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5 Evidence-Based Ways to Practice Positive Parenting

What is positive parenting and can it really improve your child's behavior.

Posted August 7, 2021 | Reviewed by Vanessa Lancaster

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• Positive parenting is a parenting practice that focuses on building a positive relationship with your child.
• Research finds that positive parenting is associated with lower levels of challenging behavior in children.
• There are several evidence-based ways to practice positive parenting that may also be associated with improved behavior.

“Positive parenting ” is currently a buzzword that is commonly used to describe parenting practices. Yet, what exactly does this term mean? Does research find positive parenting to be effective? And how do you actually practice positive parenting?

What is positive parenting?

There is a need for a more consistent definition of positive parenting. Yet, a recent review article generated the following definition of positive parenting based on 120 articles on the topic: “a continual relationship of parents and children that includes caring, teaching, leading, communicating, and providing for the needs of a child consistently and unconditionally” (Seay & Freysteinson, 2014). Other researchers have defined positive parenting as a parent-child relationship that is “responsive to child’s needs and feelings and combines warmth and thoughtful, firm limit setting consistently over time” (Schor, 2003).

Is positive parenting effective? Will it really improve your child’s behavior?

Research finds that positive parenting is associated with lower levels of aggression and other forms of challenging behavior in children. In particular, mothers who use more positive parenting practices with their toddlers are less likely to have children who show challenging behavior later in childhood .

How do you practice positive parenting in a way associated with less challenging behavior in children (according to the research)?

1) Respect your child’s autonomy and independence. Allow them to make choices and to make their own mistakes. When possible, let them choose the clothes they wear, their play activities, and the order of tasks in their daily routines.

2) Provide developmentally appropriate opportunities for play and learning for your children. Teach them new words and skills but also teach them about emotions. Set limits and correct their behavior when necessary.

3) Be sensitive to cues from your child. Be aware and responsive to their emotions. Respond consistently to their communication (or attempts at communication, if they are not yet communicating using words),

4) Be warm and loving with your child. Regularly show them affection and love. Praise their efforts and hard work whenever you notice it.

5) Be present and interact with your child as often as possible. Practice special time with your child daily (that is, spend about 15 minutes per day one-on-one with your child with minimal distractions and following their lead in play)

Does positive parenting mean you never correct your child or provide limits?

No, positive parenting, as it is defined in the research, involves consistent and firm limit setting.

Can you practice “positive parenting” and still use consequences and time-outs?

Yes, most evidence-based parenting positive parenting programs involve natural and logical consequences, and many programs include some version of time out.

Does positive parenting mean staying close to your child during all tantrums and meltdowns?

No, positive parenting means being sensitive to your child’s cues. If they need space when they are upset, give them time and space to calm down. And if you, as the parent, need some time and space to calm down, allow yourself to do so as well!

Boeldt, D. L., Rhee, S. H., DiLalla, L. F., Mullineaux, P. Y., Schulz‐Heik, R. J., Corley, R. P., ... & Hewitt, J. K. (2012). The association between positive parenting and externalizing behaviour. Infant and Child Development, 21(1), 85-106.

Seay, A., Freysteinson, W. M., & McFarlane, J. (2014, July). Positive parenting. In Nursing Forum (Vol. 49, No. 3, pp. 200-208).

Schor, E. (2003). Family pediatrics: Report of the task force on the family. Pediatrics, 111(6), 1541–1571.

Cara Goodwin, Ph.D., is a licensed clinical psychologist who specializes in translating scientific research into information that is useful, accurate, and relevant for parents.

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May 1, 2016

11 min read

Research Reveals Key Steps to Successful Parenting

A scientific analysis ranks the 10 most effective child-rearing practices. Surprisingly, some don't even involve the kids

By Robert Epstein

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If you search the book section of Amazon.com for “dieting,” you will find more than 76,000 listings. But “parenting” yields a much bigger number: more than 180,000 , including books such as Jane Rankin's Parenting Experts , which do nothing but evaluate the often conflicting advice the experts offer. People, it seems, are even more nervous about their parenting than they are about their waistlines.

Why is there such chaos and doubt when it comes to parenting? Why, in fact, do most parents continue to parent pretty much the way their own parents did—or, if they disliked the way they were raised, the exact opposite way? Shouldn't we all just find out what the studies say and parent accordingly?

A growing body of research conducted over the past 50 years shows fairly clearly that some parenting practices produce better outcomes than others—that is, better relationships between parent and child and happier, healthier, better functioning children. And just as we use medical science cautiously and strategically to make everyday health decisions, we can also make wise use of research to become better parents.

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A recent study I conducted with Shannon L. Fox, then a student at the University of California, San Diego, which we presented at a meeting of the American Psychological Association, compared the effectiveness of 10 kinds of parenting practices that have gotten the thumbs-up in various scientific studies. It also showed how parenting experts rate those practices and looked at just how many parents actually use those practices. In other words, we compared three things: what experts advise, what really seems to work and what parents actually do.

Our study confirmed some widely held beliefs about parenting—for example, that showing your kids that you love them is essential—and it also yielded some surprises, especially regarding the importance of a parent's ability to manage stress in his or her own life.

Ten Important Competencies

To figure out which parenting skills were most important, we looked at data from about 2,000 parents who had recently taken an online test of parenting skills I developed (which is accessible at http://MyParentingSkills.com ) and who also answered questions about their children. Parents did not know this when they took the test, but the skills were organized into 10 categories, all of which derive from published studies that show that such skills are associated with good outcomes with children. The 10 skill areas measured by the test were also evaluated by 11 parenting experts unknown to Fox and me, and we in turn were unknown to them (in other words, using a double-blind evaluation procedure).

On the test, parents indicated for 100 items how much they agreed with statements such as “I generally encourage my child to make his or her own choices,” “I try to involve my child in healthful outdoor activities” and “No matter how busy I am, I try to spend quality time with my child.” Test takers clicked their level of agreement on a five-point scale from “agree” to “disagree.” Because all the items were derived from published studies, the answers allowed us to compute an overall skill level for each test taker, as well as separate skill levels in each of the 10 competency areas. Agreement with statements that described sound parenting practices (again, according to those studies) yielded higher scores.

The 10 kinds of parenting competencies, which we call “The Parents' Ten,” include obvious ones such as managing problem behavior and expressing love and affection, as well as practices that affect children indirectly, such as maintaining a good relationship with one's co-parent and having practical life skills [ see the full list below ].

In addition to asking test takers basic demographic questions about their age, education, marital status, parenting experience, and so on, we also asked them questions about the outcomes of their parenting, such as “How happy have your children been (on average)?”; “How successful have your children been in school or work settings (on average)?”; and “How good has your relationship been with your children (on average)?” For questions such as these, test takers clicked on a 10-point scale from low to high.

With scores in hand for each parent on all “The Parents' Ten,” along with their general assessments regarding the outcomes of their parenting, we could now use a statistical technique called regression analysis to determine which competencies best predict good parenting outcomes. For an outcome such as the child's happiness, this kind of analysis allows us to say which parenting skills are associated with the most happiness in children.

Love, Autonomy and Surprises

Our most important finding confirmed what most parents already believe, namely, that the best thing we can do for our children is to give them lots of love and affection. Our experts agreed, and our data showed that this skill set is an excellent predictor of good outcomes with children: of the quality of the relationship we have with our children, of their happiness, and even of their health. What's more, parents are better at this skill than they are at any of the others. We also confirmed what many other studies have shown: that encouraging children to become independent and autonomous helps them to function at a high level.

But our study also yielded a number of surprises. The most surprising finding was that two of the best predictors of good outcomes with children are in fact indirect : maintaining a good relationship with the other parent and managing your own stress level. In other words, your children benefit not just from how you treat them but also from how you treat your partner and yourself.

