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Parental reflective functioning (PRF) is an important predictor of infant attachment, and interventions that target parent-infant/toddler dyads who are experiencing significant problems have the potential to improve PRF. A range of dyadic interventions have been developed over the past two decades, some of which explicitly target PRF as part of their theory of change, and some that do not explicitly target PRF, but that have measured it as an outcome. However, no meta-analytic review of the impact of these interventions has been carried out to date. The aim of this review was to evaluate the effectiveness of dyadic interventions targeting parents of infant and toddlers, in improving PRF and a number of secondary outcomes. A systematic review and meta-analysis was conducted in which key electronic databases were searched up to October 2018. Eligible studies were identified and data extracted. Data were synthesised using meta-analysis and expressed as both effect sizes and risk ratios. Six studies were identified providing a total of 521 participants. The results of six meta-analyses showed a nonsignificant moderate improvement in PRF in the intervention group (standardised mean difference [SMD]: -0.46; 95% confidence interval [CI] [-0.97, 0.04]) and a significant reduction in disorganised attachment (risk ratio: 0.50; 95% CI [0.27, 0.90]). There was no evidence for intervention effects on attachment security (odds ratio: 0.71; 95% CI [0.19, 2.64]), parent-infant interaction (SMD: -0.10; 95% CI [-0.46, 0.26]), parental depression (SMD: -1.55; 95% CI [-3.74, 0.64]) or parental global distress (SMD: -0.19, 95% CI [-3.04, 22.65]). There were insufficient data to conduct subgroup analysis (i.e. to compare the effectiveness of mentalisation-based treatment with non-mentalization-based treatment interventions). Relational early interventions may have important benefits in improving PRF and reducing the prevalence of attachment disorganisation. The implications for future research are discussed.El funcionamiento de reflexión del progenitor (PRF) es un factor importante de predicción de la afectividad del infante, y las intervenciones que se enfocan en díadas progenitor/infante/niño pequeñito que experimentan problemas significativos tienen la posibilidad de mejorar el PRF. La meta de esta revisión fue evaluar la eficacia de las intervenciones diádicas que se enfocan en los progenitores de infantes y niños pequeñitos, para mejorar el PRF y un número de resultados secundarios. Se llevó a cabo una revisión sistemática y un meta-análisis en los que se investigaron bancos de información electrónica claves hasta octubre de 2018. Se identificaron estudios elegibles y se sacó de ellos la información. Se sintetizó esa información usando meta-análisis y la misma fue presentada tanto en términos de dimensión de efectos como la proporción de riesgo. Se identificaron seis estudios que aportaron un total de 521 participantes. Los resultados de seis meta-análisis mostraron un moderado, poco significativo y limítrofe mejoramiento en cuanto al PRF en el grupo de intervención (SMD: -0.46; 95% CI -0.97, 0.04), una reducción significativa en la afectividad desorganizada (RR: 0.50; 95% CI: 0.27, 0.90), pero no así en la afectividad segura (OR: 0.71; 95% CI: 0.19, 2.64), y ninguna evidencia de beneficio para la interacción progenitor-infante (SMD: -0.09; 95% CI: -0.51, 0.32). Se dio un mejoramiento grande no significativo en la depresión del progenitor (SMD: -1.55; 95% CI -3.74, 0.64), pero no hubo evidencia de beneficio en cuanto a la angustia total (SMD: -0.19; 95% CI: -3.04, 22.65). Se discuten las implicaciones para la futura investigación.Le fonctionnement parental réfléchi (en anglais Parental Reflective Functioning, soit PRF) est un facteur de prédiction important de l'attachement du bébé, et les interventions qui ciblent les dyades parent-bébé/petit enfant qui font l'expérience de problèmes importants ont le potentiel d'améliorer le fonctionnement PRF. Le but de cette article était d’évaluer l'efficacité d'interventions dyadiques ciblant les parents de bébés et de petits enfants, en améliorant le fonctionnement PRF et un bon nombre de résultats secondaires. Une revue et une méta-analyse ont été faites, les bases de données électroniques clés ayant été passées au crible en octobre 2018. Les études pouvant être utilisées ont été identifiées et les données ont été extraites. Les données ont été synthétisées en utilisant une méta-analyse et exprimées sous forme d'ampleur de l'effet et de risque relatif. Six études ont été identifiées, pour un total de 521 participants. Les résultats de six méta-analyses ont montré une amélioration limite non importante modérée dans le PRF dans le groupe d'intervention (SMD: -0,46; 95% CI -0,97, 0,04), une réduction importante dans l'attachement désorganisé de l'enfant (RR: 0,50; 95% CI: 0,27, 0,90) mais non dans l'attachement sécure (OR: 0,71; 95% CI: 0,19, 2,64), ainsi qu'aucune preuve de bénéfice pour l'interaction parent-bébé (SMD: -0,09; 95% CI -0,51, 0,32). Il y avait une grande amélioration non-importante dans la dépression parentale (SMD: -1,55; 95% CI -3,74, 0,64) mais aucune preuve de bénéfice dans la détresse globale (SMD: -0,19; 95% CI: -3,04, 22,65. Les implications pour les recherches futures sont discutées.Verbesserung der elterlichen Reflektionsfähigkeit durch frühe dyadische Interventionen: Systematisches Review und Metaanalyse Die elterliche Reflexionsfähigkeit (Parental Reflective Functioning; PRF) ist ein wichtiger Prädiktor für die Säuglingsbindung. Interventionen für Eltern-Säuglings bzw. Eltern-Kleinkind Dyaden, die unter erheblichen Problemen leiden, haben das Potenzial, die PRF zu verbessern. Ziel dieses Reviews war es, die Wirksamkeit von dyadischen Interventionen zu bewerten, die sich an Eltern von Säuglingen und Kleinkindern richten, um deren PRF zu verbessern und eine Reihe von sekundären Ergebnissen zu erzielen. Das systematische Review und die Metaanalyse wurden durchgeführt indem relevante elektronische Datenbanken bis Oktober 2018 durchsucht wurden. Geeignete Studien wurden identifiziert und die Daten extrahiert. Anschließend wurden die Daten durch metaanalytisches Vorgehen synthetisiert und sowohl auf Effektgrößen als auch auf Risikoverhältnisse geprüft. Es wurden sechs Studien mit insgesamt 521 Teilnehmenden identifiziert. Die Ergebnisse von sechs Metaanalysen zeigten eine annähernd signifikante, moderate Verbesserung der PRF in der Interventionsgruppe (SMD: -0,46; 95% CI -0,97; 0,04), eine signifikante Verringerung desorganisierter (RR: 0,50; 95% CI: 0,27, 0,90) nicht aber sicherer (OR: 0,71; 95% CI: 0,19, 2,64) kindlicher Bindung und keinen belegbaren Nutzen für die Eltern-Kind-Interaktion (SMD: -0,09; 95% CI -0,51, 0,32). Es gab eine große nicht signifikante Verbesserung elterlicher Depression (SMD: -1,55; 95% CI -3,74, 0,64), aber keinen Hinweis auf einen Nutzen bei globaler Belastung (SMD: -0,19; 95% CI: -3,04, 22,65). Die Implikationen für die zukünftige Forschung werden diskutiert.早期の親子への介入を通じて親の内省機能を高める:系統的レビューとメタ分析 親の内省機能(PRF)は、乳児のアタッチメントと、深刻な問題を抱えている乳幼 児親子がPRFを向上させる可能性のある介入に対する重要な予測因子である。 本レビューの目的は、PRFの向上といくつかの二次的な結果における乳幼児の親 を対象にした親子介入の効果を測定することである。 系統的レビューとメタ分析は、2018年10月まで探索された主要な電子データベー スを基に実施された。的確な研究が同定され、データが抽出された。データはメ タ分析を使って統合され、効果量とリスク比として表された。 6つの研究が合計521人の参加者を提供するものとして同定された。6つの研究の メタ分析の結果は、介入グループにおいてPRFの境界線上の有意でない中程度の 改善(SMD: −0.46; 95% CI −0.97, 0.04)、安定型アタッチメントには見られない が(OR: 0.71; 95% CI: 0.19, 2.64)、無秩序型アタッチメントにおける有意な低 下(RR: 0.50; 95% CI: 0.27, 0.90)が見られ、乳幼児親子の相互交流に関するメ リットを支持する根拠はなかった(SMD: −0.09; 95% CI −0.51, 0.32)。 親の抑鬱における有意でない大きな改善はあった(SMD: −1.55; 95% CI −3.74, 0.64) が、全体的なストレスにおけるメリットを支持する根拠はなかった(SMD: −0.19; 95% CI: −3.04, 22.65)。 今後の研究に対する示唆を論じる。.家长反思功能 (PRF) 是婴儿依恋的一个重要预测因子, 对有严重问题的家长和婴幼儿采取干预措施有可能改善家长反思功能。 这篇综述的目的是评估针对婴幼儿父母的二元干预在改善家长反思功能和一些次要方面的有效性。 本文对截至2018年10月的关键电子数据库进行了系统评价和荟萃分析, 找到符合条件的研究并提取了数据, 进而使用荟萃分析合并数据, 计算其效应量和风险比。 最终确定了6项符合条件的研究, 提供了521个研究对象。6项荟萃分析的结果显示, 干预组的家长反思功能呈现非边缘显著型中度改善 (SMD: −0.46; 95% CI −0.97, 0.04), 絮乱型婴儿依恋明显减少 (RR: 0.50; 95% CI: 0.27, 0.90), 安全型婴儿依恋没有减少 (OR: 0.71; 95% CI: 0.19, 2.64), 并且没有证据表明对母婴互动有益 (SMD: −0.09; 95% CI −0.51, 0.32)。家长压力呈现明显的非显著型改善 (SMD: −1.55; 95% CI −3.74, 0.64), 但没有证据表明对整体痛苦有益 (SMD: −0.19; 95% CI: −3.04, 22.65)。 本文也对今后的研究方向进行了展望。.تعزيز الأداء التأملي للوالدين من خلال التدخلات الثنائية المبكرة: مراجعة منهجية وتحليل تلوي إن الأداء التأملي للوالدين (PRF) هو مؤشر مهم على تعلق الرضع، والتدخلات التي تستهدف ثنائيات الوالدين والرضع/الأطفال الصغار الذين يعانون من مشاكل كبيرة لديها القدرة على تحسين PRF. كان الهدف من هذا الاستقصاء المنهجي هو تقييم فعالية التدخلات الثنائية التي تستهدف آباء الرضع والأطفال الصغار، في تحسين PRF وعدد من النتائج الثانوية. وأجري استعراض منهجي وتحليل تلوي تم خلالهما البحث في قواعد البيانات الإلكترونية الرئيسية حتى أكتوبر 2018. وتم تحديد الدراسات المؤهلة واستخراج البيانات. وتم تجميع البيانات باستخدام التحليل التلوي والتعبير عنها من خلال حجم التأثير ونسب المخاطرة. وتم تحديد ست دراسات قدمت مجموع 521 مشاركاً. وأظهرت نتائج ستة تحليلات تلوية تحسناً متوسطا غير دال إحصائيا في الأداء التأملي للوالدين في مجموعة التدخل (0.97, 0.04-0.46; 95% CI -SMD:)، وانخفاض كبير في تعلق الطفل غير المنظم (0.90RR: 0.50; 95% CI: 0.27,) ولكنه تعلق غير آمن (OR: 0.71; 95% CI: 0.19, 2.64) .ولا يوجد دليل على فائدة التفاعل بين الوالدين والرضع (% CI 950.09; -SMD: 0.51, 0.32-). بينما كان هناك تحسن كبيرغير دال إحصائيا في الاكتئاب الوالدي (0.09; 95% -SMD: 0.51, 0.32-CI) ولكن لا يوجد دليل على الفائدة في مستوى الكرب العام (-0.19; 95% CI: -SMD: 3.04, 22.65). وتناقش الدراسة التطبيقات العملية للبحوث المستقبلية.

