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Background: Research has indicated disagreement between physicians, caregivers, and adolescents with special health care needs regarding appropriate risk counseling.Objective: The study examines caregivers' perceptions of adolescent risk counseling. We hypothesize caregivers of adolescents with special healthcare needs will perceive a lower rate of risk counseling.Methods: Data come from the 2016 National Survey of Children's Health. The sample included 13,542 adolescents. Analysis completed using logistic regression with odds ratios.Results: The results indicate no difference in caregiver perceptions of risk counseling for adolescents with special healthcare needs. Gender, race/ethnicity, and relationship between caregiver and provider influenced perception of receipt of risk counseling, regardless of health status.Conclusions: Although adolescents with special healthcare needs perceive their risk behavior counseling to be lacking in quantity/quality, caregivers perceive such counseling does occur. These results highlight the need for comprehensive risk counseling for groups at risk of known health disparities.Practice Implications: Physicians and providers should be provided with the training and resources needed to be comfortable to engage in risk counseling. Adolescents need the opportunity to see their provider privately, and education to advocate for information risky behaviors. Parents, providers, and adolescents should be included in future risk counseling intervention plans. [ABSTRACT FROM AUTHOR]

There is little empirical understanding of how young children's screen engagement links to their well-being. Data from 19,957 telephone interviews with parents of 2- to 5-year-olds assessed their children's digital screen use and psychological well-being in terms of caregiver attachment, resilience, curiosity, and positive affect in the past month. Evidence did not support implementing limits (< 1 or < 2 hr/day) as recommended by the American Academy of Pediatrics, once variability in child ethnicity, age, gender, household income, and caregiver educational attainment were considered. Yet, small parabolic functions linked screen time to attachment and positive affect. Results suggest a critical cost-benefit analysis is needed to determine whether setting firm limits constitutes a judicious use of caregiver and professional resources. [ABSTRACT FROM AUTHOR]

Participation in community-based family interventions characterized by an integrated service approach is linked to enhanced caregiver and child outcomes. However, more research is needed that examines the developmental impacts of interventions serving young children and their families, given that adversity in early childhood may predict problematic developmental trajectories. We examined potential relations among perceived characteristics of an early childhood system of care serving children with severe emotional and behavioral challenges and their families, dimensions of family involvement, and changes in child and caregiver functioning from intake to 6 months. We analyzed data from 158 caregivers of children under age 6 ( M = 3.9 years, SD = 1.11, Range = 1.4-5.9 years) who were primarily White and boys. Results indicated, for instance, that perceived cultural competence and general satisfaction were positively associated with active caregiver participation in services. Although multiple path models tested via path analyses were not statistically significant, the model that assessed the potential mediating effect of active caregiver participation on the relation between cultural competence and caregiver stress approached significance ( z = −1.89, SE = .03, p = .06). Qualitative results indicated that caregivers primarily viewed receiving family support as the most helpful aspect of the SOC, followed by learning enhanced parenting skills and observing positive changes in their children's behaviors. Our findings highlight important facets of an early childhood SOC linked to positive participant experiences and outcomes. We discuss limitations of our study and implications for future research. [ABSTRACT FROM AUTHOR]

This qualitative study examined caregivers' perceptions of Parent Peer Support (PPS) services, embedded in the Wraparound service delivery model for youth with severe emotional and behavioral disturbances (SEBD), to identify potential engagement facilitators and barriers. Wraparound is a holistic process involving multiple formal and informal providers to collectively implement an individualized, family-centered plan of care focused on maintaining youth with SEBD within the community. PPS are frequently referred to caregivers involved in Wraparound to provide additional support. Caregivers ( n = 35) previously involved in an evaluation of one state's Wraparound model participated in a single 30-60-min interview. Interview questions examined caregivers' expectations about PPS, reasons for accepting or refusing PPS, and caregivers' perceived impact of PPS. Transcribed interviews were analyzed using strategies from grounded theory methodology. Perceived need, as well as desire for shared experiences, knowledge, and assistance in accessing resources, facilitated accepting the PPS service. Barriers included inaccurate expectations of PPS, time limitations on Wraparound services, escalating youth behavior requiring more restrictive placements, scheduling difficulties, perceived unresponsiveness, and caregivers feeling overwhelmed by the number of providers. Caregivers indicated that PPS provided several benefits for themselves, youth in the care, and their families. However, potential barriers to ongoing engagement included perceived intrusiveness, as well as misalignment between services offered and caregivers' needs. [ABSTRACT FROM AUTHOR]