Getting along with the other parent is necessary because children inherently want their parents to get along. Many years ago, when my first marriage was failing, my six-year-old son once led me by the hand into the kitchen where his mom was standing and tried to tape our hands together. It was a desperate act that conveyed the message: “Please love each other. Please get along.” Children do not like conflict, especially when it involves the two people in the world they love most. Even in co-parenting situations where parents live apart, it is crucial to adhere to practices that do not hurt children: to resolve conflicts out of sight of the children, to apologize to one another and forgive each other (both can be done in front of the kids), to speak kindly about the other parent, and so on.

Stress management is also important for good parenting, just as it is vital in all aspects of life. In our study, parents' ability to manage stress was a good predictor of the quality of their relationship with their kids and of how happy their children were. Perhaps more telling, people who rated themselves as great parents scored more highly on stress management than on any of the other nine parenting competencies. There is, possibly, a simple lesson here: parents who lose their temper around their kids know it is bad parenting. Keeping calm is probably step one in good parenting. Fortunately, stress-management practices such as meditation, imagery techniques and breathing exercises can be learned, no matter what one's natural tendencies. People can also learn better organizational skills and even ways of managing stressful thinking.

Keeping children safe—a matter of almost obsessive concern among American parents these days—seems to have both positive and negative outcomes. On the bright side, in our study safety skills did contribute to good health outcomes. But being overly concerned with safety appears to produce poorer relationships with children and appears to make children less happy. A study by Barbara Morrongiello and her colleagues at the University of Guelph in Ontario shows how complex the safety issue can be. In their study, young people between the ages of seven and 12 said that even though they were generally conforming to the safety rules of their parents, they planned to behave like their parents when they grew up, even where their parents were, by their own standards, behaving unsafely. Had they detected their parents' hypocrisy?

Another surprise involves the use of behavior-management techniques. Although my own training in psychology (under the pioneering behavioral psychologist B. F. Skinner) suggests that sound behavior management—providing lots of reinforcement for good behavior, for example—is essential for good parenting, our study casts doubt on this idea. Behavior management ranked low across the board: it was a poor predictor of good outcomes with children; parents scored relatively poorly in this skill area; and our experts ranked it ninth in our list of 10 competencies.

In general, we found that parents are far better at educating their children and keeping them safe than they are at managing stress or maintaining a good relationship with the other parent, even though the latter practices appear to have more influence on children. Getting along with one's co-parent is the third most important practice, but it ranked eighth on the parents' list of actual abilities. Even more discouraging, stress management (number two in importance) ranked 10th.

Who Make Good Parents?

Setting aside “The Parents' Ten” for the moment, our study also shed some interesting light on what characteristics a good parent has.

A general parenting ability appears to exist—something like the “g” factor that exists for intelligence (also known as general intelligence). The g factor for parenting emerged very strongly in our study using a statistical technique called factor analysis, which organizes large amounts of test data by clustering test items into a small number of highly predictive variables. Some people just seem to have a knack for parenting, which cannot be easily described in terms of specific skills.

We also found that a number of characteristics that people often associate with good parenting are probably not very significant. For example, women appear to be only a hair better than men at parenting these days—a huge change in our culture. Women scored 79.7 percent on our test, compared with 78.5 percent for men—a difference that was only marginally significant. Parents who were older or who had more children also did not produce significantly better parenting outcomes in our study. Parents seem to perform just as well whether or not they have ever been married, and divorced parents appear to be every bit as competent as those who are still married, although their children are somewhat less happy than the children of parents who were never divorced.

Neither race nor ethnicity seems to contribute much to parenting competence, and gays and straights are just about equal in parenting ability. In fact, gays actually outscored straights by about 1 percentage point in our test.

One characteristic that does seem to make a difference is education: generally speaking, the more the education, the better the parenting. This might be because better educated people also work harder to improve their parenting skills through parent education programs (confirmed by our data). It is also possible that good parents—those with a high parenting g—are also generally competent people who are better educated. In other words, the g for parenting might be the same as the g for intelligence, a matter to be explored in future research.

The bottom line on such findings is that if you really want to know about an individual's competence as a parent, you should measure that competence directly rather than default to commonly held stereotypes. In the U.S., after all, women did not get the vote until 1920 because of faulty assumptions about female limitations. I believe this is one of the main lessons of our study: there is simply no substitute for the direct measure of competence.

Perhaps the best news is that parents are trainable. Our data confirm that parents who have taken parenting classes produce better outcomes with their children than parents who lack such training and that more training leads to better outcomes. Training programs, such as the evidence-based Parenting Wisely program developed by Donald A. Gordon, of Ohio University, can indeed improve parenting practices. Programs are available in major cities around the country, sometimes sponsored by local therapists or state or county agencies. The National Effective Parenting Initiative, which I have been associated with since its inception in 2007, is working to make quality parent training more widely available (see http://EffectiveParentingUSA.org for additional information).

Where Experts Fail

Although parenting experts do indeed offer conflicting advice at times (perhaps because they don't keep up with the studies!), our experts generally did a good job of identifying competencies that predict positive outcomes with children. There were two notable exceptions: First, they ranked stress management eighth in our list of 10 competencies, even though it appears to be one of the most important competencies. Second, our experts seemed to be biased against the religion and spirituality competency. They ranked it rock bottom in the list of 10, and several even volunteered negative comments about this competency area, even though studies suggest that religious or spiritual training is good for children.

Historically, clinicians and behavioral scientists have shied away from religious issues, at least in their professional lives; that could explain the discomfort our experts expressed about religious or spiritual training for children. Why they were so far off on stress management is truly a mystery, however, given psychology's long interest in both the study and treatment of stress. I can only speculate that stress management is not widely taught in graduate programs in psychology-related fields as an essential component of good parenting. It should be.

Bringing It Home

Tempering one's parenting with relevant scientific knowledge can truly have great benefits for one's family. It can reduce or eliminate conflict with one's children, for one thing, which in turn can improve a marriage or co-parenting relationship. It can also help produce happier, more capable children.

I have seen how this works in my own parenting. I am a much better parent with my younger children (who range in age from nine to 17) than I was with my older two (now 34 and 36). The more I have learned about parenting over the years, the more loving and skillful I have become, with obvious benefits. These days I really do hug my children and tell them I love them several times a day, every day, without exception. When love is never in question, children are much more understanding and tolerant when a parent needs to set limits, which I do regularly. I have also learned to stay calm—to improve the way I react to things. When I am calm, my children are, too, and we avoid that deadly cycle of emotional escalation that can ruin relationships.

Most important, I am much more a facilitator now than a controller. While building my own competence as a parent, I have also put more effort into recognizing and strengthening the competence of my children, helping them to become strong and independent in many ways. My 17-year-old son is now a calm, helpful role model to his siblings, and by the time she was 10, even before I had gotten out of bed, my daughter had often made scrambled eggs for all of us—and cleaned up, too.

The Parents’ Ten

Here are 10 competencies that predict good parenting outcomes, listed roughly in order from most to least important. The skills—all derived from published studies—were ranked based on how well they predict a strong parent-child bond and children’s happiness, health and success. —R.E.

1. Love and affection You support and accept the child, are physically affectionate and spend quality one-on-one time together.

2. Stress management You take steps to reduce stress for yourself and your child, practice relaxation techniques and promote positive interpretations of events.

3. Relationship skills You maintain a healthy relationship with your spouse, significant other or co-parent and model effective relationship skills with other people.

4. Autonomy and independence You treat your child with respect and encourage him or her to become self-sufficient and self-reliant.

5. Education and learning You promote and model learning and provide educational opportunities for your child.

6. Life skills You provide for your child, have a steady income and plan for the future.

7. Behavior management You make extensive use of positive reinforcement and punish only when other methods of managing behavior have failed.

