Parenting

High-quality partnerships between families and schools can bring enormous benefits to the development, learning, and well-being of children. Although past literature has frequently identified the parenting self-efficacy element of parental self-regulation as a key determinant of the strength of the home-school partnership, this knowledge base relies heavily on cross-sectional studies. This paper follows on from an article in Family Process reporting the findings of a cluster randomized trial of an evidence-based parenting program designed to promote parental self-regulation, namely the seminar version of the Triple P-Positive Parenting Program. The trial found post-intervention improvements in two domains of the home-school partnership, namely parent-teacher communication and parent school-based involvement. Given that the home-school partnership was not a target of the intervention, the current study conducted a mechanism of change analysis to examine whether improvements in the home-school partnership could be attributed to post-intervention improvements in parental self-regulation. Data were collected from a sample of 912 parents of children attending 160 different primary schools across three Australian states. Following a Random Intercept Cross-lagged Panel Model (RI-CLPM) approach, bidirectional within-participant effects between parental self-regulation and parent-teacher communication were found, while unidirectional within-participant effects were found for parent school-based involvement. The findings provided support to the proposed theory of change where improvements in parental self-regulation are the underlying mechanism behind reported post-intervention improvements in the quality of the home-school partnership. The findings also support the potential spillover benefits of school-based delivery of evidence-based parenting programs. Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12623000852651.

ImportanceParents of children with autism spectrum disorder (ASD) experience significant stress and caregiving burden and urgently require targeted psychological support and parenting guidance. Integrating acceptance and commitment therapy (ACT) into the World Health Organization's caregiver skills training has demonstrated good feasibility, acceptability, and potential benefits in addressing these parents' unmet psychological and informational needs; however, its effectiveness remains unexplored.ObjectiveTo evaluate the effectiveness of an evidence-based ACT-based parenting program on parental stress and that of other health outcomes on parents and their children with ASD immediately and 6 months after intervention.Design, setting, and participantsThis randomized clinical trial using the intention-to-treat principle was conducted across 7 government-designated rehabilitation institutions in Shenzhen, China, from February 18, 2024, to January 20, 2025. Participants were adult parents serving as the primary caregivers of their children with ASD (aged 3-9 years).InterventionsParticipants were randomly allocated in a 1:1 ratio to either an intervention group or a control group using block randomization. Participants in the intervention group received usual care plus an 8-week, group-format ACT-based parenting program, while the control group received usual care only.Main outcomes and measuresParental stress was the primary outcome, assessed by the Chinese version of the Parenting Stress Index-Short Form. Secondary outcomes included parental depressive symptoms, anxiety, psychological flexibility, and parenting competence and children's emotional and behavioral problems.ResultsAmong 154 parents (mean [SD] age, 36.55 [4.92] years; 135 [87.66%] mothers) caring for children with ASD (mean [SD] age, 5.69 [1.75] years; 118 [76.62%] boys), 77 participants were randomized to the ACT-based intervention group and 77 were randomized to the control group. Those in the intervention group reported significantly greater improvements in parental stress (group × time effect, β = -2.04 [95% CI, -3.51 to -0.57]; P = .007), psychological flexibility (β = 1.12 [95% CI, 0.29 to 1.95]; P = .008), and parenting competence (β = 2.45 [95% CI, 0.53 to 4.36]; P = .01) and children's emotional and behavioral problems (β = -1.16 [95% CI, -2.26 to -0.05]; P = .04) during the 6-month follow-up. Significant effects on parental depressive symptoms (β = -1.61 [95% CI, -3.12 to -0.10]; P = .04) and anxiety (β = -1.62 [95% CI, -2.81 to -0.44]; P = .007) were observed in the ACT-based intervention group immediately post intervention.Conclusion and relevanceIn this randomized clinical trial of an ACT-based parenting program, the intervention was effective in helping parents manage their stress in caregiving and the emotions and behaviors of their children with ASD, underscoring the need for future studies among more diverse populations globally.Trial registrationChiCTR Identifier: 2400080472.

PURPOSE: This longitudinal investigation examined the association between traumatic birth experiences (measured via self-report and clinician-report) and caregiving behaviors and attitudes and any race-related differences in these associations. METHODS: Subjective childbirth trauma was measured via a three-item questionnaire at 12 weeks postpartum. Medical childbirth factors were extracted from the electronic health record. Maternal caregiving behaviors and attitudes were assessed via comprehensive questionnaires (i.e., mother-infant bonding and parenting stress) and observation ratings (i.e., positive parenting and mother-infant interactions) at 12 weeks, 12 months, and 24 months postpartum. Multiple linear regressions were run to analyze these relationships. RESULTS: A total of 255 mothers (106 Black and 149 White) who gave birth from April to December 2020 were examined. More traumatic childbirth experiences were significantly associated with higher-rated observed positive parenting scores (β = 0.21, pFDR<0.05) when controlling for demographic factors. There were no significant relationships at 12 weeks or 24 months postpartum. Additionally, there were no effects of race on the relationship between childbirth trauma and caregiving. CONCLUSIONS: Subjective reports of childbirth trauma were not significantly associated with poorer maternal caregiving behaviors and attitudes. This study adds to the literature by examining Black women, as they are underrepresented in this body of research and more at risk of experiencing traumatic childbirths.