Pilot study of a program delivered within the regular service system in Germany: Effect of a short-term attachment-based intervention on maternal sensitivity in mothers at risk for child abuse and neglect

This pilot study examined the effectiveness of a short-term attachment-based intervention, the Ulm Model, in a German population at risk for child abuse and neglect. The intervention used home visits and video feedback to promote maternal sensitivity, and was implemented by trained staff within the health care and youth welfare systems. Mothers in the control group (n = 33) received standard services only, while those in the intervention group (n = 63) additionally the Ulm Model intervention. The outcomes measured were maternal sensitivity, as assessed by the CARE-Index at pre-intervention, after the last session, and at about 6 and 12 months of age; and infant socio-emotional development, as assessed by the ET6-6 development test at about 6 and 12 months of age. The moderating effects on treatment outcomes of two variables were examined: risk for child abuse (moderate vs. high) and type of maternal attachment representation (secure vs. insecure). Among participants at moderate risk for child abuse, no differences were found between the intervention group and control group in either maternal sensitivity or infant development. Among those considered high risk, mothers in the intervention group showed a significant increase in maternal sensitivity from pre- to post-intervention; however, no group differences were seen at follow-up. There were some indications that infants of mothers in the intervention group showed better emotional development. The variable of maternal attachment representation was not a significant moderator for the intervention effect, but post hoc analysis indicated that the mean sensitivity of secure mothers was significant higher at the 6-month follow-up.     

The effect of blended learning on student performance at course-level in higher education: A meta-analysis

The present paper analyzes the impact of blended learning (BL) on the academic achievement of higher education students. A meta-analysis (k = 51 effect sizes) was conducted to perform a statistical synthesis of studies contrasting student performance in BL conditions with traditional classroom instruction. We include disciplines and instructors’ end-of-course evaluation method as moderating variables. The results show that BL demonstrates a small summary effect (g⁺ = 0.385, p < 0.001) compared to traditional teaching methods A significantly higher mean effect size was found in STEM disciplines (g⁺ = 0.496) compared to that of non-STEM disciplines (g⁺ = 0.210). Nevertheless, the weighted mean effect sizes reveal no significant differences regarding of end-of-course assessment methods, namely one-moment and multiple-component assessment. The finding confirms that BL is significantly associated with greater learning performance of STEM-disciplined students than with traditional classroom practice. Accordingly, discussion concerning the findings and implications for future research are elaborated.     

Attachment representations and socio-emotional difficulties in alternative care: A comparison between residential,foster and family based children in Chile

Attachment has been assessed in children living in alternative care (AC) settings, such as Residential Homes (RC) and Foster Care (FC). However, no study has been conducted to compare attachment styles in residential, foster and parental care conducted as usual in the same country at the same point in time. There is also a lack of studies conducted in less developed countries. Therefore, the aim of this study was to compare outcomes for children living in three different types of care in Chile. Three groups of children (N = 77), living in (RC), (FC) and with biological parents (PC) were compared. Attachment styles, Indiscriminate Friendliness (IF) and socio-emotional/behavioral difficulties were assessed.Higher rates of secure attachment were observed in the RC group (36.1%) when compared to studies in RC in other countries (mean 18%). However, children in both types of AC were significantly more likely to have insecure and/or disorganized attachment styles than PC children. Higher rates of socio-emotional and behavioral problems were observed in RC (55.6%) and FC (50%) compared to PC (10%). Within type of AC, no significant differences were found, for attachment styles or for socio-emotional/behavioral difficulties, the only difference were the levels of IF, with children in RC having higher levels. As a conclusion, impact of placement in AC can vary between different countries, other factors, rather than only type of AC could better explain differences in attachment security for children. Implications for research and practices are discussed.     