8. Health You model a healthy lifestyle and good habits, such as regular exercise and proper nutrition, for your child.

9. Religion You support spiritual or religious development and participate in spiritual or religious activities.

10. Safety You take precautions to protect your child and maintain awareness of the child’s activities and friends.

Robert Epstein , senior research psychologist at the American Institute for Behavioral Research and Technology in Vista, Calif., is a contributing editor for Scientific American Mind and former editor in chief of Psychology Today . His latest book is Teen 2.0: Saving Our Children and Families from the Torment of Adolescence (Linden Publishing, 2010).

What is Positive Parenting? 33 Examples and Benefits

And while most of us strive to be great parents, we may also find ourselves confused and frustrated by the seemingly endless challenges of parenthood.

As both parents of toddlers and teenagers can attest, such challenges are evident across all developmental stages.

But there is good news— numerous research-supported tools and strategies are now available for parents. These resources provide a wealth of information for common parenting challenges (i.e., bedtime issues, picky eating, tantrums, behavior problems, risk-taking, etc.); as well as the various learning lessons that are simply part of growing up (i.e., starting school, being respectful, making friends, being responsible, making good choices, etc.).

With its focus on happiness, resilience and positive youth development ; the field of positive psychology is particularly pertinent to discussions of effective parenting. Thus, whether you are a parent who’s trying to dodge potential problems; or you are already pulling your hair out— you’ve come to the right place.

This article provides a highly comprehensive compilation of evidence-based positive parenting techniques. These ideas and strategies will cover a range of developmental periods, challenges, and situations. More specifically, drawing from a rich and robust collection of research, we will address exactly what positive parenting means; its many benefits; when and how to use it; and its usefulness for specific issues and age-groups.

This article also contains many useful examples, positive parenting tips, activities, programs, videos, books , podcasts – and so much more. By learning from and applying these positive parenting resources; parents will become the kind of parents they’ve always wanted to be: Confident, Optimistic, and even Joyful.

Before you continue, we thought you might like to download our three Positive Parenting Exercises for free . These detailed, science-based exercises will help you or your clients identify opportunities to implement positive parenting practices and support healthy child development.

This Article Contains:

What is positive parenting, a look at the research, how can it encourage personal development and self growth in a child, how old must the child be, what are the benefits, 12 examples of positive parenting in action, positive parenting styles, a look at positive discipline, positive parenting with toddlers and preschoolers, how to best address sibling rivalry, positive parenting with teenagers, positive parenting through divorce, a take-home message.

Before providing a definition of positive parenting, let’s take a step back and consider what we mean by “parents.” While a great deal of parenting research has focused on the role of mothers; children’s psychosocial well-being is influenced by all individuals involved in their upbringing.

Such caregivers might include biological and adoptive parents, foster parents, single parents, step-parents, older siblings, and other relatives and non-relatives who play a meaningful role in a child’s life. In other words, the term “parent” applies to an array of individuals whose presence impacts the health and well-being of children (Juffer, Bakermans-Kranenburg & van Ijzendoorn, 2008).

Thus, any time the terms “parent” or “caregiver” are used herein; they apply to any individuals who share a consistent relationship with a child, as well as an interest in his/her well-being (Seay, Freysteinson & McFarlane, 2014).

Fortunately, parenting research has moved away from a deficit or risk factor model towards a more positive focus on predictors of positive outcomes (e.g., protective factors ). Positive parenting exemplifies this approach by seeking to promote the parenting behaviors that are most essential for fostering positive youth development (Rodrigo, Almeida, Spiel, & Koops, 2012).

Several researchers have proposed definitions of positive parenting, such as Seay and colleagues (2014), who reviewed 120 pertinent articles. They came up with the following universal definition:

Positive parenting is the continual relationship of a parent(s) and a child or children that includes caring, teaching, leading, communicating, and providing for the needs of a child consistently and unconditionally.

(Seay et al., 2014, p. 207).

The Committee of Ministers of the Council of Europe (2006) similarly defined positive parenting as “ … nurturing, empowering, nonviolent… ” and which “ provides recognition and guidance which involves setting of boundaries to enable the full development of the child ’’ (in Rodrigo et al., 2012, p. 4). These definitions, combined with the positive parenting literature, suggest the following about positive parenting:

• It involves Guiding
• It involves Leading
• It involves Teaching
• It is Caring
• It is Empowering
• It is Nurturing
• It is Sensitive to the Child’s Needs
• It is Consistent
• It is Always Non-violent
• It provides Regular Open Communication
• It provides Affection
• It provides Emotional Security
• It provides Emotional Warmth
• It provides Unconditional Love
• It recognizes the Positive
• It respects the Child’s Developmental Stage
• It rewards Accomplishments
• It sets Boundaries
• It shows Empathy for the Child’s Feelings
• It supports the Child’s Best Interests

Along with these qualities, Godfrey (2019) proposes that the underlying assumption of positive parenting is that “… all children are born good, are altruistic and desire to do the right thing …” (positiveparenting.com).

Godfrey further adds that the objective of positive parenting is to teach discipline in a way that builds a child’s self-esteem and supports a mutually respectful parent-child relationship without breaking the child’s spirit (2019). These authors reveal an overall picture of positive parenting as warm, thoughtful and loving— but not permissive.

There is plenty of research supporting the short- and long-term effects of positive parenting on adaptive child outcomes. To begin with, work by the Positive Parenting Research Team ( PPRT ) from the University of Southern Mississippi (Nicholson, 2019) is involved in various studies aimed at examining the impact of positive parenting.

• The following are included among the team’s research topics:
• Relationships between positive parenting and academic success;
• Positive parenting as a predictor of protective behavioral strategies;
• Parenting style and emotional health; maternal hardiness, coping and social support in parents of chronically ill children, etc.

The PPRT ultimately seeks to promote positive parenting behaviors within families.

In their seven-year longitudinal study; Pettit, Bates and Dodge (1997) examined the influence of supportive parenting among parents of pre-kindergartners. Supportive parenting was defined as involving mother‐to‐child warmth, proactive teaching, inductive discipline, and positive involvement. Researchers contrasted this parenting approach with a less supportive, more harsh parenting style.

Supportive parenting was associated with more positive school adjustment and fewer behavior problems when the children were in sixth grade. Moreover, supportive parenting actually mitigated the negative impact of familial risk factors (i.e., socioeconomic disadvantage, family stress, and single parenthood) on children’s subsequent behavioral problems (Pettit et al., 2006).

Researchers at the Gottman Institute also investigated the impact of positive parenting by developing a 5-step ‘emotion coaching’ program designed to build children’s confidence and to promote healthy intellectual and psychosocial growth.

Gottman’s five steps for parents include:

• awareness of emotions;
• connecting with your child;
• listening to your child;
• naming emotions; and
• finding solutions (Gottman, 2019).

Gottman has reported that children of “emotional coaches” benefit from a more a positive developmental trajectory relative to kids without emotional coaches. Moreover, an evaluation of emotional coaching by Bath Spa University found several positive outcomes for families trained in emotional coachings, such as parental reports of a 79% improvement in children’s positive behaviors and well-being (Bath Spa University, 2016).

Overall, research has indicated that positive parenting is related to various aspects of healthy child development (many more examples of evidence supporting the benefits are positive parenting are described further in this article). Such outcomes are neither fleeting nor temporary; and will continue well beyond childhood.

Another way of thinking about the role of positive parenting is in terms of resilience. When children—including those who begin life with significant disadvantages— experience positive and supportive parenting, they are far more likely to thrive.

It is in this way that positive parenting minimizes health and opportunity disparities by armoring children with large stores of emotional resilience (Brooks, 2005; Brooks & Goldstein, 2001). And since we know positive parenting works; what parent wouldn’t want to learn how to use it and thereby give his/her child the best shot at a healthy and happy life?

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There are various mechanisms through which positive parenting promotes a child’s prosocial development.

For example, Eisenberg, Zhou, and Spinrad et al. (2005) suggest that positive parenting impacts children’s temperament by enhancing emotion regulation (e.g., “effortful control” enabling children to focus attention in a way that promotes emotion modulation and expression).

