectly through parenting behaviours,34 such that the mother’s expectations affect
her own behaviour, which in turn impacts on the child’s developmental competencies.

Specific parenting behaviours and skills have been examined, particularly in relation to the
development of aggressive and disruptive behaviour. Parents of aggressive children are
characterized as highly punitive and critical of their children35,36 and more likely to attribute their
children’s misbehaviour to more dispositional, intentional and stable causes compared to parents
of non-problem children.37,38,39 These attributional processes tend to become more pronounced
over time.40

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Parent-child interactions affect many different domains of development.41,42,43 Child- focused,
responsive and moderately controlling parenting attitudes have been positively associated with
self-esteem, academic achievement, cognitive development and fewer behaviour problems.44,45
Furthermore, high warmth and contingent responsiveness promote a wide range of positive
developmental outcomes.46,47,48,49 Parental management style and affective involvement may be
especially salient for children’s prosocial development, self-control and internalization of
behaviour standards.41 The quality of parenting has been found to be important for child
socialization,50,51 and parenting variables show direct links with child adjustment.52

The research on parental mood indicates that maternal mood disturbance and stress are
associated with more child behaviour and emotional problems,53,54,55 and this finding has also been
demonstrated for fathers.56 In general, however, the link is higher for maternal than paternal
psychopathology.57 Higher depressive symptoms in the postpartum period have also been related
to less accurate knowledge of infant development.58 The link between parental mood and stress
and children’s behaviour is somewhat unclear, as a number of studies have failed to find a
mediation effect of parenting behaviour between stress and child outcomes.53,59

There is less evidence to support a link between parental mood disturbance and children’s
cognitive development. For example, Kurstjens and Wolke60 concluded that maternal depression
has negligible effects on the child’s cognitive development (at six years), but may be more
relevant long-term if depression is chronic, the child is a boy and there are neonatal risk or social
risks in family. Nevertheless, parenting stress in the preschool years has been related to
preschool teacher ratings of social competence, as well as internalizing behaviour and
externalizing problems.59 In addition, Schmidt, Demulder, and Denham61 found that more family
stress during the preschool years was associated with greater child aggression, and anxiety and
lower social competence in kindergarten. 

The value of parenting interventions in improving parenting practices

Parent Management Training (PMT) interventions, derived from social-learning, functional

analysis, and cognitive-behavioural principles, are considered the interventions of choice for
conduct problems in young children.62,63,64 PMT programs have also been proven efficacious in
prevention studies.65,66 Positive effects for PMT interventions have been replicated many times
across different studies, investigators and countries, and with a diverse range of client
populations.1 In PMT programs, parents are typically taught to increase positive interactions with

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children and to reduce coercive and inconsistent parenting practices. Studies demonstrating the
efficacy of PMT interventions show improvements in parental perceptions and parenting skills,
improvements in children’s social skills and school adjustment, and reductions in behaviour and
attention problems.66,67 PMT interventions are associated with large effect sizes,68 the effects often
generalize to a variety of home and community settings,69,70 they are maintained over time,71 and
are associated with high levels of consumer satisfaction.72 PMT has been successfully used with
two-biological-parent families, step-parents and single parents. There is mounting evidence that a
variety of delivery modalities can produce positive outcomes for children,1 including individually
administered face-to-face programs,73 group programs74,75,76 telephone-assisted programs77,78 and
self-directed programs.79,80 In addition, a number of effectiveness trials of PMT interventions have
demonstrated meaningful effects for children with conduct problems.81,82

Conclusions

Although parenting programs based on social learning models have been remarkably successful
in assisting parents to change their children’s behaviour and improve their relationships with their
children, there is still a great deal to learn about how to promote concurrent change across the
cognitive, affective and behavioural domains of parenting. Greater understanding of the cognitive
and affective mechanisms that may underpin parents becoming more positive and less negative
with their children is needed.

Implications

Strengthening the impact of parenting interventions

Despite the strength of the evidence for PMT cited above, there are several potentially important
future directions that might further strengthen the population reach and impact of parenting
interventions.