Parent-Child Interaction Therapy with Toddlers (PCIT-T) is a new attachment-based parenting intervention designed to meet the needs of children aged 12-24 months presenting with challenging behaviors. This study examined outcomes of the first phase of PCIT-T, Child Directed Interaction-Toddler (CDI-T), 4-months post treatment. Participants were 56 toddlers (Child Mage = 19.13 months) referred to receive CDI-T over an 8-week period at an Australian community-based child behavior treatment clinic for treatment of difficult toddler behaviors. Participants completed questionnaires and observational measures at baseline (Time 1), post-treatment (Time 2), and 4-month follow-up (Time 3). At both Time 2 and Time 3, there were statistically significant increases in observed positive parenting skills and emotional availability and decreases in negative parenting behaviors and child noncompliance. There were also significant improvements in parent-reported child externalizing and internalizing behaviors, parental stress, and maternal depression. There was a pattern of a shift away from attachment insecurity and attachment disorganization. Results suggest that the CDI-T phase of PCIT-T is a promising intervention for toddlers presenting with behavioral issues. Future studies should be conducted to assess efficacy in other settings, using larger samples and utilizing randomized controlled designs.La terapia de interacción progenitor-niño con niños pequeñitos (PCIT-T) es una nueva intervención de crianza con base en la afectividad y diseñada para cubrir las necesidades de niños de edad de 12 a 24 meses que enfrentan retos de comportamiento. Este estudio examinó los resultados de la primera fase de PCIT-T, Interacción Dirigida del Niño - Niño Pequeñito (CDI-T), 4 meses después del tratamiento. Participaron 56 niños pequeñitos (Edad promedio del niño = 19.13 meses) que habían sido referidos para recibir el CDI-T en un período de 8 semanas en una clínica en Australia con base comunitaria de tratamiento de comportamiento del niño, dedicada al tratamiento de comportamientos difíciles de niños pequeñitos. Los participantes completaron cuestionarios y medidas de observación al momento básico (Primer momento), posteriormente al tratamiento (Segundo momento) y en el seguimiento a los 4 meses (Tercer momento). Tanto en el momento segundo como en el tercero, se dieron mejorías estadísticamente significativas en cuanto a las observadas habilidades positivas de crianza y la disponibilidad emocional y disminuciones en cuanto a las conductas de crianza negativas y la falta de obediencia del niño. También se dieron mejorías significativas en los comportamientos de externalización e internalización del niño según el reporte del progenitor, el estrés de los padres y la depresión materna. Se dio un patrón de alejarse de la inseguridad de la afectividad y la desorganización de la afectividad. Los resultados sugieren que la fase CDI-T del PCIT-T es una intervención prometedora para niños pequeñitos que presentan asuntos de comportamiento. Futuros estudios deben llevarse a cabo para evaluar la efectividad en otros escenarios, usando grupos muestras más grandes y utilizando diseños de control al azar.La thérapie d'interaction parent-enfant avec un jeune enfant (en anglais Parent-child interaction therapy with Toddlers, soit PCIT-T) est une nouvelle intervention de parentage basée sur l'attachement, conçue afin de remplir les besoins d'enfants âgés de 12 à 24 mois qui présentent des comportements difficiles. Cette étude a examiné les résultats de la première phase de PCIT-T, l'Interaction Dirigée vers l'Enfant - Petit Enfant (Child Directed Interaction - Toddler, soit CDI-T), à 4 mois après le traitement. Les participants ont consisté en 56 jeunes enfants (âgeM de l'Enfant = 19,13 mois) envoyés consulter afin de recevoir une CDI-T sur une période de 8 semaines dans une clinique de traitement du comportement de l'enfant communautaire en Australie, spécialisé dans le traitement de comportements difficiles de jeunes enfants. Les participants ont rempli des questionnaires et des mesures d'observation au niveau de référence (Temps 1), après le traitement (Temps 2) et au suivi de 4 mois (Temps 3). A la fois au Temps 2 et 3 on a noté des augmentations statistiquement significatives dans les compétences positives observées de parentage et la disponibilité émotionnelle ainsi que des baisses dans les comportements négatifs de parentage et le refus d'obéir. On a aussi noté des améliorations importantes dans l'externalisation de l'enfant rapportée par le parent et les comportements d'internalisation, le stress parental et la dépression maternelle. On a observé une tendance se détachant de l'insécurité de l'attachement et de la désorganisation de l'attachement. Les résultats suggèrent que la phases CDI-T de la PCIT-T est une intervention prometteuse pour les jeunes enfants présentant des problèmes de comportement. Des études futures devraient être faites afin d’évaluer l'efficacité d'autres contextes, en utilisant des échantillons plus larges et en utilisant des plans d’étude contrôlées randomisées.Eltern-Kind-Interaktionstherapie mit Kleinkindern in einem gemeindebasierten Setting: Verbesserungen in der emotionalen Verfügbarkeit, im kindlichen Verhalten und in der Bindung Die Eltern-Kind-Interaktionstherapie mit Kleinkindern (Parent-child interaction therapy with Toddlers; PCIT-T) ist eine neue bindungsbasierte Elternkompetenz-Intervention, die auf die Bedürfnisse von Kindern im Alter von 12 bis 24 Monaten mit herausfordernden Verhaltensweisen zugeschnitten ist. Die vorliegende Studie untersuchte die Ergebnisse der ersten Phase von PCIT-T, an das Kind gerichtete Interaktion - Kleinkind (Child Directed Interaction - Toddler: CDI-T), 4 Monate nach der Behandlung. 56 Kleinkinder (mittleres Alter = 19,13 Monate), die aufgrund von Verhaltensstörungen über einen Zeitraum von 8 Wochen an eine gemeindebasierte Klinik in Australien verwiesen worden waren, um die CDI-T Intervention zu erhalten, nahmen an der Studie teil. Die Datenerhebung erfolgte zu Studienbeginn (Messzeitpunkt 1), nach der Behandlung (Messzeitpunkt 2) und nach 4 Monaten (Messzeitpunkt 3) durch Fragebögen und Beobachtungsmaße. Sowohl zum Messzeitpunkt 2 als auch zum Messzeitpunkt 3 gab es statistisch signifikante Steigerungen in der beobachteten Elternkompetenz und in der emotionalen Verfügbarkeit sowie Abnahmen im negativen Elternverhalten und im unbeteiligten Verhalten der Kinder. Es gab auch signifikante Verbesserungen bei dem von Eltern berichteten kindlichen Externalisierungs- und Internalisierungsverhalten, beim elterlichen Stress und bei der mütterlichen Depressivität. Außerdem gab es eine Tendenz hin zur Abkehr von Bindungsunsicherheit und desorganisierter Bindungen. Die Ergebnisse legen nahe, dass die CDI-T-Phase von PCIT-T eine vielversprechende Intervention für Kleinkinder mit Verhaltensproblemen ist. Zukünftige Studien sollten durchgeführt werden, um die Wirksamkeit in anderen Settings und unter Verwendung größerer Stichproben sowie randomisierter kontrollierter Designs zu bewerten.地域における幼児との親子相互交流療法:情緒的応答性、幼児の行動及びアタッチメントの向上 幼児との親子相互交流療法(PCIT-T)は、挑戦的行動を示す12-24ヶ月児の要求に応えることを目的とし、アタッチメント理論を基盤とした養育への介入のものである。本研究は、PCIT-Tの第一段階である 子ども指向相互交流−幼児 (CDI-T)の治療後4ヶ月たった時点において、結果を考察した。参加者は、困難な幼児行動の治療を行うために、オーストラリアの地域を基盤とした幼児行動治療クリニックに8週間のCDI-Tを受けるために紹介された56人の幼児(子ども平均19.13ヶ月)であった。参加者は、開始前(Time 1)と治療直後(Time 2)、4ヶ月後のフォローアップ時(Time 3)に、質問紙と観察測定を完了した。Time 2とTime 3の両方に、 観察された肯定的な養育スキルと情緒的応答性において統計的に有意な増加があり、否定的な養育スキルと子どもの不服従において有意な減少があった。また、 親の報告による子どもの外在化・内在化行動、親自身のストレス及び母親の抑鬱に関しては有意な改善があった。アタッチメントの不安型と無秩序型から変化していくという傾向があった。結果は、PCIT-TにおけるCDI-T段階というものが、 行動に課題のある幼児にとって有望な介入であると示唆される。今後は、別の設定において、より多くの標本を使用したり、無作為化対照デザインを活用するなどして、効果を評価する更なる研究が必要であろう。.针对幼儿的亲子互动疗法 (PCIT-T) 是一种基于依恋的新型育儿干预措施, 旨在满足表现出挑战性行为的12-24个月龄儿童的需要。本研究检验了治疗后4个月的PCIT-T第一阶段--以幼儿为主导的干预疗法 (CDI-T) 的疗效。研究参与者为56名幼儿 (平均月龄为19.13) , 他们在专治困难幼儿行为的澳大利亚社区儿童行为治疗诊所接受了为期8周的CDI-T治疗。参与者分别在治疗起始阶段 (时间1) 、治疗后 (时间2) 和4个月的随访阶段 (时间3) 三个时间点完成了调查问卷和观测评估。在时间2和时间3两个阶段, 我们观测到父母的积极育儿技能和情感回馈度在统计学上均显著增加, 而消极育儿行为和儿童不顺从性在统计学上均显著减少。父母报告的儿童外化和内化行为、育儿压力和母亲抑郁症也都有显著改善。 从而得到一种摆脱不安全型依恋和混乱型依恋的方式。结果表明, PCIT-T的CDI-T阶段对于出现行为问题的幼儿是一种有希望的干预疗法。未来的研究应该在其他环境下, 使用更大的样本并利用随机对照设计来评估疗效。.العلاج بالتفاعل بين الوالدين والطفل مع الأطفال الصغار في بيئة مجتمعية: التحسينات في التوافر العاطفي وسلوك الأطفال والتعلق. الملخص العلاج بالتفاعل بين الوالدين والطفل مع الأطفال الصغار (PCIT-T) هو تدخل أبوي جديد قائم على التعلق مصمم لتلبية احتياجات الأطفال الذين تتراوح أعمارهم بين 12-24 شهرًا الذين يعانون من سلوكيات صعبة. تناولت هذه الدراسة نتائج المرحلة الأولى من PCIT-T، والتفاعل الموجه للأطفال (CDI-T)، و4 أشهر من العلاج. وكان المشاركون 56 طفلاً صغيراً (معدل عمر = 19.13 شهراً) المشار إليهم في تلقي CDI-T على مدى 8 أسابيع في عيادة علاج سلوك الأطفال المجتمعية الأسترالية لعلاج سلوكيات الأطفال الصعبة. وأكمل المشاركون استبيانات ومقاييس ملاحظة في بداية العلاج (الوقت 1)، وما بعد العلاج (الوقت 2)، والمتابعة لمدة 4 أشهر (الوقت 3). وفي كل من الوقت 2 والوقت 3، حدثت زيادات ذات دلالة إحصائية في مهارات الأبوة الإيجابية الملحوظة والتوافر العاطفي والانخفاض في السلوكيات الوالدية السلبية وعدم امتثال الأطفال. كما حدثت تحسينات كبيرة في السلوكيات الخارجية والداخلية للأطفال المبلغ عنها من الوالدين، والإجهاد الأبوي، والاكتئاب الأمومي. كان هناك نمط من التحول بعيدا عن انعدام أمن وعدم تنظيم التعلق. تشير النتائج إلى أن مرحلة التفاعل الموجه للأطفال من PCIT-T هي تدخل واعد للأطفال الصغار الذين يظهرون مشكلات سلوكية. ويجب إجراء دراسات مستقبلية لتقييم الفعالية في بيئات أخرى، باستخدام عينات أكبر واستخدام تصاميم معشاة خاضعة للرقابة.