The authors reported a significant link between parental warmth and positive expressivity on children’s long-term emotion regulation. This ability to use effortful control was found to predict reduced externalizing problems years later when children were adolescents (Eisenbert et al., 2005).

Along with emotion regulation, there are many other ways in which positive parenting encourages a child’s positive development and self-growth.

Here are some examples:

• Teaching and leading promote children’s confidence and provides them with the tools needed to make good choices.
• Positive communication promotes children’s social and problem-solving skills while enhancing relationship quality with caregivers and peers.
• Warm and democratic parenting enhances children’s self-esteem and confidence.
• Parental supervision promotes prosocial peer bonding and positive youth outcomes.
• Autonomy-promoting parenting supports creativity, empowerment, and self-determination.
• Supportive and optimistic parenting fosters children’s belief in themselves and the future.
• Providing recognition for desirable behaviors increases children’s self-efficacy and the likelihood of engaging in prosocial, healthy behaviors.
• Providing boundaries and consequences teaches children accountability and responsibility.

Generally speaking, there are many aspects of positive parenting that nurture children’s self-esteem; creativity; belief in the future; ability to get along with others; and sense of mastery over their environment.

Warm, loving and supportive parents feed a child’s inner spirit while empowering him/her with the knowledge and tools necessary to approach life as a fully capable individual.

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The need for positive parenting begins – well, at the beginning. The attachment literature has consistently indicated that babies under one year of age benefit from positive parenting. More specifically, a secure attachment between infants and mothers is related to numerous positive developmental outcomes (i.e., self-esteem, trust, social competence, etc.; Juffer, Bakermans-Kranenburg & van Ijzendoorn, 2008).

The quality of the mother-child attachment is believed to be a function of parental sensitivity (e.g., mothers who accurately perceive and quickly respond to their babies’ needs; Juffer et al., 2008)— which is certainly a key indicator of positive parenting practices in their earliest form.

Not only is a secure mother-child attachment related to early positive developmental outcomes, but more recent attachment research also indicates long-term increases in social self-efficacy among girls with secure attachments to their fathers (Coleman, 2003).

There are even ways in which positive parenting benefits a child or family as soon as the parents learn of a pregnancy or adoption (i.e., see the subsequent ‘sibling rivalry’ section). Therefore, it cannot be stressed enough: Positive parenting begins as early as possible.

There is empirical evidence for numerous benefits of positive parenting, which cover all developmental stages from infancy to late adolescence. The following table provides a list of many such examples:

The evidence clearly supports a relationship between positive parenting approaches and a large variety of prosocial parent and child outcomes. Therefore, practitioners have developed and implemented a range of programs aimed at promoting positive parenting practices.

Here are some noteworthy examples; including those which target specific risk factors, as well as those with a more preventative focus:

• Parent’s Circle program (Pearson & Anderson, 2001): Recognizing that positive parenting begins EARLY, this program helped parents of infants in the neonatal intensive care unit to enhance their parenting skills in order to better parent their fragile newborns.
• The Home Visiting Program (Ammaniti, Speranza, & Tambelli, et al., 2006): Also focused on babies, this program aimed to increase parental sensitivity in order to improve secure mother-infant attachments. In doing so, psychologists visited high-risk mothers at their homes in order to improve parental sensitivity to their infants’ signals.
• The Early Head Start Home-based Program (Roggman, Boyce, & Cook, 2009): This home-based program also focused on promoting parent-child attachment. Parents in semirural areas received weekly home-based visits from a family educator who taught them positive strategies aimed at promoting healthy parent-child interactions and engagement in children’s activities.
• American Psychological Association’s ACT Raising Safe Kids (RSK) program (Knox, Burkhard, & Cromly, 2013): The goal of this program was to improve parents’ positive parenting knowledge and skills by teaching nonviolent discipline, anger management, social problem‐solving skills, and other techniques intended to protect children from aggression and violence.
• New Beginnings Program (Wolchik, Sandler, Weiss, & Winslow, 2007): This empirically-based 10-session program was designed to teach positive parenting skills to families experiencing divorce or separation. Parents learned how to nurture positive and warm relationships with kids, use effective discipline, and protect their children from divorce-related conflict. The underlying goal of the New Beginnings Program was to promote child resilience during this difficult time.
• Family Bereavement Program (Sandler, Wolchik, Ayers, Tein, & Luecken, 2013): This intervention was aimed at promoting resilience in parents and children experiencing extreme adversity: The death of a parent. This 10-meeting supportive group environment helped bereaved parents learn a number of resilience-promoting parenting skills (i.e., active listening, using effective rules, supporting children’s coping, strengthening family bonds, and using adequate self-care).
• The Positive Parent (Suárez, Rodríguez, & López, 2016): This Spanish online program was aimed at enhancing positive parenting by helping parents to learn about child development and alternative child-rearing techniques; to become more aware, creative and independent in terms of parenting practices; to establish supportive connections with other parents; and to feel more competent and satisfied with their parenting.
• Healthy Families Alaska Programs (Calderaa, Burrellb, & Rodriguez, 2007): The objective of this home visiting program was to promote positive parenting and healthy child development outcomes in Alaska. Paraprofessionals worked with parents to improve positive parenting attitudes, parent-child interactions, child development knowledge, and home environment quality.
• The Strengthening Families Program (Kumpfer & Alvarado, 1998): This primary prevention program has been widely used to teach parents a large array of positive parenting practices. Following family systems and cognitive-behavioral philosophies, the program has taught parenting skills such as engagement in positive interactions with children, positive communication, effective discipline, rewarding positive behaviors, and the use of family meetings to promote organization. The program’s overall goal was to enhance child and family protective factors; to promote children’s resilience, and to improve children’s social and life skills.
• Incredible Years Program (Webster-Stratton& Reid, 2013): This program refers to a widely implemented and evaluated group-based intervention designed to reduce emotional problems and aggression among children, and to improve their social and emotional competence. Parent groups received 12-20 weekly group sessions focused on nurturing relationships, using positive discipline, promoting school readiness and academic skills, reducing conduct problems, and increasing other aspects of children’s healthy psychosocial development. This program has also been used for children with ADHD.
• Evidence-based Positive Parenting Programs Implemented in Spain (Ministers of the Council of Europe, in Rodrigo et al., 2012): In a special issue of Psychosocial Intervention, multiple evaluation studies of positive parenting programs delivered across Spain are presented. Among the programs included are those delivered in groups, at home, and online; each of which is aimed at positive parenting support services. This issue provides an informative resource for understanding which parents most benefited from various types of evidence-based programs aimed at promoting positive parenting among parents attending family support services.
• Triple P Positive Parenting Program (Sanders, 2008): This program, which will be described in more detail in a subsequent post, is a highly comprehensive parenting program with the objective of providing parents of high-risk children with the knowledge, confidence, and skills needed to promote healthy psychological health and adjustment in their children. While these programs are multifaceted, an overarching focus of the Triple P programs is to improve children’s self-regulation.

A reoccurring theme in the positive parenting literature is that a warm, yet firm parenting style is linked to numerous positive youth outcomes. This style is termed ‘authoritative’ and it is conceptualized as a parenting approach that includes a good balance of the following parenting qualities: assertive, but not intrusive; demanding, but responsive; supportive in terms of discipline, but not punitive (Baumrind, 1991).

Along with an authoritative parenting style, a developmental parenting style is also believed to support positive child outcomes (Roggman et al., 2008).

Developmental parenting is a positive parenting style that promotes positive child development by providing affection (i.e., through positive expressions of warmth toward the child); responsiveness (i.e., by attending to a child’s cues); encouragement (i.e., by supporting a child’s capabilities and interests); and teaching (i.e., by using play and conversation to support a child’s cognitive development (Roggman & Innocenti, 2009).

Developmental parenting clearly shares several commonalities with authoritative parenting, and both represent positive parenting approaches.