The use of modelling and demonstration of core parenting skills is likely to be a core feature of
any effective intervention on parenting. Research on the value of observation learning and video-
based modelling83,84,85 validates the importance of this approach. But key elements from attitude
and behaviour change models (cognitive social learning theory, social influence theory and
acceptance-based models) are still underutilized. Bandura’s83,84 cognitive social learning theory is
a useful conceptual framework for the development of media interventions, as it highlights the
importance of both external and internal factors, including associated cognitive mechanisms that

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influence human behaviour. This theory points to the importance of using strategies that increase
parental self-efficacy and that create favourable outcome expectancies, which in turn increase
parents’ behavioural intentions, their setting of personal performance standards and their self-
evaluation of their performance. The social influence model86 is also a useful conceptual
framework to guide development of media interventions, as it highlights the core principles that
promote successful persuasion and influence; for example, to the extent that interventions make
use of the power of social validation by similar or liked others (i.e. “others like me are doing it”)
and of humans’ tendency to act in accordance with prior commitments to others and to deep-
seated values, they are likely to have more influence on viewers’ attitudes, intents and
behaviours. Finally, acceptance-based models of behaviour change87 emphasize the importance
of managing distressing thoughts and feelings in such a way that they do not interfere with taking
effective action.

To strengthen the impact of a parenting skills intervention, various elements from cognitive social
learning theory, social influence theory and acceptance theory could be used to enhance changes
in parental behaviour, affect and cognition. Parents are more likely to learn the skills, increase
their intentions to implement them and actually implement and maintain them when targeted
parenting skills are modelled and demonstrated, and also (a) dysfunctional attributions or beliefs
about the reasons for children’s behaviour are changed; (b) positive expectancies and parenting
self-efficacy are increased; (c) social supports are activated; and (d) parents learn to manage
distressing affect that interferes with effective parenting.

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Sources, Effects and Possible Changes in
Parenting Skills: Comments on Belsky, Grusec,
and Sanders and Morawska
Jacqueline J. Goodnow, PhD

Macquarie University, Sydney, Australia

December 2014, 3e éd.

Introduction

Research on parenting skills offers a route into understanding development and a potential basis
for clinical, educational or social action. To that research, these authors bring the assumptions
that the quality of parenting matters and that it is open to change. They also share a record of
productive breaks from some traditional approaches, leading research in new directions and
offering changes in implications for action. Where they differ is in the nature of those breaks.

Grusec, for example, builds on a long-standing interest in parents’ general “styles” (e.g. their
warmth, coerciveness, consistency, sense of efficacy) and “schemas” (e.g. their views about
appropriate methods of control). There is an additional recognition that parents can hold more
than one view of children or parenting (e.g. parenting as easy or impossible). What matters then
are the particular thoughts, feelings and actions that come to the fore in specific situations,
especially problem situations.

Belsky starts from a long-standing recognition of two influences on parenting: the characteristics
of the child and those of the parent. To the latter, he brings a revitalized interest in a parent’s
own history (parenting is in this sense “inheritable”). To both, he adds an emphasis on “the
broader social context” (this includes the relationship between parents) and on the accumulation
of stresses and supports that multiple influences involve.

Sanders and Morawska start from a tradition of action often cast in a clinical frame. They argue
for a move beyond parents who are already experiencing problems. Instead, all parents may
benefit from instruction or advice related to the nature of development and to useful strategies.
Parents’ expectations, for example, may then become more age-appropriate. They may also
avoid coercive strategies, building instead on the positives already present.

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Research and Conclusions

It would be unreasonable to expect three short papers to cover the field, noting all its directions
and implications. I would have liked, however, to see more space given to four trends. 

The first trend has to do with ways of specifying parenting skills, both within and outside the home
. Within the family, parents’ skills in interpreting events and in establishing some degree of
routine or pattern in family life have emerged as important, both for everyday life (e.g.
understanding television, establishing safety rules) and at times of trauma or radical change.1-4
Outside the family, skill takes the form of being alert to what neighbourhoods offer and being
able to negotiate with daycare centres or schools in order to achieve one’s goals.5,6 It also takes
the form of effective monitoring. Children are not always under a parent’s eyes. Parents need to
be able to stay informed about what children do, either by a direct check or – from a young age –
promoting a child’s willingness to “disclose.”7,8 For the mix of life within and “outside,” skill may
also take the form of effectively preparing children for what they may encounter (especially
negative encounters).9,10 

The second trend has to do with ways of specifying outcomes, for children or for parents
. There is general agreement that we need tighter accounts of which aspects of parenting are
related to which outcomes and by what processes, especially over time. We also need to have a
wider recognition of outcomes in relational terms: for example, in terms of a child’s sense of
reciprocity or group membership (e.g. “we’re a family”) or collective identity.11-14

The third trend has to do with ways of putting children more fully into the picture. We now know
more about parents’ views of parenting and of children than about children’s views of what
makes a good parent or what represents appropriate parental action.15 This is all the more
surprising in the face of proposals that children’s interpretations are a major part of children
coming to adopt parents’ values and to see them as their own.16,17