The findings of this empirical research provide new information about the importance of caregiver interactions during care routines, specifically diaper changing, in supporting infant and toddler involvement and well-being. This correlational study involved observations of 144 separate diapering cycles by 31 caregivers with 74 infants and toddlers in 30 infant and toddler classrooms in a U.S. Midwest city. Based on these observations, caregiver responsiveness was found to be significantly related to both child involvement and child well-being. Another feature of caregivers' behavior, caregiver encouragement, was significantly associated with child well-being, but not child involvement. The study results suggest that caregivers' behaviors, specifically responsiveness and encouragement, during diapering are vital proximal processes in the moment-to-moment interactions between a caregiver and child. Thus, responsiveness and encouragement in care routines should be emphasized in infant care settings and be a focus for caregiver professional development, including pre- and in-service training. Although training related to diapering is often restricted to health concerns, the findings suggest that specific caregiver-child interactions during this care routine may support or hinder children's well-being and involvement in the moment. Caregiver responsiveness to children's cues in this context may enhance children's opportunities to practice involvement in bidirectional relationships and support children's well-being.Los resultados de esta investigación empírica aportan información acerca de la importancia de las interacciones del cuidador durante las rutinas de prestar el cuidado, específicamente el cambio de los pañales, en cuanto a apoyar la participación y el bienestar del infante y el niño pequeñito. Este estudio correlativo incluyó las observaciones de 144 ciclos separados de cambios de pañales por parte de 31 cuidadores con 74 infantes y niños pequeñitos en 30 salas para infantes y niños pequeñitos en una ciudad del medio oeste de los Estados Unidos. Con base en estas observaciones, se encontró que la sensibilidad del cuidador estaba significativamente relacionada con la participación y el bienestar del niño. Otra característica del comportamiento del cuidador, la motivación del cuidador, se asoció significativamente con el bienestar del niño, pero no con la participación del niño. Los resultados del estudio sugieren que los comportamientos de los cuidadores, específicamente la sensibilidad y la motivación, durante el cambio de pañales son procesos vitales proximales en las interacciones de momento a momento entre un cuidador y el niño. Por tanto, la sensibilidad y la motivación en las rutinas de prestar cuidado deben enfatizarse en escenarios de cuidados a infantes y deben ser el enfoque para el desarrollo profesional del cuidador, incluyendo el entrenamiento previo y durante el servicio. Mientras que el entrenamiento relacionado con el cambio de pañales es a menudo restringido a las preocupaciones de salud, los resultados sugieren que interacciones específicas entre cuidador y niño durante la rutina de este cuidado pudieran apoyar o impedir el bienestar y la participación del niño en este momento. La sensibilidad del cuidador a las señales del niño en este contexto pudiera mejorar las oportunidades del niño para practicar la participación en relaciones bidireccionales y apoyar el bienestar de los niños.Les résultats de ces recherches empiriques offrent de nouvelles données sur l'important des interactions de la personne prenant soin de l'enfant durant les routines de soin, plus particulièrement le changement de couche, dans le soutien à l'implication et au bien-être du nourrisson et du petit enfant. Cette étude corrélationnelle a compris des observations de 144 cycles de changement de couche séparés, faits par 31 personnes prenant soin de 74 nourrissons et petits enfants dans 30 crèches dans une ville américaine du centre-nord des Etats-Unis. Basé sur ces observations on a établi que la réaction des personnes prenant soin des enfants était liée de manière importante à l'implication de l'enfant et au bien-être de l'enfant. Un autre trait du comportement des personnes prenant soin de l'enfant, leurs encouragements, était lié de manière important au bien-être de l'enfant, mais pas à l'implication de l'enfant. Les résultats de l’étude suggèrent que les comportements des personnes prenant soin de l'enfant, plus spécifiquement la réaction et l'encouragement, durant le changement de couche sont des processus de proximité essentiels dans les interactions moment-à-moment entre la personne prenant soin de l'enfant et l'enfant. Donc la réaction et l'encouragement dans les routines de soin devraient être soulignés dans les contextes de soin au nourrisson et leur nécessitée accentuée dans la formation professionnelle des personnes prenant soin d'enfant, y compris durant la formation pré-emploi et la formation continue. Bien que la formation au changement de couches soit souvent confinée aux préoccupations en matière de santé les résultats suggèrent que les interactions spécifiques personne prenant soin de l'enfant-enfant durant cette routine de soin peut soutenir ou entraver le bien-être et l'implication des enfants dans le moment. La réaction des personnes prenant soin de l'enfant aux signaux des enfants dans ce contexte peut accroître les opportunités qu'ont les enfants de s'impliquer dans des relations bidirectionnelles et soutenir le bien-être des enfants.Interaktionen zwischen Säuglingen, Kleinkindern und ihren Betreuer:innen während des Wickelns: Reaktivität der Betreuungsperson, Wohlbefinden und Beteiligung des Kindes Die Ergebnisse dieser empirischen Untersuchung liefern neue Informationen über die Bedeutung der Interaktionen von Betreuer:innen während Pflegeroutinen. Dabei liegt der Fokus darauf, inwiefern das Windelwechseln für die Beteiligung sowie das Wohlbefinden von Säuglingen und Kleinkindern eine Unterstützung sein kann. Die vorliegende Korrelationsstudie umfasste 144 Beobachtung von separaten Wickelzyklen, an denen 31 Betreuer:innen mit 74 Säuglingen und Kleinkindern in 30 Säuglings- und Kleinkindgruppen in einer Stadt im mittleren Westen der USA beteiligt waren. Basierend auf diesen Beobachtungen wurde festgestellt, dass die Reaktivität der Betreuer:innen signifikant mit der Beteiligung und dem Wohlbefinden der Kinder assoziiert ist. Ermutigung durch die Betreuer:innen war ebenfalls signifikant mit dem kindlichen Wohlbefinden, aber nicht mit der kindlichen Beteiligung assoziiert. Die Ergebnisse der Studie deuten darauf hin, dass das Verhalten der Betreuer:innen während des Wickelns, insbesondere Reaktivität und Ermutigung, wichtige proximale Prozesse in den Moment-zu-Moment-Interaktionen zwischen Betreuungsperson und Kind sind. In der Säuglingspflege sollten daher Reaktivität und Ermutigung während der Pflegeroutine in den Vordergrund gerückt werden. Außerdem sollten sie einen Schwerpunkt in der Ausbildung von KiTa-Betreuer:innen darstellen, einschließlich vor- und nachbereitender Schulungen. Aktuell sind Schulungen zum Wickeln oft auf gesundheitliche Belange beschränkt. Die vorliegenden Ergebnisse deuten allerdings darauf hin, dass spezifische Interaktionen zwischen Betreuungsperson und Kind während dieser Pflegeroutine das kindliche Wohlbefinden und die Beteiligung des Kindes in diesem Moment unterstützen oder behindern können. Das Eingehen der Betreuer:innen auf die kindlichen Signale in diesem Kontext kann den Kindern eine Gelegenheit bieten, sich in bidirektionalen Beziehungen zu üben und somit das kindliche Wohlbefinden fördern.おむつ替え時の保育者と乳幼児・幼児の相互作用:保育者の応答性と子の幸福と関わり この実証研究では成果として、乳幼児と幼児の関わりと幸福を支援する上で、日常的な世話、特におむつ替え時の保育者との相互作用の重要性についての新しい情報を提供する。この相関研究は、米国中西部のある都市の乳幼児と幼児の30教室で、74人の乳幼児と幼児を担当する31人の保育者による144の独立したおむつ交換サイクルの観察を含む。これらの観察によると、保育者の応答性が、子の関わりや子の幸福と有意に関連していた。保育者の行動の別の特徴である保育者の励ましは、子の幸福と有意な関連性があったが、子の関わりとは相関しなかった。研究の結果は、保育者のおむつ替え時の行動、特に応答性と励ましが、保育者と子の間の瞬間瞬間の相互作用において、不可欠な近接過程であると示唆している。このように、日常的な世話の時の応答性と励ましは、乳幼児を世話する場では重視されるべきである。そして、保育者の前研修や実地訓練を含めて、専門性の発達の中心であるべきである。おむつに関係するトレーニングがしばしば健康懸念に限定される一方で、結果は、日常的な世話の時の特定の保育者-子の相互作用はその瞬間の子の幸福と関わりを支えたり妨げたりしている可能性があると示唆している。この文脈における子どもからのサインに対する保育者の応答性は、双方向の関係性への関わりを経験し、子どもの幸福を支える子どもの機会を強化するであろう。.这项实证研究的结果提供了看护者有关护理程序中 (特别是换尿布) , 用以帮助婴幼儿参与度和健康度的互动的重要性的新信息。这项相关研究涉及在美国中西部城市的30个婴幼儿教室中, 由31位看护者对74名婴幼儿进行的144个单独的换尿布周期的观察。基于这些观察, 发现看护者的响应与儿童参与度、儿童健康度显著相关。看护者行为的另一个特征, 即看护者的鼓励, 与儿童健康度显著相关, 但与儿童参与度无关。研究结果表明, 看护者在换尿布过程中的行为, 特别是响应和鼓励, 是看护者与儿童之间即时互动的重要近体过程。因此, 在婴儿护理机构中应强调护理程序中的响应和鼓励, 并将其作为看护者专业发展的重点, 包括岗前和在职培训。虽然与换尿布有关的培训通常只限于健康方面的考虑, 但研究结果表明, 在这一护理程序中, 特定的看护者与儿童之间的互动可能会帮助或阻碍儿童的健康度和参与度。在这种情况下, 看护者对儿童暗示的响应可能会增加儿童练习参与双向关系以及帮助儿童健康的机会。.تفاعلات الرضع والأطفال مع مقدمي الرعاية أثناء وضع الحفاظات: استجابة مقدم الرعاية ورفاه الطفل ومشاركته توفر نتائج هذا البحث التجريبي معلومات جديدة حول أهمية تفاعلات مقدمي الرعاية أثناء روتين الرعاية ، وتحديدا تغيير الحفاضات ، في دعم مشاركة الرضع والأطفال الصغار ورفاهيتهم. شملت هذه الدراسة الارتباطية ملاحظات على 144 دورة حفاضات منفصلة من قبل 31 من مقدمي الرعاية مع 74 رضيعا وطفلا صغيرا في 30 فصل دراسي للرضع والأطفال الصغار في مدينة في الغرب الأوسط الأمريكي. واستنادا إلى هذه الملاحظات، تبين أن استجابة مقدمي الرعاية كانت ترتبط ارتباطا كبيرا بمشاركة الطفل ورفاهيته. وهناك سمة أخرى لسلوك مقدمي الرعاية، وهي تشجيع مقدمي الرعاية، ترتبط ارتباطا كبيرا برفاهية الطفل، ولكن ليس بمشاركته. تشير نتائج الدراسة إلى أن سلوكيات مقدمي الرعاية، وعلى وجه التحديد الاستجابة والتشجيع، أثناء وضع الحفاظات هي عمليات حيوية في التفاعلات اللحظية بين مقدم الرعاية والطفل. وبالتالي، ينبغي التأكيد على الاستجابة والتشجيع في روتينات الرعاية في سياق رعاية الرضع وأن يكونا محورا للتطوير المهني لمقدمي الرعاية، بما في ذلك التدريب قبل الخدمة وفي أثناءها. وفي حين أن التدريب المتعلق بوضع الحفاظات يقتصر في كثير من الأحيان على الشواغل الصحية، فإن النتائج تشير إلى أن التفاعلات المحددة بين مقدمي الرعاية والأطفال أثناء روتين الرعاية هذا قد تدعم أو تعوق رفاهية الأطفال ومشاركتهم في لحظة التفاعل. وقد تعزز استجابة مقدمي الرعاية لإشارة الأطفال في هذا السياق فرص الأطفال لممارسة المشاركة في العلاقات الثنائية الاتجاه ودعم رفاهية الأطفال.