Overall, by taking a good look at positive parenting strategies that work for raising healthy, happy kids; it is evident that positive parenting styles encourage a child’s autonomy by:

• Supporting exploration and involvement in decision-making
• Paying attention and responding to a child’s needs
• Using effective communication
• Attending to a child’s emotional expression and control
• Rewarding and encouraging positive behaviors
• Providing clear rules and expectations
• Applying consistent consequences for behaviors
• Providing adequate supervision and monitoring
• Acting as a positive role model
• Making positive family experiences a priority

In a nutshell, positive parents support a child’s healthy growth and inner spirit by being loving, supportive, firm, consistent, and involved. Such parents go beyond communicating their expectations, but practice what they preach by being positive role models for their children to emulate.

4 Things you must say to your kids daily – Live on Purpose TV

The term ‘discipline’ often has a negative, purely punitive connotation. However, ‘discipline’ is actually defined as “training that corrects, molds, or perfects the mental faculties or moral character” (Merriam-Webster, 2019).

This definition is instructive, as it reminds us that as parents, we are not disciplinarians, but rather teachers. And as our children’s teachers, our goal is to respectfully show them choices for behaviors and to positively reinforce adaptive behaviors.

Positive discipline again harkens back to authoritative parenting because it should be administered in a way that is firm and loving at the same time. Importantly, positive discipline is never violent, aggressive or critical; it is not punitive.

Relevant: Examples of Positive Punishment & Negative Reinforcement

Physical punishment (i.e., spanking) is ineffective for changing behaviors in the long-term and has a number of detrimental consequences on children (Gershoff, 2013). Indeed, the objective of positive discipline is to “teach and train. Punishment (inflicting pain/purposeful injury) is unnecessary and counter-productive” (Kersey, 2006, p. 1).

Nelsen (2006) describes a sense of belonging as a primary goal of all people; a goal that is not achieved through punishment. In fact, she describes the four negative consequences of punishment on children (e.g., “the four R’s”) as resentment toward parents; revenge that may be plotted in order to get back at parents; rebellion against parents, such as through even more excessive behaviors; and retreat, that may involve becoming sneaky and/or experiencing a loss of self-esteem (Nelsen, 2006).

She provides the following five criteria for positive discipline (which are available on her positive discipline website ):

• Is both kind and firm
• Promotes a child’s sense of belonging and significance
• Works long-term (note: punishment may have an immediate impact, but this is short-lived)
• Teaches valuable social and life skills (i.e., problem-solving, social skills, self-soothing, etc.)
• Helps children develop a sense that they are capable individuals

In her comprehensive and helpful book for parents: Positive Discipline , Nelsen (2006) also describes a number of key aspects of positive discipline, such as being non-violent, respectful, and grounded in developmental principles; teaching children self-respect, empathy, and self-efficacy; and promoting a positive relationship between parent and child.

Stated another way, “ respecting children teaches them that even the smallest, most powerless, most vulnerable person deserves respect, and that is a lesson our world desperately needs to learn ” (LR Knost, lovelivegrow.com).

Since we know that positive discipline does not involve the use of punishment; the next obvious questions become “Just what exactly does it involve?”

This question is undoubtedly urgent for parents who feel like their child is working diligently toward driving them mad. While we will discuss some of the more typical frustrations that parents regularly encounter later in the article, Kersey (2006) provides parents with a wonderful and comprehensive resource in her publication entitled “101 positive principles of discipline.”

Here are her top ten principles:

• Demonstrate Respect Principle : Treat the child in the same respectful way you would like to be treated.
• Make a Big Deal Principle : Use positive reinforcement in meaningful ways for desired behaviors. Reward such behaviors with praise, affection, appreciation, privileges, etc.
• Incompatible Alternative Principle : Provide the child with a behavior to substitute for the undesirable one, such as playing a game rather than watching tv.
• Choice Principle : Provide the child with two choices for positive behaviors so that he/she feels a sense of empowerment. For example, you might say “would you rather take your bath before or after your brush your teeth?”
• When/Then – Abuse it/Lose it Principle : Ensure that rewards are lost when rules are broken. For example, you might say “After you clean your room, you can play outside” (which means that a child who does not clean his/her room, will not get to play outside. Period.)
• Connect Before You Correct Principle : Ensure that the child feels loved and cared for before behavioral problems are attended to.
• Validation Principle : Validate the child’s feelings. For example, you might say “I know you are sad about losing your sleepover tonight and I understand”.
• Good Head on Your Shoulders Principle : Ensure that the child hears the equivalent of “you have a good head on your shoulders” in order to feel capable, empowered and responsible for his/her choices. This is especially important for teenagers.
• Belonging and Significance Principle : Ensure that your child feels important and as if he/she belongs. For example, remind your child that he/she is really good at helping in the kitchen and that the family needs this help in order to have dinner.
• Timer Says it’s Time Principle : Set a timer to help children make transitions. This helps kids to know what’s expected of them and may also involve giving them a choice in terms of the amount of time. For example, you might say “Do you need 15 or 20 minutes to get dressed?” Make sure to let the child know that the time is set.

The reader is encouraged to check-out Kersey’s 101 positive discipline principles, as they contain an enormous amount of useful and effective approaches for parents; along with principles that reflect many everyday examples (e.g., Babysitter Principle; Apology Principle; Have Fun Together Principle; Talk About Them Positively to Others Principle; Whisper Principle; Write a Contract Principle; and so much more).

This section has provided many helpful positive discipline ideas for a myriad of parenting situations and challenges. Positive discipline (which will be expounded on later sections of in the article: i.e., ‘positive parenting with toddlers and preschoolers,’ ‘temper tantrums,’ ‘techniques to use at bedtime,’ etc.) is an effective discipline approach that promotes loving parent-child relationships, as well as producing productive, respectful, and happy children.

The notion of parenting a toddler can frighten even the most tough-minded among us. This probably isn’t helped by terms such as ‘terrible two’s,’ and jokes like “ Having a two-year-old is kind of like having a blender, but you don’t have a top for it ” (Jerry Seinfeld, goodreads.com).

Sure, toddlers and preschoolers get a bad rap; but they do sometimes seem like tiny drunken creatures who topple everything in their path. Not to mention their tremendous noise and energy, mood swings, and growing need for independence.

While their lack of coordination and communication skills can be endearing and often hilarious; they are also quite capable of leaving their parents in a frenzied state of frustration. For example, let’s consider the situation below.

The Grocery Store Blow-out

In this relatable example, a dad and his cranky 3-year-old find themselves in a long line at a grocery store. The child decides she’s had enough shopping and proceeds to throw each item out of the cart while emitting a blood-curdling scream.

The father, who may really need to get the shopping done, is likely to shrivel and turn crimson as his fellow shoppers glare and whisper about his “obnoxious child” or “bad parenting.” He, of course, tells her to stop; perhaps by asking her nicely, or trying to reason with her.

When this doesn’t’ work, he might switch his method to commanding, pleading, threatening, negotiating, or anything else he can think of in his desperation. But she is out of control and beyond reason. The father wants an immediate end to the humiliation; but he may not realize that some quick fixes intended to placate his child, will only make his life worse in the long run.

So, what is he to do?

Before going into specific solutions for this situation, it is essential that parents understand this developmental stage. There are reasons for the child’s aggravating behaviors; reasons that are biologically programmed to ensure survival.

For example, kids aged two-to-three are beginning to understand that there are a lot of things that seem scary in the world. As such, they may become anxious about a variety of situations; like strangers, bad dreams, extreme weather, creepy images, doctor and dentist offices, monsters, certain animals, slivers or other minor medical issues, etc.

While these childhood fears make life more difficult for parents (i.e., when a child won’t stay in his/her room at night due to monsters and darkness, or when a child makes an enormous fuss when left with a babysitter), they are actually an indicator of maturity (Durant, 2016).

