Parental use of routines, setting limits, and child screen use during COVID-19: findings from a large Canadian cohort study

BackgroundAn increase in child screen time has been observed throughout the COVID-19 pandemic. Home environment and parenting practices have been associated with child screen time. The purpose of this study was to examine associations between parental use of routines, limit setting, and child screen time during the (COVID-19) pandemic to inform harm-reducing strategies to limit the potential harms ensued by excessive screen use.MethodsA cohort study was conducted in 700 healthy children (3,628 observations) aged 0–11 years though the TARGet Kids! COVID-19 Study of Children and Families in Toronto, Canada from May 2020-May 2021. The independent variables assessed were parent-reported use of routines and setting limits. Outcomes were parent-reported child daily screen time in minutes and whether the Canadian 24-Hour screen time guideline was met, defined as 0 for <1 years, 60 or less for 1–5 years, and 120 or less for >5 years. Linear and logistic mixed-effects models were fitted using repeated measures of independent variables and outcomes with a priori stratification by developmental stages (<3, 3–4.99, ≥5 years).ResultsA total of 700 children with 3,628 observations were included in this study [mean age = 5.5 (SD = 2.7, max = 11.9) years, female = 47.6%]. Mean change in child screen time before vs. during the pandemic was +51.1 min/day and level of parental use of routines and setting limits remained stable. Lower use of routines was associated with higher child screen time (β = 4.0 min; 95% CI: 0.9, 7.1; p = 0.01) in ages ≥5 years and lower odds of meeting the screen time guideline in ages <3 years and ≥5 years (OR = 0.59; 95% CI: 0.38, 0.88; p = 0.01; OR = 0.76; 95% CI: 0.67, 0.87; p < 0.01). Lower use of limit setting was associated with higher child screen time and lower odds of meeting the screen time guideline in ages ≥5 years (β = 3.8 min; 95% CI: 0.69, 6.48; p < 0.01; OR = 0.86; 95% CI: 0.78, 0.94; p < 0.01).ConclusionsLower parental use of routines and limits during the COVID-19 pandemic were associated with higher screen time and lower odds of meeting the screen time guideline among school-age children. Results may help inform strategies to promote healthy screen use in this age group

CRISIS AFAR: an international collaborative study of the impact of the COVID-19 pandemic on mental health and service access in youth with autism and neurodevelopmental conditions

BackgroundHeterogeneous mental health outcomes during the COVID-19 pandemic are documented in the general population. Such heterogeneity has not been systematically assessed in youth with autism spectrum disorder (ASD) and related neurodevelopmental disorders (NDD). To identify distinct patterns of the pandemic impact and their predictors in ASD/NDD youth, we focused on pandemic-related changes in symptoms and access to services.MethodsUsing a naturalistic observational design, we assessed parent responses on the Coronavirus Health and Impact Survey Initiative (CRISIS) Adapted For Autism and Related neurodevelopmental conditions (AFAR). Cross-sectional AFAR data were aggregated across 14 European and North American sites yielding a clinically well-characterized sample of N = 1275 individuals with ASD/NDD (age = 11.0 ± 3.6 years; n females = 277). To identify subgroups with differential outcomes, we applied hierarchical clustering across eleven variables measuring changes in symptoms and access to services. Then, random forest classification assessed the importance of socio-demographics, pre-pandemic service rates, clinical severity of ASD-associated symptoms, and COVID-19 pandemic experiences/environments in predicting the outcome subgroups.ResultsClustering revealed four subgroups. One subgroup-broad symptom worsening only (20%)-included youth with worsening across a range of symptoms but with service disruptions similar to the average of the aggregate sample. The other three subgroups were, relatively, clinically stable but differed in service access: primarily modified services (23%), primarily lost services (6%), and average services/symptom changes (53%). Distinct combinations of a set of pre-pandemic services, pandemic environment (e.g., COVID-19 new cases, restrictions), experiences (e.g., COVID-19 Worries), and age predicted each outcome subgroup.LimitationsNotable limitations of the study are its cross-sectional nature and focus on the first six months of the pandemic.ConclusionsConcomitantly assessing variation in changes of symptoms and service access during the first phase of the pandemic revealed differential outcome profiles in ASD/NDD youth. Subgroups were characterized by distinct prediction patterns across a set of pre- and pandemic-related experiences/contexts. Results may inform recovery efforts and preparedness in future crises; they also underscore the critical value of international data-sharing and collaborations to address the needs of those most vulnerable in times of crisis

The more things change, the more things stay the same : maternal attitudes 3 to 18 months postpartum