We apply a biopsychosocial approach to introduce early-in-life experiences that explain a significant part of the male preponderance in the perpetration of violence. Early caregiver abuse and neglect, father absence, and exposure to family and neighborhood violence exacerbate boys' greater risk for aggressive behavior and increase the probability of carrying out violent acts later in life. We examine the development of the psychological self and explore conditions that encourage physical aggression, focusing on the impact on the infant and toddler's emergent mental representation of self, others, and self-other relationships. Boys' slower developmental timetable in the first years of life may enhance their vulnerability for disorganization in emergent neurobiological networks mediating organization of socioemotional relationships. Emergent attachment and activation relationship systems may differentially affect risk and resilience in boys and girls, particularly in single-parent families. Evidence has suggested that the dramatic increase in single-parent families is especially linked to corresponding increases in behavioral undercontrol, antisocial behavior, and the emergence of violence in boys.

Parental reflective functioning (RF), the ability to consider the child's behavior as a function of mental states (cognitions, emotions), is theorized to promote emotion regulation in children via its positive impact on parenting sensitivity. Using a sample of mothers and toddlers (N = 151 dyads; 41% Latinx; 54% girls; MLa función de reflexión de los padres (RF), la habilidad de considerar el comportamiento del niño como una función de los estados mentales, promueve, según la teoría, la regulación de la emoción en los niños por medio de su impacto en la sensibilidad de los progenitores. Con un grupo muestra de madres y niños pequeñitos (N = 151 díadas; 41% Latinx; 54% niñas; Edad M = 21 meses; Edad SD = 2.5 meses), medimos la auto-reportada RF de las madres (RF alta = baja certeza/alto interés-curiosidad/baja pre-mentalización), la angustia de los niños pequeñitos durante una tarea estándar de reto de comportamiento (apartar un juguete) y tres métodos de cómo los niños se las arreglan con la angustia. Entonces, pusimos a prueba si la RF moderaba la asociación entre la observada angustia de los niños pequeñitos y el arreglárselas con la tarea (el arreglárselas con adaptarse a la directriz de la madre, el arreglárselas con adaptarse a la directriz de la tarea, agresión mal adaptada) como índice de regulación de la emoción. A pesar de que no se asoció la RF con la angustia de los niños pequeñitos, los índices de RF moderaron las asociaciones entre la angustia y el proceso de arreglárselas. A medida que la RF aumentó, también aumentó la positiva asociación entre la angustia del niño pequeñito con ambas, orientado hacia la madre, mientras que la asociación entre la angustia del niño pequeñito y la agresividad del niño disminuyó. Los resultados estuvieron presentes sólo en cuanto a la certeza de los estados mentales, mientras que ningún efecto se presentó en el caso de la pre-mentalización o el interés/curiosidad. Discutimos estos resultados en términos de sus contribuciones a la teoría acerca de las relaciones progenitor-niño, RF materna y la regulación de la emoción del niño.Parental reflective functioning (RF), the ability to consider the child's behavior as a function of mental states, is theorized to promote emotion regulation in children via its positive impact on parenting sensitivity. Using a sample of mothers and toddlers (N = 151 dyads; 41% Latinx; 54% girls; MAge = 21 months; SDAge = 2.5 months), we measured mothers’ self-reported RF (high RF = low certainty/high interest-curiosity/low prementalizing), toddlers’ distress during a standardized challenging behavioral task (toy removal), and three methods of children's coping with distress. Then, we tested whether RF moderated the association between children's observed distress and coping during the task (mother-directed adaptive coping, task-directed adaptive coping, maladaptive aggression) as an index of emotion regulation. Although RF was not associated with toddlers’ distress, indices of RF moderated the associations between distress and coping. As RF increased, the positive association between toddler distress with both mother-oriented increased, whereas the association between toddler distress and child aggression decreased. Findings were present only for certainty of mental states, whereas no effects were present for prementalizing or interest/curiosity. We discuss these findings in terms of their contributions to theory regarding parent-child relationships, maternal RF, and child emotion regulation.Der Zusammenhang von mütterlicher Reflexionsfähigkeit und der adaptiven Emotionsregulation von Kleinkindern Es wird angenommen, dass die elterliche Reflexionsfähigkeit (RF; d.h. die Fähigkeit, kindliches Verhalten als Konsequenz mentaler Zustände zu betrachten) durch ihren positiven Einfluss auf die elterliche Sensibilität die kindliche Emotionsregulation fördert. Anhand einer Stichprobe von Müttern und Kleinkindern (N = 151 Dyaden; 41% Latinx; 54% Mädchen; M(Alter) = 21 Monate; SD(Alter) = 2,5 Monate) haben wir folgende Konstrukte gemessen: die selbstberichtete mütterliche RF (hohe RF = geringe Gewissheit / große(s) Interesse-Neugierde / geringe Prementalisierung), die Belastung der Kleinkinder während einer standardisierten herausfordernden Verhaltensaufgabe (Spielzeugentfernung) und drei kindliche Methoden des Stress-Copings als Index für Emotionsregulation (auf die Mutter gerichtete adaptive Bewältigung, auf die Aufgabe gerichtete adaptive Bewältigung und maladaptive Aggression). Anschließend prüften wir, ob RF die Assoziation zwischen der beobachteten kindlichen Belastung und dem Coping während der Aufgabe moderierte. Obwohl RF nicht der kindlichen Belastung assoziiert war, moderierten die RF-Indizes die Assoziationen zwischen Belastung und Coping. Mit zunehmender RF nahm der positive Zusammenhang zwischen kindlicher Belastung und Orientierung zur Mutter zu, während der Zusammenhang zwischen kindlicher Belastung und Aggression abnahm. Diese Ergebnisse fanden sich nur im Zusammenhang mit der Gewissheit über mentale Zustände, während bzgl. Prementalisierung oder Interesse/ Neugierde keine Effekte gefunden wurde. Wir diskutieren die Ergebnisse im Hinblick auf ihren theoretischen Beitrag zu Eltern-Kind-Beziehungstheorien, mütterlicher RF und kindlicher Emotionsregulation.母の内省機能の高まりと幼児の適応的情緒調節の関連について 親の内省機能 (reflective fuctioning: RF) 、つまり子どもの行動を心理状態の働きのひとつとみなして考察する能力は、子育ての感受性への良い影響を通じて子どもの情緒調節を促進すると理論づけられている。私達は母と幼児 (N = 151組;41％ラテンアメリカ系;54％女児;年齢の平均値 = 生後21か月;年齢の標準偏差 = 2.5か月) のサンプルにおいて、母の自己報告によるRF (高RFとは、確信的理解の低さ/興味関心の高さ/メンタライジング前の低さ) と、標準化された困難な行動上の課題 (おもちゃを奪われる) の間の幼児のストレスと、３つの方法での子どものストレスコーピングを評価した。さらに私達は、RFが子どもに観察されたストレスと課題へのコーピング (母指向適応的コーピング、課題指向適応的コーピング、不適応による攻撃性) の関連を和らげるかどうかを感情調節の指標として検証した。RFと幼児のストレスとは関連が認められなかったが、RFの指標はストレスとコーピングの関係を緩和した。RFが高くなると、幼児のストレスと母指向適応的コーピングの増加には明らかな関連が認められる一方で、幼児のストレスと攻撃性の関連は減少した。心理状態の確信的理解については有意な所見を認めたが、メンタライジング前状態と興味関心の高さについては関連がみられなかった。私達はこれらの結果を親子の関係性、母のRF、子どもの情緒調節に関する理論に寄与するものとして、考察する。.育儿反思功能 (RF) , 将孩子的行为视为心理状态的一种能力, 理论上被认为是通过其对父母育儿敏感性的积极影响来促进儿童的情绪调节。以母亲和幼儿为样本 (N = 151 母婴二元组;41%拉丁裔;54%女孩;MAge = 21月;SDAge = 2.5月) , 我们测量了母亲自述的RF (高RF = 低确定性/高兴趣好奇心/低预心智化) , 幼儿在标准化挑战性行为任务中的困扰 (移走玩具) , 以及儿童应对困境的三种方法。然后, 我们检验了RF作为情绪调节的一个指标, 是否缓解了任务期间 (母亲导向的适应性应对、任务导向的适应性应对、不适应的攻击性) 儿童观察到的困扰与应对之间的联系。虽然RF与幼儿的困扰没有关联, 但RF指数缓和了困扰与应对之间的联系。随着RF的增加, 幼儿困扰与母亲导向的正相关性增加, 而幼儿困扰与儿童攻击性之间的正相关性减小。研究结果仅对精神状态的确定性有影响, 而对预心智化或兴趣/好奇心没有影响。我们将根据这些发现对有关亲子关系, 母亲RF和儿童情绪调节的理论贡献来讨论他们。.الأداء التأملي المرتفع للأمهات مرتبط بتنظيم العاطفة التكيفية عند الأطفال الصغار الأداء التأملي للوالدين (RF) ، هو القدرة على النظر في سلوك الطفل من منظور الحالات العقلية ، وينظر إليه الباحثون على أنه يعمل على تعزيز تنظيم العاطفة لدى الأطفال من خلال تأثيره الإيجابي على حساسية الأبوة والأمومة. استخدمت الدراسة عينة من الأمهات والأطفال الصغار (151 ثنائي) ؛ منهم 41 % من اللاتينو و54 % من الفتيات بمعدل أعمار 21 سنة. وتم قياس الأداء التأملي المبلغ عنه ذاتياً من الأمهات بحيث أن الأداء التأملي العالي = انخفاض اليقين / ارتفاع الاهتمام أو الفضول ، كما تم قياس ضيق أو انزعاج الأطفال الصغار أثناء مهمة سلوكية صعبة (إزالة لعبة) ، وثلاث طرق أخرى في كيفية تكيف الأطفال مع الضيق. ثم اختبرنا ما إذا كان الأداء التأملي (RF) قد يتوسط العلاقة بين الضيق الملاحظ على الأطفال والتعامل أثناء المهمة (التكيف الموجه من الأم ، والتكيف الموجه من خلال المهمة ، والسلوك العدائي اللاتكيفي) كمؤشر لتنظيم العاطفة. وعلى الرغم من أن الأداء التأملي لم يكن مرتبط بضيق الأطفال ، فإن مؤشراته قد توسطت العلاقة بين ضيق الطفل وسلوك التكيف. ومع زيادة مؤشر الأداء التأملي ، زادت العلاقة الإيجابية بين ضيق الأطفال الصغار والتكيف الموجه من الأم ، في حين انخفضت العلاقة بين ضيق الأطفال والسلوك العدائي. وكان هناك نتائج واضحة فقط للتيقن من الحالات العقلية، في حين لم تكن هناك آثار لمرحلة التأمل العقلي المسبق أو الاهتمام والفضول. نناقش هذه النتائج من حيث مساهماتها في النظرية الخاصة بالعلاقات بين الوالدين والطفل ، والأداء التأملي الأمومي ، وتنظيم عاطفة الطفل.