The child is reacting in a way that supports positive development by fearing and avoiding perceived dangers. While fear of monsters does not reflect a truly dangerous situation, avoidance of individuals who appear mean or aggressive is certainly in the child’s best interest.

Similarly, fear of strangers is an innate protective mechanism that prompts children to stay close to those adults who keep them healthy and safe. And some strangers indeed should be feared. Although a challenge for parents, young children who overestimate dangers with consistent false-positives are employing their survival instincts.

In her book  Positive Discipline (which is free online and includes worksheets for parents), Durant (2016) notes the importance of respecting a child’s fears and not punishing her/him for them, as well as talking to the child in a way that shows empathy and helps him/her to verbalize feelings. Durant proposes that one of the keys of effective discipline is “… to see short-term challenges as opportunities to work toward your long-term goals” (2016, p. 21).

With this objective in mind, any steps a parent takes when dealing with a frightened or misbehaving child should always be taken with consideration of their potential long-term impact. Long-term goals, which Durant describes as “the heart of parenting” may be hard to think about when a child is challenging and a frustrated parent simply wants the behavior to stop.

However, punishing types of behaviors such as yelling, are not likely to be in-line with long-term parenting goals. By visualizing their preschooler as a high school student or even an adult, it can help parents to ensure that their immediate responses are in-line with the kind, peaceful and responsible person they wish to see in 15 years or so. Durant (2016) provides several examples of long-term parenting goals, such as:

• Maintaining a quality relationship with the parent
• Taking responsibility for actions
• Being respectful of others
• Knowing right from wrong
• Making wise decisions
• Being honest, loyal and trustworthy

Related: Examples of Positive Reinforcement in the Classroom

Grocery Store Blow-out Solutions

Long-term parenting goals are highly relevant to the maddening grocery store example. If the dad only thinks about the short-term goal of making his daughter’s behavior stop embarrassing him at the store, he might decide to tell her she can have a candy bar if she is quiet and stops throwing items from the cart.

This way, he might reason, he can finish his shopping quickly and without humiliation. Sure, this might work as far as getting the child to behave on that day— at that moment; BUT here are some likely consequences:

• Next time they go shopping, she will do this again in order to receive the candy reward.
• Pretty much every time they go shopping, she will do the same thing; and the value of the reward is likely to escalate as she gets tired of the candy.
• She will learn that this behavior can get her rewards in all sorts of places beyond the grocery store, thus making her exhausted parents afraid to take her anywhere.

Moreover, the message she receives from the candy tactic will not reinforce the qualities the father likely wants to see in his daughter over time, such as:

• Being respectful of her parents
• Being respectful of others around her
• Being respectful of others’ property
• Being responsible for her behavior
• Being courteous and considerate
• Being helpful
• Having good manners
• Having good social skills

Therefore, the father might instead deal with this situation by calmly telling her that she needs to stop or she will get a time-out. The time-out can take place somewhere in the store that is not reinforcing for her, such as a quiet corner with no people around (e.g., no audience). Or they can go sit in the car.

If the store is especially crowded, the dad might also ask the clerk to place his cart in a safe place and/or save his place in line until he returns (which he/she will likely be inclined to do if it will get the child to be quiet). After a brief time-out, he should give his daughter a hug and let her know the rules for the remainder of the shopping trip, as well as the consequences of not following them.

In some cases, it might be better for the parent to simply leave the store without the groceries and go home. He won’t have completed his shopping, but that will be a small price for having a child who learns a good lesson on how to behave.

Very importantly, however; if he does take her home, this absolutely cannot be done in a way that is rewarding (i.e., she gets to go home and play, watch tv, or anything else she enjoys). She will need a time-out immediately upon arriving home, as well as perhaps the message that dinner won’t be her favorite tonight since the shopping was not done.

This is not meant to be punitive or sarcastic, more of a natural consequence for her to learn from (e.g., “If I act-out at the store, we won’t have my favorite foods in the house”). In fact, even though he may not feel like it, the father needs to speak to his daughter in a kind and loving way.

Regardless of whether the consequence is in the store or at home, the dad absolutely must follow-through consistently. If he doesn’t, he will teach her that sometimes she can misbehave and still get what she wants; this is a pattern of reinforcement that is really difficult to break.

Of course, the father cannot leave the store each time she misbehaves, as he won’t get anything done and he’s also giving her too much control. Thus, he should prepare in advance for future shopping trips by making her aware of the shopping rules, expectations for her behavior, and the consequences if she breaks them.

The father should be specific about such things, as “I expect you to be good at the store” is not clear. Saying something more like “The rules for shopping are that you need to talk in your quiet voice, listen to daddy, sit still in the cart, help daddy give the items to the clerk, etc.” The dad is also encouraged to only take her shopping when she is most likely to behave (i.e., when well-rested, well-fed, not upset about something else, etc.).

He might also give her something to do while shopping, such as by bringing her favorite book or helping to put items in the cart. Giving his daughter choices will also help her feel a sense of control (i.e., “You can either help put the items in the cart or you can help give them to the clerk”).

And, finally, the little girl should be rewarded for her polite shopping behavior with a great deal of praise (i.e., “You were a very good girl at the store today. You really helped Daddy and I enjoyed spending time with you”).

He might also reward her with a special experience (i.e., “You were so helpful at the store, that we saved enough time to go the park later” or “You were such a great helper today; can you also help daddy make dinner?”). Of course, the reward should not consist of food, since that can lead to various other problems.

There are many more positive parenting tips for this and other difficult parenting scenarios throughout this article, as well as numerous helpful learning resources. In the meantime, it is always wise to remember that your toddler or preschooler does not act the way he/she does in order to torture you— it’s not personal.

There are always underlying reasons for these behaviors. Just keep your cool, plan-ahead, think about your long-term goals, and remember that your adorable little monster will only be this age for a brief time.

Related:  Parenting Children with Positive Reinforcement (Examples + Charts)

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Siblings, whether biological; adopted; full or half stepsiblings; often pick at each other endlessly. Arguments between siblings are a normal part of life. However, sometimes the degree of animosity between siblings (e.g., sibling rivalry) can get out of control and interfere with the quality of the relationship. Not to mention creating misery for parents. Plus, there are negative long-term consequences of problematic sibling relationships, such as deviant behavior among older children and teens (Moser & Jacob, 2002).

Sibling rivalry is often complicated, as it is affected by a range of family variables, such as family size, parent-child interactions, parental relationships, children’s genders, birth order, and personality—among others. And it starts really early. Sometimes, as soon as a child realizes a baby brother or sister is on the way, emotions begin to run high. Fortunately, parents have a great opportunity to prepare their children from the start.

For example, the parent can foster a healthy sibling relationship by engaging in open communication about becoming a big brother or sister early on. This should be done in a way that is exciting and supports the child’s new role as the older sibling. Parents can support bonding by allowing the child to feel the baby kick or view ultrasound pictures. They can solicit their child’s help in decorating the baby’s room.

For some families, their newborn baby may be premature or have other medical problems that require time in the neonatal intensive care unit (NICU). In this situation, which can be quite stressful for siblings, parents should talk to the older child about what’s happening. Parents might also provide the child with updates on the baby’s progress, prepare the child for visits to the NICU, have the child draw a picture to leave with the baby, make a scrapbook for the baby, and set aside plenty of time with the older child (Beavis, 2007).

If the new child is going to be adopted, it is also important to encourage a connection. For example, along with explaining how the adoption will work, the child can be involved in the exciting aspects of the process once it is confirmed. In the case of an older child or international adoption, there are special things parents can do as well.

For example, if a child is in an orphanage, the sibling can help pick-out little gifts to send ahead of time (i.e., a stuffed animal, soft blanket or clothing). Having the child draw a picture and/or write a letter to the new sibling is another way to enhance the relationship. Adopting an older child will require particular preparation; as the new sibling will arrive with his/her own fears, traits, memories, and experiences that will certainly come into play.