The rapid increase in grandparents caring for grandchildren has received growing attention, but little research has focused on Chinese-American grandparents and their caregiving experiences. Drawing on cross-sectional data from the Population Study of Chinese Elderly-a community-engaged, epidemiological study of Chinese-American adults aged 60 and older, the relationships between caregiving experiences and psychological well-being were examined. Of 2,365 older adults who answered the question about grandparent caregiving, 818 (35%) were designated as caregivers, spending an average of 12 hours a week on childcare. About one in five caregivers reported caregiving burden, pressure, or negative health effect of caregiving. Caregivers had better psychological well-being than noncaregivers, with significantly lower levels of depressive symptoms, anxiety, stress, and loneliness. For caregivers, higher levels of caregiving burden, pressure from adult children, and perceived negative effect were related to greater rates of psychological distress. With a strong cultural expectation of family care, grandparent caregiving is generally associated with positive psychological well-being, but it can also be stressful, especially when older adults feel pressured to provide childcare or that doing so is a burden. The study implies that cultural values and life transitions may shape grandparent caregiving experiences and well-being, indicating the importance of respecting cultural differences in family caregiving. Understanding positive and negative aspects of grandparent caregiving and the underlying mechanisms will help healthcare professionals identify caregivers at risk of psychological distress and provide proper interventions to attenuate negative outcomes while maximizing positive experiences for Chinese-American older adults. [ABSTRACT FROM AUTHOR]

Mounting evidence links paternal incarceration to harmful outcomes for the children of incarcerated fathers. These findings hold across a host of important behavioral, developmental, and attainment outcomes, including mental health and behavioral problems, substance use, educational attainment, and social inequality. The process by which paternal incarceration causes poor outcomes is much less clear, however. Declines in quality parenting by the partners of former inmates represent one important domain where theory would suggest important effects but where the research evidence lags far behind. This Article analyzes the effects of paternal incarceration on parenting quality and finds that paternal incarceration has no effect on positive parenting behaviors but significantly increases problematic parenting behaviors, including negative conflict resolution tactics and physical abuse. The implications of the results for childhood well-being and development are also discussed. [ABSTRACT FROM AUTHOR]

The Maternal Self-report Support Questionnaire (MSSQ) is among the most rigorously evaluated measures of caregiver support following child sexual abuse, but there is a paucity of data on the factor structure and variance of the MSSQ across diverse groups of caregivers and their children. The present study examined the factor structure and measurement invariance of the MSSQ across 386 non-offending caregivers following a disclosure of child sexual abuse. Data were collected from non-offending caregivers at two Child Advocacy Centers (n = 277; n = 109) in the United States. Caregivers completed the MSSQ and assessments of child age, caregiver-child relationship, and caregiver preferred language. Confirmatory factor analyses replicated the original two-factor structure, with the emotional support and blame/doubt subscales emerging as distinct factors. Multigroup confirmatory factor analyses showed measurement invariance across child age and caregiver-child relationship (mother vs. another caregiver). Evidence of partial invariance was found for caregiver preferred language. Comparisons of scores indicated caregiver support varied by child age and caregiver preferred language. Overall, findings suggest the MSSQ can be used to measure caregiver support across caregivers with children of different ages and both mothers and non-mothers, but caution should be practiced in interpreting mean-level differences between English- and Spanish-speaking caregivers. [ABSTRACT FROM AUTHOR]

The article focuses on the need to share the developmental delays observed in the child by parents or caregivers to be able to implement early interventions with the child in the U.S. It has been suggested that parents or caregivers need to observe, take note and assessed the developmental delays to be able to help children reach their full potential. However, infant or toddler teachers feel fear in communicating the deficiency of the child because of the possibility for parents to transfer the child to another program. It further suggests that teacher-caregiver and family needs to have mutual trust, good communication and respect to be able to establish good communication with parents.

Background: We sought to determine whether maternal Medicaid retention influences child Medicaid retention because caregivers play a critical role in assuring children's health access.Methods: We conducted a longitudinal prospective cohort study of a convenience sample of 604 Medicaid-eligible mother-child dyads followed from the infant's birth through 24 months of age with parent surveys. Individual enrollment status was abstracted from administrative Medicaid eligibility files. Generalized estimating equations quantified the effect of maternal Medicaid enrollment status on child Medicaid retention, adjusting for relevant covariates. Because varying lengths of gaps may have different effects on child health outcomes, Medicaid enrollment status was further categorized by length of gap: any gap, > 14-days, and > 60-days.Results: This cohort consists primarily of African-American (94%), unmarried mothers (88%), with a mean age of 23.2 years. In multivariable analysis, children whose mothers experienced any gaps in coverage had 12.6 times greater odds of experiencing gaps when compared to children whose mothers were continuously enrolled. Use of varying thresholds to define coverage gaps resulted in similar odds ratios (> 14-day gap = 11.8, > 60-day gap = 16.8). Cash assistance receipt and maternal knowledge of differences between Temporary Assistance to Needy Families and Medicaid eligibility criteria demonstrated strong protective effects against child Medicaid disenrollment.Conclusions: Medicaid disenrollment remains a significant policy problem and maternal Medicaid retention patterns show strong effects on child Medicaid retention. Policymakers need to invest in effective outreach strategies, including family-friendly application processes, to reduce enrollment barriers so that all eligible families can take advantage of these coverage opportunities. [ABSTRACT FROM AUTHOR]