Quality child care and socio-emotional risk factors: No evidence of diminishing returns for urban children

The purpose of this study was to test the hypothesis that quality improvements in early childhood centers experience diminishing returns as the quality of the classroom rises with regards to concurrent socio-emotional outcomes. This hypothesis lies at the core of Scarr's argument that public policy should concentrate on improving low quality settings rather than improving settings that already have acceptable quality. The study detected sizeable effect sizes linking process quality in the good to excellent range with reduction of existing socio-emotional risk factors (d = 0.51) and prevention of the emergence of new socio-emotional risk factors (d = −0.41). These effect sizes are substantially larger than those reported by other studies investigating quality environments in the poor to good quality range (d = 0.16), and larger than Durlak and Wells meta-analytic effect size for universal preventive interventions (d = 0.35). Therefore, the hypothesis that as quality increases the benefits for children increase but at a diminishing rate was rejected for concurrent socio-emotional outcomes in urban populations.     

Children's elevated cortisol levels at daycare: A review and meta-analysis

We reviewed nine studies in which children's cortisol levels at center daycare were assessed. Our first hypothesis, concerning intraindividual differences in cortisol levels across home and daycare settings, was also tested in a meta-analysis. Our main finding was that at daycare children display higher cortisol levels compared to the home setting. Diurnal patterns revealed significant increases from morning to afternoon, but at daycare only. The combined effect size for seven pertinent studies (n = 303) was r = .18 (CI .06–.29, p = .003). We examined all papers on possible associations between cortisol levels and quality of care, and the influences of age, gender, and children's temperament. Age appeared to be the most significant moderator of this relation. It was shown that the effect of daycare attendance on cortisol excretion was especially notable in children younger than 36 months. We speculate that children in center daycare show elevated cortisol levels because of their stressful interactions in a group setting.     

Adverse childhood experiences (ACE) and adult attachment interview (AAI) in a non-clinical population

Adverse childhood experiences (ACE) tend to be interrelated rather than independently occurring. There is a graded effect associated with ACE exposure and pathology, with an increase when ACE exposure is four or more. This study examined a sample of active individuals (n = 129) to determine distribution patterns and relationships between ACEs, attachment classification, unresolved mourning (U), and disclosure difficulty. The results of this study demonstrated a strong relationship between increased ACEs and greater unresolved mourning. Specifically, the group differences for individuals who experienced no ACE (n = 42, 33%), those with 1–3 ACEs (n = 48, 37.8%), and those with ≥4 ACEs (n = 37, 29.1%) revealed a pattern in which increased group ACE exposure was associated with greater lack of resolution for past trauma/loss experiences, more adult traumatic events, and more difficulty disclosing past trauma. Despite ≥4 ACEs, 51.4% of highly exposed individuals were classified as secure in the Adult Attachment Interview. Resilience in this group may be related to a combination of attachment security, college education, and engagement in meaningful activities. Likewise, adversity may actually encourage the cultivation of more social support, goal efficacy, and planning behaviors; factors that augment resilience to adversity.     

Physical maltreatment of children with autism in Henan province in China: A cross-sectional study

The aim of this study was to investigate the frequency of child physical maltreatment (CPM) in children with autism aged 2–5 years in Henan province (China), and to explore the risk factors for severe CPM in these children. This cross-sectional study was performed at the Psychology Clinic of the Third Affiliated Hospital of Zhengzhou University between September 2012 and September 2013 with 180 parents of children with autism. Children and parents had no history of any cognitive therapy. The childhood autism rating scale (CARS) was used to evaluate the severity of autism in children. Data on parental CPM during the past 3 months were collected from parental self-reporting. Logistic regression was used to investigate the risk factors of severe CPM. CPM was self-reported by 88% of the parents of children with autism. One hundred and fifty four of these cases were in the minor CPM group (86%) and 64 in the severe CPM group (36%). Most cases of severe CPM were unlikely to have caused injury. Univariate analyses showed that child's age (p = .018), age started to speak (p = .043) and CARS score (p = .048) were associated with severe CPM. Child's age (p = .011) and CARS score (p = .041) were independently associated with severe CPM. The risk of severe CPM increased with age and CARS score. Our findings showed that CPM is widespread in families of children with autism in Central China and more knowledge should be provided to parents of children with autism, particularly in cases of severe autism (those with high CARS scores).     