The Parent-Child Play Scale was developed as a scale that complements the Parent-Child Feeding Scale, created by I. Chatoor et al. (1997), to evaluate mother-infant/toddler interactions in two different caregiving contexts of a young child's everyday life, specifically play and feeding. This Play Scale can be used with infants and toddlers ranging in age from 1 month to 3 years and provides reliable global ratings of mother-child interactions during 10 min of videotaped free-play in a laboratory setting. The scale consists of 32 mother and infant/toddler interactive behaviors which are rated by trained observers from videotaped observations. Four subscales are derived: Dyadic Reciprocity, Maternal Unresponsiveness to Infant's/Toddler's Cues, Dyadic Conflict, and Maternal Intrusiveness. Construct validity and interrater and test-retest reliability of the Play Scale have been demonstrated. This Play Scale discriminates between children with and without feeding disorders as well as between children with different subtypes of feeding disorders as defined by the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised (DC:0-3R) (Feeding Disorder of State Regulation, Feeding Disorder of Caregiver-Infant Reciprocity, and Infantile Anorexia). It can be used for research or clinical practice in the diagnosis and treatment of early feeding problems, to assess the pervasiveness of mother-infant/toddler difficulties and to monitor changes following therapy.

Parents who are involved with child welfare services (CWSI) often have a history of childhood adversity and depressive symptoms. Both affect parenting quality, which in turn influences child adaptive functioning. We tested a model of the relations between parental depression and child regulatory outcomes first proposed by K. Lyons-Ruth, R. Wolfe, A. Lyubchik, and R. Steingard (2002). We hypothesized that both parental depression and parenting quality mediate the effects of parental early adversity on offspring regulatory outcomes. Participants were 123 CWSI parents and their toddlers assessed three times over a period of 6 months. At Time 1, parents reported on their childhood adversity and current depressive symptoms. At Time 2, parents' sensitivity to their child's distress and nondistress cues was rated from a videotaped teaching task. At Time 3, observers rated children's emotional regulation, orientation/engagement, and secure base behavior. The results of a path model partly supported the hypotheses. Parent childhood adversity was associated with current depressive symptoms, which in turn related to parent sensitivity to child distress, but not nondistress. Sensitivity to distress also predicted secure base behavior. Depression directly predicted orientation/engagement, also predicted by sensitivity to nondistress. Sensitivity to distress predicted emotion regulation and orientation/engagement. Results are discussed in terms of intervention approaches for CWSI families.

Using data from a diverse sample of low-income families who participated in the Early Head Start Research Evaluation Project (n = 73), we explored the association between mothers' and fathers' playfulness with toddlers, toddler's affect during play, and children's language and emotion regulation at prekindergarten. There were two main findings. First, fathers' playfulness in toddlerhood was associated with children's vocabulary skills in prekindergarten whereas mothers' playfulness was related to children's emotion regulation. Cross-parental effects were found only for mothers. The association between mothers' playfulness and children's vocabulary and emotion regulation was strengthened when fathers engaged in more pretend play and when children were affectively positive during the play. These findings show that playfulness is an important source of variation in the vocabulary and emotion regulation of children growing up in low-income families. They also point to domain-specific ways that mothers and fathers promote children's regulatory and vocabulary skills, and highlight the importance of children's positive engagement in play.

The purpose of this study was to explore the influence of the quality of early father-child rough-and-tumble play (RTP) on toddler aggressive behaviors and more fully understand how child, mother, and father characteristics were associated with higher quality father-child RTP among contemporary urban Chinese families. Participants included 42 families in Changsha, China. Play observations of fathers and their children were coded for RTP quality. The specific RTP quality of father-child reciprocity of dominance was associated with fewer toddler aggressive behaviors, as rated by both fathers and mothers. Mothers' democratic parenting attitudes were associated with higher quality father-child RTP. These findings suggest that higher quality father-child RTP may be one way in which some fathers influence children's expression of aggressive behaviors, and the quality of father-child RTP may be influenced by the broader family, social, and cultural contexts.

Using the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) data set (U.S. Department of Education Institute of Education Sciences, National Center for Education Statistics, 2001), this study examined child, family, and community factors in the early years (infant and toddler years) to predict the cognitive and language outcomes for preschool-age Black boys in relation to Black girls and White boys. Findings indicate that Black children face many challenges, with Black boys experiencing less sensitive parenting as compared to their peers. We live in a highly complex, racialized environment. While there are universal indicators that predict children's preschool outcomes such as strong social positioning and positive parenting, there are, in addition, some indicators that are more beneficial for Black boys’ early development, including a stable, less urban home environment with parents engaging in “tough love.”

The study examined whether the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised Edition (DC: 0-3R; ZERO TO THREE, 2005) Parent-Infant Relationship Global Assessment Scale (PIR-GAS) is applicable to six European countries and contributes to the identification of caregiver-infant/toddler dyads with abusive relationship patterns. The sample consisted of 115 dyads with children's ages ranging from 1 to 47 months. Sixty-four dyads were recruited from community settings without known violence problems, and 51 dyads were recruited from clinical settings and already had been identified with violence problems or as being at risk for violence problems. To classify the dyads on the PIR-GAS categories, caregiver-child interactions were video-recorded and coded with observational scales appropriate for child age. To test whether the PIR-GAS allows for reliable identification of dyads with abusive relationship patterns, PIR-GAS ratings were compared with scores on the the International Society for the Prevention of Child Abuse and Neglect's (ISPCAN) Child Abuse Screening Tool-Parental Version (ICAST-P; D.K. Runyan et al., ), a questionnaire measuring abusive parental disciplinary practices. It was found that PIR-GAS ratings differentiated between the general and the clinical sample, and the dyads with abusive patterns of relationship were identified by both the PIR-GAS and the ICAST-P. Interrater reliability for the PIR-GAS ranged from moderate to excellent. The value of a broader use of tools such as the DC: 0-3R to promote early identification of families at risk for infant and toddler abuse and neglect is discussed.

The experience of touch is critical for early communication and social interaction; infants who show aversion to touch may be at risk for atypical development and behavior problems. The current study aimed to clarify predictive associations between infant responses to tactile stimuli and toddler autism spectrum, internalizing, and externalizing behaviors. This study measured 9-month-old infants' (N = 561; 58% male) avoidance and negative affect during a novel tactile task in which parents painted infants' hands and feet and pressed them to paper to make a picture. Parent reports on the Pervasive Developmental Problems (PDP), Internalizing, and Externalizing scales of the Child Behavior Checklist were used to measure toddler behaviors at 18 months. Infant observed avoidance and negative affect were significantly correlated; however, avoidance predicted subsequent PDP scores only, independent of negative affect, which did not predict any toddler behaviors. Findings suggest that incorporating measures of responses to touch in the study of early social interaction may provide an important and discriminating construct for identifying children at greater risk for social impairments related to autism spectrum behaviors.

Recent research has revealed gender differences in emotional communication and affect regulation during early mother-child interactions that are consistent with later gender differences in relational behavior. The current study extends those findings to father-child interactions. Parent-toddler dyads were videotaped during quiet indoor play when the toddlers were 19 and 24 months old. The observations were coded with Biringen, Robinson, and Emde's (1998) Emotional Availability scales (3rd ed.), which yields scores for parent sensitivity, structuring, nonintrusiveness, and nonhostility, and for child responsiveness to and involvement of the parent. Analyses of mean differences revealed a consistent pattern of larger parent than child gender differences. Dyadic analyses revealed more complex results. Mother-daughter dyads displayed the highest scores, followed by mother-son, then father-daughter, and finally father-son dyads for all variables but hostility, which by 24 months was higher in same-sex than in opposite-sex dyads. Scores for father-son dyads more often fell below the scale point indicating "good enough" parenting than scores for other dyads. The inclusion of fathers in the sample extends previous findings both by eliciting an increased range of variation within child gender and by providing a first look at the emotional availability of fathers relative to that of mothers.

Early findings from the Prohibition Coding Scheme (PCS; Houck & LeCuyer, 1995; LeCuyer-Maus & Houck, 2002; Medvin & Spieker, 1985) revealed that maternal limit-setting styles with toddlers were differentially related to later child social competence, self-concept, and delay of gratification. For this study, the PCS was revised to provide more information about the specific strategies mothers used during limit-setting in relation to those outcomes. Results from the PCS-Revised (PCS-R; LeCuyer & Houck, 2004) included that the more time mothers spent actively distracting their toddlers away from a prohibited object during limit-setting, as early as 12 months, the longer their children could delay gratification at age 5 years. Mothers who spent more time sensitively following and being engaged in their toddler's own interests (other than the prohibited object), again as early as 12 months, had more socially competent children with more developed self-concepts at age 3 years. Maternal use of reasoning statements later in toddlerhood also related to higher levels of social competence. Maternal limits and prohibitions were not related to these outcomes, and appeared to contribute to the development of self-regulation mainly by creating the opportunity for the use of other, less directive strategies. The findings indicate that these strategies may be important to include in intervention programs for the promotion of toddler and child development of self-regulation.