Aim: Becoming a parent precipitates changes in new mothers' psychological and social domains. Previous literature has focused exclusively on pregnancy and the early postpartum, but parenting is an evolving process, necessitating adaption to changing circumstances. We extended previous literature and investigate the changes in the postpartum from 3 to 18 months that occur in maternal attitudes.Methods: Using the Childbearing Attitudes Questionnaire, we collected data on mothers’ ratings of maternal worries, self-efficacy, mother–infant bonding, relationship with the partner and interest in sex (n = 171 women). Data were analysed with a latent growth curve.Results: Results demonstrated stability in all maternal attitudes after 3 months postpartum. Further, different maternal attitudes are affected by different variables. Maternal worries and self-efficacy are associated with parity, postpartum depression and child temperament. Interestingly, a negative evaluation of the relationship with the partner was only associated with breastfeeding status, while interest in sex was associated with parity, socio-economic status (SES) and depressive symptoms.Conclusion: Despite general stability, different maternal attitudes related to different sets of variables. These patterns of attitudes in relation to relevant variables are discussed in terms of the literature on self-efficacy and gender roles, with important implications for clinical interventions.publishe

Patterns of parent screen use, child screen time, and child socioemotional problems at 5 years

Background: Digital media screens have become an essential part of our family life. While most studies focus on children’s screen use, we know less about parental screen use patterns and how these affect children’s socio-emotional development. Method: 867 Canadian parents of 5-year old children from the TARGet Kids! Cohort (73.1% mothers, mean age=38.88±4.45 years) participated from 2014 to 2020. Parents reported parental and child time on TV and handheld devices and completed the Strengths and Difficulties Questionnaire (SDQ). Latent profile analysis (LPA) was used to identify groups of parents with similar patterns of screen use and link these profiles with child screen time and SDQ. Results: We identified six latent profiles of parent screen use: low users (P1, reference; n=323), more TV than handheld (P2; n=261), equal TV and handheld (P3; n=177), more handheld than TV (P4; n=57), high TV and handheld (P5; n=38) and extremely high TV and handheld (P6; n=11). P6 were more likely to be living in single parent households compared to P1 (estimate=-1.49(0.70), p=0.03). P2 (estimate=-0.67(0.32), p=0.04) and P4 (estimate=-1.42(0.40), p<0.001) were more likely to have lower household income compared to P1. P4 (χ2=12.32, p<0.001) and P5 (χ2=9.54, p=0.002) have higher total child screen time compared to P1. P6 (χ2=6.82, p=0.009) had higher total SDQ compared to P1. Discussion: Patterns of parent screen use were associated with child screen use and child socioemotional problems. The link between parental screen use profiles and child behaviours suggests a need for guidelines on parental screen time

Checking assumptions: Advancing the analysis of sex and gender in human health and psychological sciences

Sex and gender are dissociable, multi-component variables. Focusing on the analytic problems associated with dichotomising continuous variables, we synthesize a new approach to collecting and analysing sex and gender data in health research, in contrast to the conventional use of dichotomous tickboxes to code sex/gender. Methods. Using a literature review and data simulations in R, we examined the magnitude of the statistical and methodological problems associated with the use of a single dichotomised sex/gender variable, including construct validity, predictive validity, measurement error, residual confounding, misclassification and bias due to cut points, power, and representative sampling. Results. Using the dichotomous sex/gender predictor rather than a continuous sex/gender predictor increased residual confounding up to 80% and misclassification of individual participants up to 50%. Further, there was substantial bias in model parameters when continuous sex/gender variables were dichotomised. Finally, we found that using the dichotomous sex/gender predictor decreased power, in some cases by more than 50%. Conclusions. Using a dichotomous sex/gender predictor in place of a continuous sex/gender predictor has profound impacts on the statistical model and the validity of inferences drawn from such a model. We describe measurement and analytic approaches to reduce the statistical problems related to a dichotomised sex/gender analysis

Association of parenting with suicidal ideation and attempts in children and youth: protocol for a systematic review and meta-analysis of observational studies

Abstract Background Suicide is a leading cause of death in children and youth, with suicidal thoughts and suicide attempts (referred to as non-fatal suicidal behaviors (NFSB)) being among its strongest predictors. Positive parenting (e.g., warmth, responsiveness), negative parenting (e.g., control, hostility), and parent-child relationship quality (e.g., trust, communication) have been reported to be associated with differences in NFSB in this population. To date, no comprehensive systematic review has considered together the wide range of parenting factors studied in relation to NFSB, and no meta-analysis of existing findings has been conducted. The present study will critically appraise and synthesize the existing evidence from observational studies that examine the relationships between parenting factors and (i) suicidal ideation and (ii) suicide attempt in children and youth. Methods Studies will be retrieved from APA PsycInfo, MEDLINE, CINAHL, Embase, Scopus, and the Cochrane Library databases. Retrospective, cross-sectional, and longitudinal studies, conducted in clinical and population settings, among youth aged less than 25 years and published as articles and dissertations in English or French will be eligible. Two reviewers will select articles using the Covidence Software after title and abstract screening and full-text assessment, will extract information using double data entry, and will appraise studies’ quality using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Any disagreements will be discussed with a third reviewer. Publication bias will be evaluated using funnel plots and Egger’s test. In addition to a narrative summary of results, meta-analyses will be conducted using results from at least three studies. Three-level random effect models will allow to derive pooled estimates from dependent effect sizes (from the same sample or study). In case of significant heterogeneity, moderation analyses will be performed considering participants’ characteristics and methodological aspects of studies. The results will be reported according to the PRISMA guidelines, and the certainty of evidence will be assessed using the GRADE approach. Discussion In highlighting parenting factors associated with NFSB and in estimating the overall strength of these associations in children and youth, our results will inform further intervention and prevention strategies designed for young people experiencing NFSB and their families. Systematic review registration PROSPERO CRD4202016534