Empowering and protecting children by enhancing knowledge,skills and well-being: A randomized trial of Learn to BE SAFE with Emmy™

Australia needs effective programs to protect children and prevent abuse, but there is little information available for policymakers or families. Using a randomized controlled trial, Learn to BE SAFE with Emmy™, a school-based protection program for young children designed by Act for Kids, was evaluated to determine its effectiveness for promoting young children's knowledge and skills. Grade one children (n = 245) from 15 classrooms across 5 primary schools completed assessment measures. A subset of these children received the program (n = 131) or acted as a comparison group (n = 114). Parents (n = 72) completed questionnaires about their child's participation in the program. When compared with children who had not received the program, children who completed Learn to BE SAFE with Emmy™ demonstrated increased knowledge of interpersonal safety and were more likely to choose a safe response option to hypothetical unsafe scenarios 6 months after participation than at both pre- and post-intervention. Parents reported their children who participated used more safety strategies immediately and 6 months after participation compared to pre-intervention. Outcomes can assist in guiding future policies around the prevention of child abuse and protect the well-being of Australian children.     

Achievement goals and academic achievement: A closer look at moderating factors

Two recently published meta-analyses (Huang, 2012, Hulleman et al., 2010) have focused on the association between achievement goals and achievement outcomes. These meta-analyses differed to some extent, e.g., regarding the identified moderators. The present meta-analysis serves to clarify those heterogeneous findings by considering more studies through 2011 and by considering more moderators. Our literature search identified 180 publications (N = 81 947). Analyses (using random effects models) revealed small but significant associations between achievement goals and achievement outcomes (r = −.12 to r = .13; all ps < .01; global performance goals: r = .01, p > .05). The results of the present moderator analyses differed from those of the previous meta-analyses. For example, in contrast to Huang (2012), we were able to find several moderators of the association between performance-approach goals and academic achievement. The results have several important implications, especially regarding the assessment of achievement goals.     

Punishment for bedwetting is associated with child depression and reduced quality of life

This study assessed the relationship between parental punishment and depression as well as quality of life in children with primary monosymptomatic nocturnal enuresis (PMNE). A consecutive sample of 65 children (7–13 years) with PMNE and 40 healthy children, selected as controls (Group III), were included in the study. The children with PMNE were further sub-classified into two groups: Group I, which included children who received parental punishment for enuresis and Group II, which comprised children who were not punished for bedwetting. Depression and health-related quality of life (HRQL) were assessed among the three groups. The number of wet nights per week was significantly increased in Group I compared with Group II (P < .001). In addition, the severity of depressive symptoms increased in Group I as compared to the other two groups (P < .001). Similarly, the psychosocial HRQL lower in Group compared to the control group (Group III) (P < .001). Prior parental discipline, including corporal punishment (B = 0.55, P = .008), as well as the frequency (B = 0.73, P < .001) and duration of punishment (B = 0.33, P = .02) were strong predictors of increased depressive symptom severity. It was also found that prior punishment (B = −0.42, P = .01) and the frequency (B = −0.62, P < .001) and duration of punishment (B = −0.34, P = .02) were strong predictors for poor psychosocial HRQL. Overall, parental punishment has a poor outcome in children with PMNE.     