The fourth and last piece that I see as needing more emphasis has to do with cultural variations
in the way parents think, feel or act, as noted briefly by Grusec and now strongly documented.18-20
Those variations matter not simply as a way of documenting that people differ. They are also a
vivid reminder of the need, when one social or cultural group decides that the skills of another
need improving, to examine the values and assumptions of both groups, and their views of each
other.21 

Implications for Policy

Research can contribute to action in two large ways.22 One is by providing general models that

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guide decisions: models, for example, of why parents act as they do or – less apparent in the
present papers – of how children change (e.g. models of whether children grow into or grow out
of aggressive behaviours23). The other route is by input into more specific policy questions:
questions about why, when, who and how. 

Questions about “who” provide a starting point for comparing the present papers. In one
approach (often described as “targeted”), the emphasis is on particular groups of parents.
Grusec, for example, places the emphasis on parents who are already experiencing problems.
The critical issue is then one of isolating where the problem lies and how it can best be tackled.
Grusec points to the value of considering specific problem situations (in everyday terms, this
might mean pinpointing “the worst times of the day” or times when parents are at risk of losing
their temper). Action can then be directed toward ways of coping with the particular feelings,
thoughts or strategies that are “activated” at these times and that get in the way of effective
action. 

Sanders and Morawska come closer to approaches that have been called “universal.” Skill in
parenting is in many ways seen as comparable to skill in driving a car. It seldom comes naturally,
and it always benefits from some degree of instruction. The parents of most interest are first-
timers (first baby, or first encounters with a new problem). Potentially, however – and Sanders
and Morawska suggest this expansion – providing a mix of useful strategies and information could
be brought to bear on all aspects of behaviour and all groups of parents, before or after the
appearance of difficulties. It could also be provided by ways not limited to face-to-face
approaches. 

Neither of these papers, however, points strongly to changes in the physical or social
environment. It is possible to aim to change the way daycare centres or schools operate, to try to
improve social contexts (e.g. promoting parent-friendly work practices), or to enhance parents’
financial resources, all in ways that can flow on to what parents do and how children develop.24
Belsky’s emphasis on multiple influences on parenting comes closest to including this approach.
There is, he argues, no single way forward. Instead, a variety of steps may alter the accumulation
of stresses and supports that shapes the nature of parenting. 

In effect, the implications for action are varied. All three papers share, however, an emphasis on
the ultimate goal being changes within the child and within the parent-child interactions. These
changes also remain the prime indicators of effects from any action taken. All three also provide
a clear sense of major concerns and a strong reminder of the need to continue both with research
and with the analysis of what its results and its underlying concepts imply for the way parenting
proceeds.

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 notion of training. Child Development 1994;65(4):1111-1119.

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Parenting and Sleeping Problems and Universal
Parenting Programs
Harriet Hiscock, MBBS, FRACP, MD

Centre for Community Child Health, The Royal Children's Hospital, Murdoch Childrens Research
Institute, and Department of Paediatrics, University of Melbourne, Australia
December 2014

Introduction

Sleep problems in infants and children are common and typically include problems going to 
sleep and problems maintaining sleep. Sleep problems can be further divided into medical (e.g.,
obstructive sleep apnea) and behavioural problems. Parenting often plays a role in the
development and maintenance of behavioural problems. This review therefore focuses on
behavioural sleep problems, how parenting may perpetuate or reduce such problems, and the
role of universal parenting programs in the prevention of behavioural sleep problems.

Subject 

Before understanding how parenting may give rise to sleep problems, we first need to 
understand normal sleep. Infants and children (like adults) pass from consciousness into non-
Rapid Eye Movement (NREM) or deep sleep, then into REM or light sleep, and back into NREM
sleep, several times per night.1 These phases are known as ‘sleep cycles’ and last 20- 50 minutes
in infants and children and 90 minutes in adults. A child can wake fully from light sleep and either
self-settle back to sleep or signal (i.e., call out) to their parent. The way an infant or child is
settled to sleep at the start of the night often dictates how they re-settle after naturally waking
overnight.1 Thus if the last thing a child remembers is being fed, having a pacifier, or being
rocked to sleep, upon waking they will call out for a parent to come and feed them, replace their
pacifier, or rock them before returning to sleep once more. These actions are known as “parent-
dependent” sleep cues. 