There are a number of children’s books designed to help parents prepare their children for a new sibling, such as You Were the First (MacLachlan, 2013), My Sister Is a Monster : Funny Story on Big Brother and New Baby Sister How He Sees Her (Green, 2018), and Look-Look : The New Baby (Mayer, 2001).

There are also children’s books that help prepare children for adopted siblings, with some that are even more focused on the type of adoption. Here are a few examples: Seeds of Love : For Brothers and Sisters of International Adoption (Ebejer Petertyl & Chambers, 1997), A Sister for Matthew : A Story About Adoption (Kennedy, 2006), and Emma’s Yucky Brother (Little, 2002).

Along with the above tips, Amy McCready (2019) provides some excellent suggestions for ending sibling rivalry, these include:

• Avoid Labeling Children: by labeling children in ways such as “the social one,” “the great student,” “the athlete,” “the baby” etc., parents intensify comparisons, as well as one child’s belief that he/she does not possess the same positive qualities as the other one (i.e., “if he’s the ‘brainy one,’ I must be the ‘dumb one,’”).
• Arrange for Attention: Make sure each child has plenty of regular intentional attention so that they will be less inclined to fight for it.
• Prepare for Peace: McCready describes several ways to teach conflict resolution skills that help to avoid further issues between siblings.
• Stay out of Squabbles: Unless absolutely necessary (i.e., during a physical fight), it is best to stay out of squabbles. In doing so, the parent is not reinforcing the disagreement, while also enabling the children to work out solutions together.
• Calm the Conflict: If you must intervene, it is best to help the children problem-solve the situation without judgment or taking sides.
• Put them All in the Same Boat: McCready suggests that all children involved in the conflict receive the same consequence, which teaches them that they each will benefit from getting along.

These and other useful tips and resources are available on McCready’s Positive Parenting Solutions website . Luckily, by being thoughtful and preparing ahead of time, parents can avoid excessive competition between children and promote meaningful lifelong sibling bonds.

Before discussing positive parenting with teenagers, it is important to remember one key fact: Teens still need and want their parents’ support, affection, and guidance— even if it doesn’t seem like it. Just as with younger kids, parental figures are essential for helping adolescents overcome difficult struggles (Wolin, Desetta & Hefner, 2016).

Indeed, by fostering a sense of mastery and internal locus of control, adults help to empower a teen’s sense of personal responsibility and control over the future (Blaustein & Kinniburgh, 2018). In fact, the presence of nurturing adults who truly listen has been reported among emotionally resilient teens (Wolin et al., 2016).

Positive parenting practices such as quality communication, parental monitoring, and authoritative parenting style also have been found to predict fewer risky behaviors among adolescents (DeVore & Ginsburg, 2005).

As parents of teens know, there are many challenges involved in parenting during this developmental period. Adolescents often find themselves confused about where they fit in the area between adulthood and childhood. They may desire independence, yet lack the maturity and knowledge to execute it safely. They are often frustrated by their bodily changes, acne and mood swings.

Teens may be overwhelmed by school, as well as pressures from parents and peers. Teens may feel bad about themselves and even become anxious or depressed as they try to navigate the various stressors they face.

Many of these difficulties, which certainly need attention from parents, may also make conversations difficult. Parents may feel confused as to how much freedom versus protectiveness is appropriate. The Love and Logic approach (Cline & Faye, 2006) provides some terrific ways for parents to raise responsible, well-adjusted teens.

The authors’ approach for parents involves two fundamental concepts: “Love [which] means giving your teens opportunities to be responsible and empowering them to make their own decisions.” And “Logic [which] means allowing them to live with the natural consequences of their mistakes-and showing empathy for the pain, disappointment, and frustration they’ll experience” (Foster, Cline, & Faye, 2019, hopelbc.com, p. 1).

Just as with young children, the Love and Logic method is a warm and loving way to prepare teens for the future while maintaining a quality relationship with parents.

Another positive parenting approach that is particularly applicable to adolescents is the Teen Triple P Program (Ralph & Sanders, 2004). Triple P (which will be described in a subsequent post) is tailored toward teens and involves teaching parents a variety of skills aimed at increasing their own knowledge and confidence.

The program also promotes various prosocial qualities in teens such as social competence, health, and resourcefulness; such that they will be able to avoid engaging in problem behaviors (e.g., substance use, risky sex, delinquency, Bulimia, etc.). This approach enables parents to replace harsh discipline styles for those that are more nurturing, without being permissive. It aims to minimize parent-teen conflict while providing teens with the tools and ability to make healthy choices (Ralph & Sanders, 2004).

Parents of teens (or future teens) often shudder when considering the dangers and temptations to which their children may be exposed. With a focus specifically on substance use, the Partnership for Drug-free Kids website offers a great deal of information for parents who are either dealing with teen drug use or are doing their best to prevent it.

For example, several suggestions for lowering the probability that a teen will use substances include:

• knowing your teen’s friends;
• being a positive role model in terms of your own coping mechanisms and use of alcohol and medication;
• being aware of your child’s level of risk for substance use;
• providing your teen with substance use information;
• supervising and monitoring your teen;
• setting boundaries;
• communicating openly about substance use; and
• building a supportive and warm relationship with your teen (Partnership for Drug-free Kids; PDK, 2014).

These suggestions are discussed in more detail on the following PDF : Parenting Practices: Help Reduce the Chances Your Child will Develop a Drug or Alcohol Problem (PDK, 2014). By employing these and other positive parenting techniques, you are helping your teenager to become a respectful, well-adjusted and productive member of society.

Divorce has become so common that dealing with it in the best possible way for kids is of vital importance to parents everywhere.

Parental divorce/separation represents a highly stressful experience for children that can have both immediate and long-term negative consequences.

Children of divorce are at increased risk for mental health, emotional, behavioral, and relationship problems (Department of Justice, Government of Canada, 2015).

There is, however, variability in how divorce affects children; with some adverse consequences being temporary, and others continuing well into adulthood. Since we know that divorce does not impact all children equally, the key question becomes: What are the qualities that are most effective for helping children to cope with parental divorce?

There are differences in children’s temperament and other aspects of personality, as well as family demographics, that affect their ability to cope with divorce. But, for present purposes, let’s focus on the aspects of the divorce itself since this is the area parents have the most power to change.

Importantly, the detrimental impact of divorce on kids typically begins well before the actual divorce (Amato, 2000). Thus, it may not be the divorce per se that represents the child risk factor; but rather, the parents’ relationship conflicts and how they are handled. For divorced/divorcing parents, this information is encouraging—as there are things you can do to help your children (and you) remain resilient despite this difficult experience.

Parental Conflict and Alienation

There are several divorce-related qualities that make it more difficult for children to adapt to divorce, such as parental hostility and poor cooperation between parents (Amato, 2000); and interpersonal conflict between parents along with continued litigation (Goodman, Bonds, & Sandler, et al., 2005).

Parents dealing with divorce need to make a special effort not to expose their children to conflicts between parents, legal and money related issues, and general animosity. The latter point merits further discussion, as parents often have a difficult time not badmouthing each other in front of (or even directly to) their kids. It is this act of turning a child against a parent that ultimately serves to turn a child against himself (Baker & Ben-Ami, 2011).

Badmouthing the other divorced parent is an alienation strategy, given its aim to alienate the other parent from the child. Such alienation involves any number of criticisms of the other parent in front of the child. This may even include qualities that aren’t necessarily negative, but which can be depicted as such for the sake of enhancing alienation (Baker & Ben-Ami, 2011).

Baker and Ben-Ami (2011) note that parental alienation tactics hurt children by sending the message that the badmouthed parent does not love the child. Also, the child may feel that, because their badmouthed parent is flawed; that he/she is similarly damaged. When a child receives a message of being unlovable or flawed, this negatively affects his/her self-esteem, mood, relationships, and other areas of life ( Baker & Ben-Ami, 2011 ).