We know that exposure to marital conflict places infants at risk, but we know less about processes. One process may be role reversal, when a distressed parent looks to the child to meet unmet needs for comfort, intimacy, or companionship. A parent in marital conflict may be particularly prone to role reversal, which in turn adversely affects child development. The current study examined pathways from infants' exposure to marital conflict at 12 months to role reversal at 24 months. We sampled low-middle socioeconomic status (SES) families with their first child (N = 128). Independent observers assessed marital conflict (in a problem-solving task) and role reversal (in a story-telling task). We found that each parent's conflict behavior predicted the other parent's role reversal. In a direct pathway, mother's conflict behavior towards father led directly to father's role reversal with the child. In an indirect pathway, father's conflict behavior towards mother led to his withdrawal from her, which in turn led to mother's role reversal with the child. Clinical implications are discussed within a developmental psychopathology framework in terms of preventive interventions to offset the deleterious effect of marital conflict and role reversal on child development.

The present study was conducted to examine the contributions of early appearing temperament attributes to toddler and preschool-age behavior problems. High levels of negative emotionality and low levels of effortful control were linked to both externalizing and internalizing difficulties. All fine-grained dimensions of negative affect were concurrently associated with internalizing problems whereas relations between components of negative affect and externalizing were observed only for frustration, sadness, and low falling reactivity. Higher surgency was associated with increased risk for externalizing behaviors whereas low surgency increased the likelihood of internalizing problems. Trait-by-trait moderation occurred, such that negative emotionality was most closely related to behavior problems when orienting/regulatory capacity or effortful control was low or when infant surgency was high. Results of this study have implications for theory linking temperament and psychopathology, and clinical applications utilizing temperament assessment to prevent behavior problems.

This study examined detached parenting among Early Head Start mothers, and associated maternal characteristics and child behavior. Participants included 81 mother–child dyads. Data were collected in participants' homes during two visits. Mothers reported on demographic factors, parenting stress, and children's problem behaviors. Children's neurodevelopment was assessed, and videotaped parent–child play interactions were coded. Path analyses indicated that demographic risk factors and parenting stress were associated with higher levels of detached parenting. As a mediator, detached parenting significantly predicted children's later problem behavior. There was a direct effect of parenting stress on children's behavior problems, but no direct effect of children's neurodevelopmental risk. Detached parenting partially mediated the influence of parenting stress on children's problem behavior. The final model moderately accounted for the variance in detached parenting and children's problem behaviors. The results suggest that parents who experience multiple risks and high levels of parenting stress are more likely to demonstrate detached parenting. In addition, detached parenting leads to higher levels of toddler problem behavior, and may increase the problem behavior displayed by toddlers of parents experiencing multiple risks and parenting stress. These findings are discussed in the context of infant mental health practice. RESUMEN Este estudio examino la crianza indiferente o desconectada en madres del programa Early Head Start, y las caracteristicas maternales asociadas y la conducta del nino. Participantes 81 diadas madre-nino. La informacion se obtuvo en casa de los participantes durante dos visitas. Las madres reportaron acerca de factores demograficos, estres de crianza y conductas problematicas de los ninos. Se evaluo el desarrollo neural de los ninos y se codificaron las interacciones de juego madre-nino que habian sido videograbadas. Los analisis criticos indicaron que los factores demograficos de riesgo y el estres de crianza estaban asociados con mas altos niveles de crianza indiferente o desconectada. Como mediador, la crianza indiferente significativamente predijo la posterior conducta problematica del nino. El estres de la crianza produjo un efecto directo en los problemas de conducta de los ninos, pero no se dio ningun efecto directo del riesgo de desarrollo neural de los ninos. La crianza indiferente o desconectada medio parcialmente la influencia del estres de crianza sobre la conducta problematica de los ninos. El modelo final moderadamente fue responsable de la variacion en la crianza indiferente y las conductas problematicas de los ninos. Los resultados sugieren que las madres que experimentan multiples riesgos y altos niveles de estres en la crianza estan mas propensas a mostrar una crianza indiferente o desconectada. Adicionalmente, la crianza indiferente lleva a mas altos niveles de conducta problematica de los infantes, y pudiera aumentar la conducta problematica que muestran los infantes de madres que experimentan multiples riesgos y estres en la crianza. Estos resultados se discuten dentro del contexto de la practica de salud mental infantil. RESUME Cette etude a examine le parentage detache chez les meres participant au programme americain de Early Head Start (programme d’aide aux familles de milieux defavorises), ainsi que le comportement de l’enfant et les caracteristiques maternelles qui y sont lies. Les participants ont compte 81 dyades mere-enfant. Les donnees ont ete recueillies aux domiciles des participantes durant deux visites. Les meres ont rendu compte des facteurs demographiques, du stress parental et des problemes de comportement des enfants. Le neurodeveloppement des enfants a ete evalue, et des interactions parent-enfant filmees a la video ont ete codees. Les analyses causales ont indique que les facteurs demographiques de risque et le stress parental etaient lies a de plus hauts niveaux de parentage detache. En tant que mediateur, le parentage detache predisait de facon importante le comportement problematique ulterieur des enfants. On a note un effet direct du stress parental sur les problemes de comportement des enfants, sans cependant noter d’effet direct du risque neurodeveloppemental des enfants. Le parentage detache a partiellement servi d’intermediaire a l’influence du stress de parentage sur comportement problematique des enfants. Le modele final a modere explique la variance dans le parentage detache et les comportements problematiques des enfants. Les resultats suggerent que les parents qui font l’experience de plusieurs risques et de niveaux eleves de stress sont plus a meme de presenter un parentage detache. De plus, le parentage detache mene a des niveaux plus eleves de probleme de comportement chez la petite enfance, et pourrait accentuer le comportement problematique dont font etat les petits enfants de parents faisant l’experience de plusieurs risques et de stress de parentage. Ces resultats sont discutes dans le contexte de la pratique de sante mentale du nourrisson et de la petite enfance. ZUSAMMENFASSUNG Diese Studie untersuchte distanziertes Elternverhalten bei Muttern, die an einem Early-Head-Start-Programm teilnahmen, und die damit verbundenen mutterlichen Eigenschaften sowie das Verhalten der Kinder. Zu den Teilnehmern gehorten 81 Mutter-Kind-Dyaden. Die Daten wurden im Zuhause der Teilnehmer wahrend zwei Hausbesuchen gesammelt. Die Mutter berichteten uber demografische Faktoren, elterliches Stresserleben und das Problemverhalten der Kinder. Die neurologische Entwicklung der Kinder wurde bewertet und Eltern-Kind-Interaktionen, die wahrend des Spielens auf Video aufgezeichnet wurden, wurden kodiert. Pfad-Analysen zeigten, dass demografische Risikofaktoren und elterliches Stresserleben mit einem hoheren Grad an distanziertem Elternverhalten assoziiert wurden. Distanziertes Elternverhalten sagte als Mediator das spatere Problemverhalten der Kinder signifikant vorher. Elterliches Stresserleben hatte einen direkten Effekt auf das Problemverhalten der Kinder, jedoch keinen direkten Effekt auf das neurologische Entwicklungsrisiko der Kinder. Distanziertes Elternverhalten mediierte partiell den Einfluss von elterlichem Stresserleben auf das Problemverhalten der Kinder. Das endgultige Modell erklarte masig die Varianz hinsichtlich distanziertem Elternverhalten und dem Problemverhalten der Kinder. Die Ergebnisse deuten darauf hin, dass Eltern, die mehrere Risiken und einen hohen Grad an elterlichem Stress erleben eher distanziertes Elternverhalten zeigen. Zusatzlich fuhrt distanziertes Elternverhalten zu mehr Problemverhalten bei Kleinkindern und kann das Problemverhalten, das Kleinkinder von Eltern mit mehreren Risiken und elterlichem Stresserleben zeigen, erhohen. Diese Ergebnisse werden im Rahmen der Praxis zur psychischen Gesundheit von Kindern diskutiert. ABSTRACT 抄録：この研究では、早期ヘッドスタートの母親たちの間の共感の乏しい育児detached parenting、およびそれに伴う母親の特徴と子どもの行動について調査した。研究に参加したのは81組の母親と子どもだった。データは、2回の家庭訪問の時に参加者の家庭で集められた。母親は、人口統計学因子、育児ストレス、および子どもの問題行動について報告した。子どもの神経発達が評価され、ビデオ録画された親子のプレイの相互交流がコード化された。パス解析から、人口統計学上のリスク因子と育児ストレスは、高い水準の共感の乏しい育児と関連していることが示された。メディエーターとして、共感の乏しい育児は、後の子どもの問題行動を有意に予測した。育児ストレスは、子どもの行動上の問題に直接の影響があったが、子どもの神経発達のリスクには直接の影響はなかった。共感の乏しい育児は、養育ストレスが子どもの問題行動に与える影響を、部分的に媒介した。最終的なモデルは、共感の乏しい育児と子どもの問題行動の分散varianceを適度に説明した。結果から、複数のリスクを経験し、高い水準の養育ストレスを持つ親は、共感の乏しい育児をより見せやすいことが、示唆される。さらに、共感の乏しい育児は、高い水準の幼児の問題行動につながり、複数のリスクと養育ストレスを経験している親の幼児によって示される問題行動を、増加させるだろう。これらの所見は、乳幼児精神保健臨床のコンテクストで考察される。 摘要 本研究旨在探討參與學前教育計劃的母親的抽離家教模式，以及相關的母親特點和兒童的行為。八十一名母子二人組合參與研究。研究人員在兩次家庭訪問中收集數據。母親報告家庭背景，親職壓力與兒童的問題行為。研究人員評估兒童的神經發育，並錄映和分析親子遊戲。徑路分析顯示，家庭背景的風險因素和親職壓力與較高的抽離家教模式有關。作為一個中介變數，抽離家教模式預測孩子的後期問題行為。親職壓力直接影響兒童的行為問題，但對兒童的神經發育風險沒有直接的影響。抽離家教部分中介親職壓力對兒童問題行為的影響。最終統計模型能中度解釋抽離家教和兒童的問題行為。結果顯示，經歷多重風險和有高親職壓力的母親比其他母親更可能採用抽離家教。此離家教導致高度的糼兒問題行為，並增加經歷多重風險和有親職壓力的家長的幼兒問題行為。研究者在幼兒心理健康實踐的背景下討論結果。

The relationship between maternal-infant interaction and attachment quality to infant developmental outcomes has long been established. As children mature, problems stemming from troubled caregiver-infant relations may result in referral to mental health or child protection services. The accurate and appropriate assessment of attachment is critical for early recognition of problematic relations and for informing suitable treatment modalities. Evaluating the quality of attachment poses a challenge for researchers and clinicians seeking to explore the association between infant development and the quality of early caregiving experiences. Although providing a definitive answer to the question of which of these assessment procedures is the single universal standard for measuring attachment quantity is beyond the scope of this article, readers will be provided with a description and comparison of strengths and limitations of the most commonly used measures of attachment, including the Strange Situation Procedure (M.D.S. Ainsworth, M.C. Blehar, E. Waters, & S. Wall, 1978), Attachment Q-Sort (E. Waters & K.E. Deane, 1985), Toddler Attachment Sort (TAS-45; J. Kirkland, D. Bimler, A. Drawneek, M. McKim, & A. Scholmerich, 2004), CARE-Index (P. Crittenden, 1985), Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE; E. Bronfman, E. Parsons, & K. Lyons-Ruth, 1999), Massie-Campbell Scale of Mother-Infant Attachment Indicators During Stress Scale (Attachment During Stress Scale; H.N. Massie & B.K. Campbell, 1983), and the Risky Situation Procedure (D. Paquette & M. Bigras, 2010).