Problems 

How a parent settles their child to sleep and responds to night waking is key to development and
thus management of behavioural sleep problems.2 A ‘coercion trap’ can occur whereby a parent
rocks their child to sleep, their child wakes some hours later and calls out, the parent returns to

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rock their child, the child goes back to sleep (thereby reinforcing the parent’s response) but
wakes again and wants to be rocked.1 This can lead to parental fatigue and depression as well as
inadequate and fragmented sleep for the child.3,4

Research Context 

Teaching parents to allow their infant or child to self-settle at the start of the night can greatly
improve problems getting to sleep and re-settling over night. Randomized controlled trials have
demonstrated that teaching parents to use graduated extinction (i.e., parent checks on and
comforts their infant at increasing time intervals but leaves the room before the infant falls
asleep) or adult fading (i.e., a parent places a camp bed or chair next to their infant’s cot, pats
their infant to sleep for the first few nights, then gradually moves their camp bed or chair out of
the infant’s bedroom over a period of weeks) reduces both infant sleep problems and maternal
depression symptoms.5 In toddlers, provision of a bedtime routine by parents has also been
shown to reduce sleep problems.6 

Key Research Questions

What is less clear however, is whether (i) parenting can be modified to prevent sleep problems
arising; (ii) if so, which parenting practices are best to modify; and (iii) if there is a subgroup(s) of
infants who respond better to prevention.

Recent Research Results

A number of randomised trials have evaluated programs aimed at preventing infant sleep
problems. Most have included a range of parenting education and strategies, making it difficult to
establish if some strategies lead to better outcomes than others. Most interventions have
included parent education about normal sleep and sleep cycles, advice to maximise
environmental differences between day and night, and strategies to encourage infant self-settling.
7-10
Strategies included range from the graduated extinction method described above to
encouraging parents to stretch night time feed intervals (in the hope that the infant will self-
settle) and encouraging the use of parent-independent sleep cues. These trials have shown
modest improvements in infant sleep and maternal depression symptoms. Two of these trials
have been shown to be most effective in a subgroup of infants who feed less than 3 hourly.9,11
Why this is so is unclear but it may be that these infants are more unsettled and are thus fed to
sleep more frequently in the hope of improving their sleep. Teaching parents not to feed their

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infant to sleep and encourage self-settling instead may reduce development of later sleep
problems in this subgroup.

Research Gaps

While modifying parenting to manage and even prevent sleep problems appears effective, a
number of research questions remain unanswered. Popular public discourse promotes
‘attachment’ parenting whereby an infant is fed on demand, held for prolonged periods of time
and co-sleeps with their parent. Such parenting has been associated with increased night waking
at 12 weeks but effects beyond this are less clear.12 While the parenting strategies evaluated in
randomized trials are effective, their short- to medium-term effects on infant well-being as
measured by biological markers (e.g., cortisol) are unclear. Fathers are now playing an increasing
role in caring for infants and children but their unique contribution to the development and
maintenance of sleep problems has not been studied. Finally, parenting strategies work for many
but not all children and future research is needed to determine how best to help children whose
sleep does not improve with traditional parenting strategies.   

Conclusions 

Behavioural sleep problems are common in infants and children and their development and
maintenance is mediated, in part, by parenting. How a parent settles their child to sleep appears
crucial and teaching parents strategies to encourage infant self-settling and implement a bedtime
routine appear beneficial. Preventing infant sleep problems through universal programs has a
more modest benefit and subgroups of infants (e.g., those feeding less than 3 hourly) may
experience a greater benefit. Future research needs to explore the outcomes of attachment-
based parenting, impacts of parent-led behavioural strategies on infant well-being, role of fathers,
and alternative approaches for infants who do not respond to behavioural parenting practices.   

Implications for Parents, Services and Policy

Managing sleep problems in infants and children is exhausting for parents, challenging for
clinicians and costly for policy makers. Universal prevention programs providing consistent advice
to parents about normal sleep patterns, sleep cues, and ways to encourage infant self-settling
(after the first few months) should be widely available. Such programs could be incorporated into
well child, universal services and take advantage of the content in evidence-based websites such
as www.raisingchildren.net.au and http://purplecrying.info/. Once sleep problems are established,

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parents need support from a trusted health professional to manage the sleep problem. Parents
should be offered a range of evidence-based strategies and choose the best one(s) for their child
and their family. Online interventions offering such support look promising and have potential to
increase reach and uptake.13 Offering advice to parents to take up a more attachment-based
parenting style should be tempered by the lack of rigorous data on the effectiveness of this
approach to respond to unsettled infant behaviour.14 

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