Repeated reports for child maltreatment among intimate partner violence victims: Findings from the National Survey of Child and Adolescent Well-Being

ObjectivesTo determine the prevalence of intimate partner violence (defined as any physical violence during the last 12 months or previously) among mothers who maltreat their children, and to examine whether mothers’ experiences of intimate partner violence (IPV) are associated with repeated reports (rereports) of children to Child Protective Services (CPS) during the following 18 months.MethodsData for the analyses were from the National Survey of Child and Adolescent Well-Being (NSCAW), a national probability study of children investigated for child maltreatment. The sample of 5,501 children (ages 0–14) was randomly selected from the families who entered the US child welfare system between October 1999 and December 2000. The analysis sample was restricted to 1,236 families in which caregivers were: (1) the alleged perpetrators of the child maltreatment at baseline (independently of substantiation status) and (2) the biological mothers (n = 1,212 or 98.6%), adoptive mothers (n = 17 or 1%), or stepmothers (n = 7 or 0.3%) of children not placed in out-of-home care.ResultsChildren of mothers physically abused by an intimate partner during the last 12 months or previously at the intake interview (44%) were twice as likely as children of mothers who had not experienced such violence to be rereported to CPS (29% vs. 14%, Odds Ratio = 2.0, 95% Confidence Interval = 1.1–3.4). Rereports occurred almost twice as quickly for children of mothers who experienced IPV compared to children of mothers who had not experienced IPV (Hazard Ratio = 1.9, 95% Confidence Interval = 1.1–3.0).ConclusionsThe higher risk and speedier rereports of child maltreatment associated with intimate partner violence highlights the need for universal assessment and provision of services for IPV among families that are investigated by CPS.     

Adolescent expectancy-value motivation and learning: A disconnected case in physical education

This study reports adolescent expectancy-value motivation, and its relation to fitness knowledge and psychomotor skill learning in physical education. Students (N = 854) from 12 middle schools provided data on expectancy-value motivation, fitness knowledge and psychomotor skill learning. Results from dependent t-test and MANOVA indicated that 8th grade students rated task values significantly lower than 6th grade while their expectancy beliefs did not significantly differ. Students gained sizable fitness knowledge (d = 0.58, p < 0.05) and badminton skill (d = 1.40, p < 0.05). Multiple regression analyses revealed that expectancy-value motivation did not significantly predict learning in fitness knowledge or psychomotor skills. These findings suggest that expectancy-value motivation might predict engagement and performance, but not necessarily learning achievement in physical education.     

Maternal and paternal physical abuse: Unique and joint associations with child behavioral problems

Although there is a substantial amount of literature documenting the relationship between child abuse and behavioral problems in China, there is, on the other hand, a limited number of studies on the joint and unique associations of maternal and paternal physical abuse with child behaviors within the Chinese context. The present study, using the family systems theory as the theoretical framework, aims to examine these joint and the unique associations of maternal and paternal physical abuse with externalizing and internalizing behaviors among a community sample of Chinese children. A total of 296 children (54.7% boys, mean age 12.31 ± 0.56 years) from two-parent families participated in the study, and they reported their physical abuse experience by their mother and father in the previous year using the Chinese version of the Parent-Child Conflict Tactics Scale. Participants, using the Youth Self Report, reported personal externalizing and internalizing behaviors, and, similarly, their mothers, using the Child Behavior Checklist, assessed children’s externalizing and internalizing behaviors. Linear mixed effect models with random intercept and slope were used to examine the joint and unique associations of maternal and paternal physical abuse with child externalizing and internalizing behaviors. Results revealed that physically abused children were more likely to be simultaneously abused by both mothers and fathers. Furthermore, when compared with their non-abused counterparts, children with physical abuse that was carried out solely by mothers (externalizing behaviors: β = 6.71, 95% CI = 2.45–10.98, p < 0.01; internalizing behaviors: β = 4.52, 95% CI = 0.37–8.66, p < 0.05) or by both mothers and fathers (externalizing behaviors: β = 4.52, 95% CI = 1.80–7.24, p < 0.001; internalizing behaviors: β = 2.98, 95% CI = 0.34–5.61, p < 0.05) reported more externalizing and internalizing behaviors. Externalizing and internalizing behaviors of children who were physically abused solely by fathers did not significantly differ from those of their non-abused counterparts, which may result from the small sample size. The present findings suggest that maternal physical abuse may have a dominant and unique association with child behaviors, regardless of whether paternal physical abuse occurs within the family. Implications for future research and practice within the Chinese context regarding the subject of child behaviors and parental abuse are discussed.     