M.C. Sarche, C.D. Croy, C. Big Crow, C. Mitchell, and P. Spicer (2009) provided first-ever information relating the socioemotional development of American Indian toddlers to the immediate context of their mothers' lives. The current study sought to replicate and build on their earlier work by examining the impact of additional maternal risk factors, identified in previous research with non-American Indian populations, on the development of American Indian toddlers: maternal depression, negative social influences, and mother's feelings of isolation. At 27 months, American Indian mothers (N = 110) completed the Parent Demographic Questionnaire, which measured maternal psychosocial characteristics (e.g., depressed affect, social support, drug and alcohol use, isolation) and demographics. Mothers also completed the Infant-Toddler Social Emotional Assessment (A.S. Carter & M.J. Briggs-Gowan, 2006) and the Parent-Child Dysfunctional Interaction subscale of the Parenting Stress Index (R.R. Abidin, 1995, 1997). Some results replicated the original study, but others did not. Reports of a dysfunctional mother-child relationship related to externalizing and internalizing problems, replicating the earlier study. This study also found associations between a dysfunctional mother-child relationship and socioemotional competence as well as dysregulation. The previous finding of a relationship between American Indian identity and socioemotional competence was supported. Adding the effects of maternal depressed affect and isolation significantly increased prediction of toddler behavior problems.

Childcare quality has been investigated widely over the past 30 years, as increasingly more evidence has emerged that shows that children's developmental outcomes are influenced by the quality of care that they receive in group-care settings. The current emphasis on quality-improvement ratings in childcare provides a unique measurement challenge to ensure accountability for the care of our young children, with a noticeable lack of attention to caregiver interactions with children. The purpose of the current study is to investigate an easy-to-use measure that might address this oversight. The Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO) tool has been shown to be reliable and valid for use with parents and was used in the current study to determine whether the PICCOLO, when used to observe caregiver–child interactions in group-care settings, is correlated with other common measures of childcare quality, including the family of Environment Rating Scales (Early Childhood Environment Rating Scale-Revised (T. Harms, R.M. Clifford, & D. Cryer, 2005), the Family Child Care Rating Scale-Revised (T. Harms, D. Cryer, & R.M. Clifford, 2007), or the Infant/Toddler Environment Rating Scale-Revised (T. Harms, D. Cryer, & R.M. Clifford, 2006).and the Arnett Caregiver Interaction Scales (J. Arnett, 1989). Two hundred seven providers were observed for a mean of 2.87 hr (172 min). Results indicate that the PICCOLO is a valid tool to measure caregiver interaction with children in a childcare situation.

This study investigated the occurrence of depressive symptoms prior to age 36 months as retrospectively reported by parents of preschoolers with clinical depression. The study provides some of the first empirical data on the manifestations of depressive symptoms during the toddler period, advancing existing theoretical and case-report literature. A sample of 301 (depressed, disruptive, and healthy) children between the ages of 3.0 and 6.0 years were screened and oversampled for depressive symptoms from community sites. Primary caregivers (parents) were interviewed about their child's symptoms of depression (as well as other symptoms of mental disorders and developmental parameters), and age of first onset of depressive symptoms was ascertained. Findings suggest that clinical-level symptoms of depression may arise as early as age 24 months. The domain of negative self-concept during the toddler period evidenced by self-deprecation and difficulty making choices emerged as the two strongest variables predictive of preschool depression. Our results suggest that prospective empirical studies of depressive symptoms in children younger than 3 years of age should now be undertaken.

Although children born preterm or low birth weight (PT LBW) are more likely to exhibit behavior problems compared to children born at term, developmental and family processes associated with these problems are unclear. We examined trajectories of maternal depressive symptoms in relation to toddler compliance and behavior problems in families with PT LBW infants. A total of 177 infants (93 boys, 84 girls) and their mothers enrolled in the study during the infant’s NICU stay. Data were collected at five time points across 2 years. Assessments of maternal depressive symptoms were conducted at all time points, and toddler compliance and opposition to maternal requests and behavior problems were assessed at 2 years. Toddlers born earlier with more health problems to mothers whose depressive symptoms increased over time exhibited the most opposition to maternal requests during a cleanup task at 24 months, consistent with multiple risk models. Mothers with elevated depression symptoms reported more behavior problems in their toddlers. The study has implications for family-based early intervention programs seeking to identify PT LBW infants at highest risk for problem behaviors.

A longitudinal case study of a 3-year-old toddler, born with a congenital, severe, life-threatening skin disease, with comorbid diagnoses of failure to thrive and feeding disorder, is described and discussed. The referral, diagnostic, and therapeutic processes are described, and the main themes of the treatment sessions are presented in the associative order that they occurred. The understanding of the case is very much based on the "me-skin'' concept. We have tried, through this case, to show the ways that we work with multidisciplinary team countertransferential reactions to the young child and her parents, the role that the child psychiatrist may take, and the special difficulty in working with cases that raise fear of death in parents as well as in therapists. We raise existential questions about worth of life, infant's will to grow, and infant's drive to live forever a painful life.

Dyadic interactions between 84 at-risk toddlers and their nondrug-, polydrug-non-cocaine-, or polydrug-cocaine-using mothers were examined during unstructured play. Coded videotaped behaviors revealed two maternal constructs (interactive competence, maladaptive engagement) and three toddler constructs (responsiveness, active positive initiation, play). Cocaine-using mothers displayed more maladaptive engagement than did prenatal nondrug users; however, poorer interactive competence further distinguished them from polydrug-but-noncocaine users. Toddlers of cocaine-using mothers displayed less responsiveness and positive initiation than non-drug-group peers; however, these behaviors did not reliably differ from polydrug-non-cocaine counterparts. Play interest remained relatively similar across groups. Results suggest that difficulties in social interaction appear to continue among cocaine-using mothers during dyadic exchanges with their offspring in the second year; however, toddler deficits do not appear to be greater than those experienced by polydrug-non-cocaine counterparts.

This article examines the socialization goals, representations, and practices in toddler- and preschool-age children and their Mexican immigrant or U.S.-born, Mexican-heritage mothers. Eighty-eight mothers and children (49% girls) participated in this research. All mothers were visited in their homes to be observed and interviewed when the children were 8, 14, 24, and 36 months old. The study used naturalistic observations of children's behavior and participation in everyday routines and their mothers' socialization practices. Prekindergarten teachers reported on the children's school social skills. It was expected that differences in mothers' participation in four distinct cultural communities would be associated with variations in their socialization goals and practices. The mothers articulated socialization goals that were reflective of positive social relationships. Compliance episodes were less frequent than participation in everyday routines. The mothers' participation in different cultural communities was associated with different practices in routines, but not with goals or compliance practices. Toddler and preschool observations of children and mothers were associated with teachers' ratings of children's prekindergarten social skills.

This study examined maternal sensitivity in response to toddler distress in relation to mothers' childhood care and control experiences with parents, maternal depression, and maternal anger. Fifty-two mothers and infants participated. Mothers reported childhood care and control experiences prenatally. At 2½ years, mothers reported depressive symptoms and anger on questionnaires, and reported maternal behavior in a daily diary for 1 week, yielding ratings of maternal sensitivity to fear and anger. Results were as follows: (a) Mothers' acceptance during childhood correlated negatively with both maternal depression and maternal anger, and positively with maternal sensitivity to fear at 2½ years; (b) maternal anger mediated the association between childhood care and maternal sensitivity to fear at 2½ years; and (c) the interaction of maternal and paternal control during childhood predicted maternal sensitivity to anger at 2½ years, controlling for maternal education. When maternal control was low, paternal control was positively associated with maternal sensitivity to anger whereas when maternal control was high, paternal control was negatively associated with maternal sensitivity to anger. Results are discussed in relation to prior studies, with particular emphasis on attachment theory. Implications for preventive intervention efforts are considered.

We report on data provided by a nationwide panel of 23 infant mental health (IMH) experts who provided numerical ratings of the relative importance of 143 competencies desirable for licensed mental health therapists working with infants/children birth to 5 years of age and their families/caregivers. The competencies were developed based on prior state and national efforts and our own experience in training IMH therapists. The competencies were grouped conceptually into seven areas: (a) Normal infant and toddler development; (b) Atypical development (perturbations in development); (c) Emotional/behavioral disorders in infants and young children; (d) Assessment; (e) Intervention; (f) Community resources and referrals; and (g) Organization, communication, and collaboration. We calculated means, SDs, 95% confidence intervals to rank order each competency. We conducted reliability analyses and tested for mean differences in ratings for the seven areas. Interrater and intraclass correlations were modest, likely the result of restriction of range in the ratings. The seven areas showed high levels of internal consistency and, with few exceptions, did not significantly differ in the means of their ratings. The utility of the competencies are discussed as a framework for training and professional development for IMH clinicians.

One planned consequence of the national Infant Mental Health Forum held in the United States in 2000 was the funding of five research projects conducted in Early Head Start (EHS) programs. Each project strengthened existing programs by integrating infant/toddler mental health approaches and testing the outcomes on infant/toddler development, behavior, and parent-child interactions. In two of the projects, the effect of offering enrichment for EHS staff was tested. The other three projects tested the effect of services offered directly to parents and children. This article describes the five projects and the theories, methods, and outcome measures used. In order to understand more fully the elevated risk factors in these families and the consequences for mental health in their infants and toddlers, a common set of measures was developed. Data have been used to explore the common threats to mental health and the factors that moderate the impact on infants and toddlers.