Interactions Between Sex and Pet Ownership on Attitudes Toward Children

Background: Many people are attached to their pets. This attachment shares characteristics with the parental attachment to children. Previous studies have established a sex difference in attitudes about children; women compared to men report more positive attitudes about children. However, whether this sex difference is attenuated by owning and caring for pet(s) has not been investigated. Methods: In a sample of non-parents, we investigated the following: (1) whether the established main effect of sex on attitudes about children was moderated by pet ownership using a 2 (male, female) x 2 (pet owner, non–pet owner) design; and (2) whether the established main effect of sex on attitudes about children was moderated by lifetime experiences caring for pets using hierarchical multiple linear regression models. Data was collected via online survey of a community sample (n = 173). Results: We found that compared to females, males had more negative reactions to children and childcare (NRC). However, a significant sex by current pet ownership interaction revealed that current pet ownership eliminated the sex difference on NRC; males’ NRC scores were similar to females’ scores exclusively among people who currently owned a pet. Further, regression analyses revealed that the relationship between sex and NRC was moderated by the extent of lifetime experiences caring for pets. This effect was driven by males but not females; compared to males with low levels of lifetime experiences caring for pets, males with high levels of lifetime experiences caring for pets had less NRC. Conclusion: Taken together, these results provide the first reported evidence of the positive association between current pet ownership/lifetime experiences caring for pets and more favorable attitudes about children and childcare in non-parent males, but not in non-parent females

Parenting stress during infancy is a risk factor for mental health problems in 3-year-old children

Abstract Background Although research on the relationship between parent and child mental health is growing, the impact of early parenting stress on preschool-aged children’s mental health remains unclear. The objective was to evaluate the association between parenting stress during infancy and mental health problems in 3-year-old children. Methods A prospective cohort study of healthy preschool-aged children recruited from 9 primary care practices in Toronto, Canada was conducted through the TARGet Kids! primary care practice-based research network. Parenting stress was measured when children were between 0 to 16 months of age, using the Parent Stress Index Short Form, PSI-SF. Parent-reported child mental health problems were measured at 36 to 47 months using the preschool Strengths and Difficulties Questionnaire, total difficulties score (TDS). Hierarchical linear regression analysis was used to investigate the association between standardized PSI-SF and TDS, adjusted for child age, sex, temperament, sleep duration and household income. To strengthen clinical interpretation, analysis was repeated using adjusted multivariable logistic regression (TDS dichotomized at top 20%). Results A total of 148 children (mean ± SD age, 37.2 ± 1.7 months, 49% male) were included in the analysis. Parenting stress during infancy (11.4 ± 3.1 months of age) was significantly associated with mental health problems in 3-year-old children (β = 0.35; 95% CI = 0.20–0.49, p < 0.001). Higher parenting stress was also associated with increased odds of higher TDS (OR = 2.26, 95% CI = 1.69–2.83, p < 0.01). Conclusion Healthy preschool-aged children with parents reporting parenting stress during infancy had a 2 times higher odds of mental health problems at 3 years

Patterns of parent screen use, child screen time, and child socio-emotional problems at 5 years

Digital media screens have become an essential part of our family life. However, we have insufficient knowledge about parental screen use patterns and how these affect children's socio-emotional development. In total, 867 Canadian parents of 5-year-old children from the TARGet Kids! Cohort (73.1% mothers, mean ± SD age = 38.88 ± 4.45 years) participated in this study from 2014 to the end of 2019. Parents reported parental and child time on television (TV) and handheld devices and completed the Strengths and Difficulties Questionnaire (SDQ). Latent profile analysis identified six latent profiles of parent screen use: low handheld users (P1, reference; n = 323), more TV than handheld (P2; n = 261), equal TV and handheld (P3; n = 177), more handheld than TV (P4; n = 57), high TV and handheld (P5; n = 38), and extremely high TV and handheld (P6; n = 11). Parents that were more likely to belong to P6 were also more likely to be living in single-parent households compared to P1 (estimate = −1.49 ± 0.70), p = .03). High membership probability for P2 (estimate = −0.67 ± 0.32, p = .04) and P4 (estimate = −1.42 ± 0.40, p < 0.001) was associated with lower household income compared to P1. Children of parents with higher P4 (χ2 = 12.32, p < 0.001) or P5 (χ2 = 9.54, p = .002) membership probability had higher total screen time compared to P1. Finally, a higher likelihood to belong to P6 (χ2 = 6.82, p = .009) was associated with a higher SDQ Total Difficulties Score compared to P1. Thus, patterns of parent screen use were associated with child screen use and child socio-emotional problems. The emerging link between parental screen use profiles and child behaviors suggests the need for more research on parent screen time.publishe