Making the right connections: Differential effects of reading intervention for subgroups of comprehenders

The purpose of this study was to compare the effects of different types of questioning interventions on students' reading comprehension. Fourth-grade students (n = 246) were identified as struggling, average, or good readers and assigned randomly within school to one of three questioning interventions: two inferential conditions (Causal or General) or one literal condition (“Who, What, Where, When” or W-questioning). Teachers delivered the interventions for 20–30 min, 2–4 times per week, for 8–10 weeks. All readers made reliable pre- to posttest comprehension gains as measured by story recall (ps < .001 to .04). Differential effects for intervention were found between two subgroups of struggling comprehenders—elaborators and paraphrasers. Elaborators benefited more than paraphrasers from Causal questioning (d = .86) whereas paraphrasers benefited more than elaborators from General questioning (d = 1.46). These findings suggest that identifying subgroups is important in developing and evaluating the effectiveness of reading comprehension interventions.     

Sexual abuse predicts functional somatic symptoms: An adolescent population study

The main aim of this study was to investigate the effect of childhood sexual abuse on medically not well explained or functional somatic symptoms (FSSs) in adolescents. We hypothesized that sexual abuse predicts higher levels of FSSs and that anxiety and depression contribute to this relationship. In addition, we hypothesized that more severe abuse is associated with higher levels of FSSs and that sexual abuse is related to gastrointestinal FSSs in particular. This study was part of the Tracking Adolescents’ Individual Lives Survey (TRAILS): a general population cohort which started in 2001 (N = 2,230; 50.8% girls, mean age 11.1 years). The current study uses data of 1,680 participants over four assessment waves (75% of baseline, mean duration of follow-up: 8 years). FSSs were measured by the Somatic Complaints subscale of the Youth Self-Report at all waves. Sexual abuse before the age of sixteen was assessed retrospectively with a questionnaire at T4. To test the hypotheses linear mixed models were used adjusted for age, sex, socioeconomic status, anxiety and depression. Sexual abuse predicted higher levels of FSSs after adjustment for age sex and socioeconomic status (B = .06) and after additional adjustment for anxiety and depression (B = .03). While sexual abuse involving physical contact significantly predicted the level of FSSs (assault; B = .08, rape; B = .05), non-contact sexual abuse was not significantly associated with FSSs (B = .04). Sexual abuse was not a stronger predictor of gastrointestinal FSSs (B = .06) than of all FSSs. Further research is needed to clarify possible mechanisms underlying relationship between sexual abuse and FSSs.     

Children's acquisition of science terms: Simple exposure is insufficient

The ability of school children (N = 233) to acquire new scientific vocabulary was examined. Children from two age groups (M = 4.8 and M = 6.5) were introduced to previously unknown words in an educational video. Word knowledge was assessed through accuracy and latency for production and comprehension over a 9-month period. A draw and write task assessed acquisition of domain knowledge. Word learning was poorer than has previously been reported in the literature, and subject to influences of word type (domain specificity) and word class. The results indicate that the acquisition of scientific terms is a complex process moderated by lexical, semantic and pragmatic factors.     

Childhood disclosure of sexual abuse: Necessary but not necessarily sufficient

Prevention programs often encourage sexually abused children to disclose without fully considering the potential for adverse consequences. This study examined the impact of disclosure on abuse cessation and later adult symptomatology. A clinical sample of 301 adult survivors completed the Impact of Event Scale (IES/IES-R), and the Beck Depression Inventory (BDI-II). Participants were divided into 3 groups: Nondisclosure (n = 221), Disclosure/Abuse Ended (n = 25), and Disclosure/Abuse Continued (n = 55). Multivariate analyses of covariance, adjusting for abuse characteristics (age of onset, penetration, and number of perpetrators) and other trauma exposure, revealed significant differences in psychiatric symptom severity among the three groups, Wilks’ λ = 0. 95, F (6, 584) = 2.69, p = 0.014, η_p² = 0.03. Specifically, those in the Disclosure/Abuse Continued group scored significantly higher on the IES/IES-R Intrusion subscale (p = 0.04) and the BDI-II (p = 0.01), as compared to the Nondisclosure group. The Disclosure/Abuse Ended group did not differ significantly from the other groups. Results suggest that disclosure may be detrimental unless adequate steps are taken to ensure abuse cessation and appropriate treatment.     

