Children and Adolescents Who Are at RiskThe Importance of Early Parenting in At-Risk Families and Children’s Social-Emotional Adaptation to School
Section snippets
Study Design and Sample
This was a cohort study of families enrolled in a randomized trial of Hawaii’s Healthy Start Program (HSP), a paraprofessional home visiting program for families at risk for abuse or neglect of their newborns. The program serves families at risk for maltreatment of their newborns. The early identification component of the HSP identifies at-risk families through population-based screening and assessment using the Kempe Family Stress Checklist.10 Families in which either parent scored ≥25 are
Family Attributes
Table 1 summarizes key attributes of the families included in the main analyses (N = 318). One tenth of the children were premature. About 60% of mothers self-identified their sole or primary racial/ethnic affiliation as Native Hawaiian, other Pacific Islander, or Asian; over a quarter reported multiple races/ethnicities but no primary affiliation. At the time the child was born, about a third of mothers were not high school graduates and about two thirds lived in households with incomes below
Discussion
In this sample of children from psychosocially at-risk families, there was notable variation in the quality of early parenting and the children’s social-emotional adaptation to school in the first grade. Specific aspects of early parenting—parental warmth, lack of hostility, encouragement of developmental advance, and promotion of learning and literacy—were associated with more favorable teacher ratings of 1 or more domains of children’s social-emotional adaptation to school in the first grade.
Conclusions
The findings from this study point to the importance of early positive parenting skills, specifically parental warmth, lack of hostility, encouragement of developmental advance, and learning and literacy materials for at-risk children’s social-emotional adaptation to school. Pediatric primary care providers are in a unique position to promote positive parenting.30 In addition, a recent technical report by the American Academy of Pediatrics emphasized the importance of aligning well-child care
Acknowledgments
This study was funded to the Johns Hopkins University School of Medicine (Anne Dugan, Principal Investigator) by the Federal Maternal and Child Health Bureau (R40 MC00029 (formerly MCJ240637) and R40 MC00123 (formerly MCJ240838), the Robert Wood Johnson Foundation (18303); The Annie E. Casey Foundation (9404014); the David and Lucile Packard Foundation (93-6051, 94-7957, 97-8058, and 98-3448); the Hawaii State Department of Health (99-29-J); National Institute of Mental Health and National
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