Suppose a toddler becomes distressed after hearing a loud noise or when getting messy; are these indicators of sensory over-responsiveness or indicators of anxiety? There is little evidence regarding the distinction between sensory over-responsivity and anxiety disorders in toddlers. This construct validity study examined differences between occupational therapists' and psychologists' judgments of behaviors as representing sensory processing disorders (SPD) versus anxiety disorders. Twenty-four occupational therapists and 25 psychologists completed a mailed survey, rating items from sensory and anxiety scales as representing sensory and/or anxiety disorders in toddlers, and analyzing cases of toddlers with these disorders. Occupational therapists were more likely to rate items as representing SPD than psychologists, and occupational therapists were more certain of the distinction of the sensory scales from anxiety. For the case designed to present a general anxiety disorder and the one designed to present sensory over-responsivity, more occupational therapists diagnosed as sensory over-responsive, while more psychologists diagnosed with a general anxiety disorder. The overlap in judgments of sensory over-responsivity and anxiety supports the notion that these constructs in part reflect different professionals' perspectives upon behaviors as well as the difficulty in distinguishing these constructs in toddlers.

Despite prompts from the field of family therapy since its inception, contemporary infant mental health theory and practice remain firmly rooted in and guided by dyadic-based models. Over the past 10 years, a groundswell of new empirical studies of triadic and family group dynamics during infancy have substantiated that which family theory has contended for decades: looking beyond mother-infant or father-infant dyads reveals a myriad of critically important socialization influences and dynamics that are missed altogether when relying on informant reports or dyad-based interactions. Such family-level dynamics emerge within months after infants are born, show coherence through time, and influence the social and emotional adjustment of children as early as the toddler and preschool years. This report summarizes key findings from the past decade of empirical family studies, highlights several areas in need of further conceptual development and empirical study by those who work with infants and their families, and outlines important implications of this body of work for all practicing infant mental health professionals.

An accumulating body of research suggests that the capacities children acquire that prepare them for learning in formal educational settings are multilevel and complex with multiple contributing factors that begin in infancy. A new U.S. longitudinal study, the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), is designed to enable researchers to examine how an array of children's capacities and skills function individually and jointly to promote or hinder the acquisition of school readiness. The ECLS-B follows a nationally representative sample of 10,688 children born in the U.S. in 2001. Baseline data on the children and their families were collected at 9 months of age with follow-up at ages 2, 4, and kindergarten entry. Information on study children's socioemotional development is derived from several sources: videotaped mother-child interactions, parent interviews, and field staff observations. Because attachment is such an important indicator of children's socioemotional development during the toddler period, the study devoted considerable resources to designing an attachment measure. The Toddler Attachment Sort-45 (TAS-45) was designed to meet the need for a simple yet valid measure that did not require extensive training for field staff to administer easily. The TAS-45 generates the classical attachment categories and security and dependency scores.

The development of the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-3; Zero to Three: National Center for Clinical Infant Programs, 1994) has been an important step in the field of infant mental health. In this paper, we propose some additions to the existing classification system. These additions include the development of criteria for infant, toddler, and family strengths, and the development of criteria for symptomatology that represents risk for disorder, but not fully manifest disorder. These additions will give DC: 0-3R greater potential for use in the primary health care of children, thereby increasing the system's utility in diagnosing and preventing infant mental health problems.

This study was designed to examine parenting self-efficacy beliefs as correlates of mothers' competence in parenting toddlers and as predictors of toddlers' behavior and development. Sixty-eight predominantly middle-class mother–toddler pairs participated in this study. Mothers completed questionnaires, toddlers were administered the Bayley Scales of Infant Development (BSID-II), and each dyad participated in the Crowell Procedure, which is designed to observe parent and toddler behaviors in a semistructured laboratory context. Although domain-general and domain-specific parenting self-efficacy beliefs were not associated with parenting competence, domain-specific beliefs were significantly related to toddlers' scores on the Mental Scale of the BSID-II and several behaviors observed during the Crowell Procedure (Affection Towards Mother, Avoidance of Mother, Compliance, Enthusiasm, and Negativity). Implications of the findings are discussed. ©2003 Michigan Association for Infant Mental Health.

This study assessed relations between maternal depression, maternal behavior, and helplessness in toddlers. Helplessness was assessed behaviorally in 25- and 32-month-old toddlers while the toddlers were engaged with an impossible task. Maternal behavior (warmth, negativity, control, intrusiveness) was assessed during a mother–child teaching task when toddlers were 18 and 25 months of age. Mothers who reported more depressive symptoms on the BDI had 32-month-old toddlers who displayed more affect-related helplessness. No direct relations were found between maternal diagnosis of depression and helplessness in toddlers. Few differences emerged in the behavior of depressed and nondepressed mothers while interacting with their toddlers, and few relations were found between maternal behavior alone and toddlers' helplessness. However, results suggest that maternal behavior moderates the relation between maternal depression (diagnosis, recency, and symptoms) and helplessness. ©2003 Michigan Association for Infant Mental Health.

Des etudes recentes se sont interrogees et se sont demandees si le jeu d'enfants exposes a la cocaine ou exposes a plusieurs substances est defectueux ou perturbe, vraisemblablement a cause de l'exposition prenatale. Dans cette etude, la qualite du jeu du petit enfant n'a pas differe entre 13 petits enfants issus d'un milieu defavorise et exposes a plusieurs substances et 13 petits enfants issus d'un milieu defavorise mais non exposes, tous evalues durant une seance de jeu de 16 minutes chez eux et avec leurs meres. Plus specifiquement, aucune difference n'a pu etre etablie entre les dimensions cognitives ou affectives du jeu evalue par des observateurs qui ne savaient rien du status d'exposition aux substances. De plus, la qualite du soutien maternel pour le jeu, evaluee en utilisant l'Echelle d'Interaction Parent/Mode de Soin, ne differait pas entre les deux groupes. Des aspects positifs du comportement des meres dans leur facon de soutenir leur enfant jouant etaient des facteurs de prediction d'une qualite de jeu de l'enfant plus elevee. Les analyses suggerent que la taille de l'echantillon etait suffisante pour la detection de differences entre les groupes, si ces differences avaient bel et bien existe.

The Feeding Scale provides a reliable rating of mother-infant/toddler interactions during a 20-minute feeding in a laboratory setting. The scale consists of 46 mother and infant behaviors, which are rated at the end of the feeding session. Observations of mother—infant interactions during two feedings separated by 2 weeks showed considerable stability. Five subscale scores are derived (1) Dyadic Reciprocity, (2) Dyadic Conflict, (3) Talk and Distraction, (4) Struggle for Control, and (5) Maternal Non-Contingency, Predictive validity of the Feeding Scale has been demonstrated and it discriminates between infants with and without feeding disorders as well as three diagnostic categories of feeding-disordered infants. The Feeding Scale can be used with infants and toddlers ranging in age from 1 month to 3 years. © 1997 Michigan Association for Infant Mental Health

La sexualite et l'agression emergent durant la deuxieme annee d'une vie en tant que systemes importants de motivation qui organisent des aspects considerables du comportement du jeune enfant, affectant l'operation du systeme d'attachement et transformant les perceptions des parents et leurs comportements envers l'enfant. Le lien entre differents systemes de motivation chez le parent et l'enfant est discoute en tant que dimension importante dans l'elargissement de notre comprehension de l'attachement dans le contexte du systeme de mode de soin. Des exemples normatifs et cliniques sont presentes de maniere a illustrer la facon dont l'agression et la sexualite affectent l'attachement ainsi que les comportements et representations de modes de soin durant la petite enfance.

The purpose of this study was to examine the relationships among maternal confidence, knowledge of child development, and quality of mother-toddler interactions using self-efficacy (Bandura, 1977, 1989) as the theoretical framework. Using the Toddler Care Questionnaire, 50 mothers of toddlers were asked to estimate their confidence in their ability to parent their toddlers. Mothers also completed the Knowledge of Infant Development Questionnaire and were videotaped in their homes during a structured interaction with their toddlers. Maternal confidence was positively correlated with maternal knowledge of child development and parenting. The relationships among mother's knowledge of child development, maternal confidence, and quality of mother-toddler interactions were examined by a 2 × 3 analysis of variance with quality of interactions as the dependent variable. There were no significant main effects for maternal knowledge or confidence on quality of mother-toddler interactions, but there was a significant interaction effect. That is, the combined effects of maternal knowledge and confidence were related to quality of mother-toddler interactions. These results may explain previous inconsistencies in the literature regarding the significance of maternal confidence for mother-child interactions and are congruent with self-efficacy theory. Implications for interventions are discussed.

Young mothers in Japan today are faced with a conflict between the traditional image of motherhood and a sometimes lonely life without physical and emotional support from their husbands, family, and community. As a consequence of this, more and more children are becoming emotionally disturbed as a result of poor mother-child interactions that arise as early as infancy. With several cases of poor interaction, hospital treatment was undertaken to establish emotional mutuality between mother and child through therapeutically induced regression into infancy. Each mother-child pair was hospitalized in the baby unit of the pediatric ward, and the mother provided consistent emotional availability to her child. The child then regressed into infantile states that involved the following four phases: (1) The child began to interact with her mother more actively; (2) she became demanding, like a toddler in the rapproachment crisis; (3) the mother's sustained acceptance won the trust of her child, who began to show a strong attachment to her; (4) the child began to progress to a stage appropriate to her age and used the mother as a secure home base. Each child lost previous symptoms and acquired a stable character. This approach, which utilized the Japanese affinity for intimacy and regression, proved effective in the management of psychopathologies rooted in infancy.

The influence of infant physical attractiveness and infant temperament on the mother-infant relationship at 12 months of age was examined. Physical attractiveness of the infant was rated by 48 adults, and infant temperament was assessed by use of the Toddler Temperament Scale, which yields indices of activity level, rhythmicity, approach, adaptability, intensity, mood, persistence, distractibility, and threshold. Mother-infant attachment was measured via the Strange Situation. Results showed that 46% of the variance in attachment classification was accounted for by five of the nine dimensions of temperament (withdrawal from new situations, high intensity of response, low distractibility, negative mood, and low threshold of response). Physical attractiveness and other dimensions of temperament did not add significant amounts of variance over and above that contributed by the first five dimensions to the prediction of attachment.

Presentation d'une approche psychotherapeutique parent-nourrisson incluant des techniques d'education specialisee et bilan de son application pendant 3 ans et demi aupres d'un enfant autistique

A prospective longitudinal study assessed the development of the mother-child relationship within the context of other important aspects of transition to parenthood. In the prenatal phase, 238 women who were 8 months pregnant with their first child completed a set of questionnaires. At 1 month post-partum, 165 of these women completed a second set of questionnaires, and a subset of 86 were observed for 1 hour at home with their infants. When their child was 2 years old, 62 of the 86 mothers completed questionnaires and were observed in interaction with their toddler in the laboratory. The several hundred individual variables were reduced to internally consistent composite variables, 5 in the prenatal phase, 7 postpartum, and 14 in the toddler phase. Preliminary analyses reported in this paper assessed the structure of relationships among the composite variables within each phase (Pearson correlations) and whether there was significant prediction from one dimension to another across the phases, beyond stability in the predicted dimension (multiple regressions). Causal modeling analyses are still in progress. The results indicate that the development of maternal attachment is a gradual process and that feelings of attachment are related to a number of other measures of women's psychological well-being. Parenting confidence was found to play a central role in adaptation to motherhood within each phase, as well as from the prenatal to postpartum and postpartum to toddler phases.