Mother–Child Attachment From Infancy to the Preschool Years: Predicting Security and Stability

Relations between maternal mind‐mindedness (appropriate and nonattuned mind‐related comments), children's age‐2 perspective‐taking abilities, and attachment security at 44 (n = 165) and 51 (n = 128) months were investigated. Nonattuned comments predicted insecure preschool attachment, via insecure 15‐month attachment security (44‐month attachment) and poorer age‐2 perspective‐taking abilities (51‐month attachment). With regard to attachment stability, higher perspective‐taking abilities distinguished the stable secure groups from (a) the stable insecure groups and (b) children who changed from secure to insecure (at trend level). These effects were independent of child gender, stressful life events, and socioeconomic status (SES). The contribution of these findings to our understanding of stability and change in attachment security from infancy to the preschool years is discussed.     

Assessing adverse experiences from infancy through early childhood in home visiting programs

The general aim of early intervention and home visiting programs is to support families to minimize Adverse Childhood Experiences (ACEs). However, assessing children's exposure to these risks is complicated because parents serve as the conduit for both measurement and intervention. The primary aims of the study were to develop an assessment of children's exposure to ACEs and to examine concurrently measured parental child abuse and neglect potential and child social–emotional functioning. Home visiting programs in a southern state implemented the Family Map Inventories (FMI) as comprehensive family assessment and child screenings (N = 1,282) within one month of enrollment. Children (M = 33 months of age, SD = 20) were exposed at rates of 27% to one, 18% to two, 11% to three, and 12% to four or more FMI-ACEs. FMI-ACEs were associated with increased parental beliefs and behaviors associated with child abuse and neglect. FMI-ACEs also significantly predicted the likelihood of the child having at-risk social–emotional development; children with 4 or more FMI-ACEs were over 6 times more likely than those with none to have at-risk scores. The findings add to our understanding of the negative impact of trauma on children and families. Assessing these risks as they occur in a family-friendly manner provides a platform for early intervention programs to work with families to increase family strengths and reduce the impacts of adverse experiences for their children.     

Randomized controlled trial of a parenting program to reduce the risk of child maltreatment in South Africa

Parenting programs in high-income countries have been shown to reduce the risk of child maltreatment. However, there is limited evidence of their effectiveness in low- and middle-income countries. The objective of this study was to examine the initial effects of a parenting program in reducing the risk of child maltreatment in highly-deprived and vulnerable communities in Cape Town, South Africa. Low-income parents (N = 68) with children aged three to eight years were randomly assigned to either a group-based parenting program or a wait-list control group. Observational and parent-report assessments were taken at baseline and at immediate post-test after the intervention was delivered. Primary outcomes were parent-report and observational assessments of harsh parenting, positive parenting, and child behavior problems. Secondary outcomes were parent-report assessments of parental depression, parenting stress, and social support. Results indicated moderate treatment effects for increased frequency of parent-report of positive parenting (d = 0.63) and observational assessments of parent-child play (d = 0.57). Observational assessments also found moderate negative treatment effects for less frequent positive child behavior (d = −0.56). This study is the first randomized controlled trial design to rigorously test the effectiveness of a parenting program on reducing the risk of child maltreatment in sub-Saharan Africa using both observational and self-report assessments. Results provide preliminary evidence of effectiveness of reducing the risk of child maltreatment by improving positive parenting behavior. Further development is required to strengthen program components regarding child behavior management and nonviolent discipline strategies. Future research would benefit from a larger trial with sufficient power to determine program effectiveness.