An excellent resource for preventing parental alienation is Divorce Poison : How to Protect Your Family from Bad-mouthing and Brainwashing (Warshak, 2010).

Warshak describes how one parent’s criticism of the other may have a highly detrimental impact on the targeted parent’s relationship with his/her child. And such badmouthing absolutely hurts the child. Badmouthed parents who fail to deal with the situation appropriately are at risk of losing the respect of their kids and even contact altogether. Warshak provides effective solutions for bad-mouthed parents to use during difficult situations, such as:

• How to react when you find out about the badmouthing
• What to do if your kids refuse to see you
• How to respond to false accusations
• How to insulate kids from bad-mouthing effects

Reasons that parents attempt to manipulate children, as well as behaviors often exhibited by children who have become alienated from one parent,  are also described (Warshak, 2010). This book, as well as additional resources subsequently listed, provides hope and solutions for parents who are dealing with the pain of divorce.

Importantly, there are ways to support children in emerging from divorce without long-term negative consequences (i.e., by protecting them from parental animosity). It is in this way that parents can “enable their children to maintain love and respect for two parents who no longer love, and may not respect, each other” (Warshak, 2004-2013, warshak.com).

Positive parenting is an effective style of raising kids that is suitable for pretty much all types of parents and children. This article contains a rich and extensive collection of positive parenting research and resources; with the goal of arming caregivers with the tools to prevent or tackle a multitude of potential challenges. And, of course, to foster wellness and healthy development in children.

Here are the article’s key takeaways:

• Parents are never alone. Whatever the problem or degree of frustration, there is a whole community of parents who have faced the same issues. Not to mention a ton of positive parenting experts with effective solutions.
• Positive parenting begins early. Positive parenting truly starts the moment a person realizes he/she is going to become a parent since even the planning that goes into preparing for a child’s arrival will have an impact.
• Positive parenting applies to all developmental periods. With a positive parenting approach, raising toddlers and teenagers need not be terrible nor terrifying. Positive parenting promotes effective, joyful parenting of kids of all ages.
• Positive parents raise their children in a way that empowers them to reach their full potential as resilient and fulfilled individuals. Positive parents are warm, caring, loving and nurturing— and so much more: They are teachers, leaders, and positive role models. They are consistent and clear about expectations. They know what their kids and teens are doing. They encourage and reinforce positive behaviors. They make family experiences a priority. They support their children’s autonomy and individuality. They love their children unconditionally. They engage in regular, open dialogues with their children. They are affectionate, empathetic, and supportive. They understand that their teenagers still need them.
• Positive discipline is an effective, evidence-based approach that is neither punitive nor permissive. Positive discipline is performed in a loving way without anger, threats, yelling, or punishment. It involves clear rules, expectations, and consequences for behavior; and consistent follow-through. It is in alignment with parents’ long-term parenting goals.
• Positive parenting is backed by empirical evidence supporting its many benefits. Positive parenting promotes children’s self-esteem, emotional expression, self-efficacy, sense of belonging, social and decision-making skills, and belief in themselves. Positive parenting fosters secure attachments and quality relationships with parents; school adjustment and achievement; reduced behavior problems, depressive symptoms, and risk behaviors; and positive youth development in general. The outcomes associated with positive parenting are long-term and often permanent.
• Positive parenting is applicable to a vast array of challenges. Positive parenting applies to everyday challenges, as well as more frustrating and even severe issues. Positive parenting has been effectively used for dealing with temper tantrums, bedtime and eating issues, and sibling rivalry; as well as difficulties associated with divorce, ADHD, family stressors, teen pressures, and risk-taking—and much more.
• Positive parenting solutions are both abundant and accessible. Because positive parenting experts have tackled so many parenting issues, available resources are plentiful. Along with the many tips and suggestions contained in this article; there is a whole online library of positive parenting-related activities, workbooks, books, videos, courses, articles, and podcasts that cover a broad range of parenting topics.

Considering the many positive parenting solutions and resources currently available, parents can approach their role as teachers, leaders, and positive role models with confidence and optimism. And, ultimately, by consistently applying positive parenting strategies; parents will experience a deep and meaningful connection with their children that will last a lifetime. ?

We hope you enjoyed reading this article. Don’t forget to download our three Positive Parenting Exercises for free .

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I am currently a student in occupational therapy and I am in the process of completing my dissertation for my degree, focusing on positive parenting and its impact on children with ADHD. Recently, I purchased a book that contained a QR code leading me to your article. Would it be possible to receive the DOI and the PDF of this article via email, please?

Thank you in advance for your assistance.

Best regards, Anis

While we don’t currently have an option to download or convert our posts to pdf, you are very welcome to reference the article as follows (APA 7): [author last name], [author initial]. (year, month day). Title. PositivePsychology.com. https://positivepsychology.com/URL/

Hope this helps!

Warm regards, Julia | Community Manager

Thank you for compiling this research. It was truly helpful in getting started on a positive path.

Hi there! I am writing a research paper on gentle parenting and the positive effects it has. Would you be able to send me your resource list for this article?

If you scroll to the very end of the article, you will find a button that you can click to reveal the reference list.

– Nicole | Community Manager

I am also writing a paper. When citing this article, should I use 2019 or 2023 as the date? Thank you!

You can reference this article in APA 7th as follows: Lonczak, H.S. (2019, May 08). Title. PositivePsychology.com. https://positivepsychology.com/positive-parenting/

Hope this helps! Kind regards, Julia | Community Manager

Great article. I really liked. I will share this article with my school.

I totally agree with many different points has written in this useful article, I spent several days to complete it,, but it was really worthy especially what you mentioned here about model of parenting. Thank your for all details and sources you wrote up there and waiting for your new things coming up.

i love your blog and always like new things coming up from it.

Positive parenting is key for a happy family! I totally agree that positive parenting promotes effective, joyful parenting of kids of all ages. The most important things about such a model of parenting are to know your kid’s friends, being a positive role model in terms of your own coping mechanisms and use of alcohol and medication, and building a supportive and warm relationship with your child. We are responsible for the future generation, therefore raising happy and good person is a must!

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What Is Evidence-Based Parenting? + 12 Resources To Start With

Evidence-based parenting is rapidly becoming a popular approach for parenting — and with good reason. In an age of misinformation and an over-abundance of content, it can be hard to figure out who and what to trust. Parents find that turning to tried and true methods based on research that demonstrates positive outcomes can be the most reliable way to approach parenting. 

How do you find trustworthy sources of information? Many parents of children or other caregivers working with children want to know what strategies and approaches are backed by research and are considered evidence-based. But what does ‘evidence-based’ mean? And what qualifies a parenting practice as ‘evidence-based’? 

Since there isn’t one authority spelling out exactly what is evidence-based and what isn’t, we will jump into how you can determine if a source of parenting information is trustworthy. Then I’ll guide you towards resources that will help hone your parenting skills with evidence-based parenting practices. 

In this post explaining what evidence-based parenting is all about, you’ll learn:

What Is Evidence-Based Parenting?

What qualifies a parenting practice as evidence-based, 3 simple tips to be a savvy consumer of parenting content.

• 4 Reliable Parent Coaches To Follow On Social Media

3 Evidence-Based Parenting Books For Parent Education

5 evidence-based parenting programs, the bottom line on parenting programs, when a standardized program is not enough.

Before we dive in, let’s start with the basics and explain what evidence-based parenting really means. Evidence-based parenting is making use of strategies that are demonstrated to be effictive by empirical research and are applied by caregiver in a way that supports the wellbeing of families and is in line with their values. Yes, I added on the values part because that’s important to me!

Empirical research might include meta-analyses, systematic reviews, randomized controlled trials (RCTs), single-subject experimental design or other types of research. The bottom line is that there is some sort of empirical data that has been collected to demonstrate that an intervention has had a direct impact on parenting outcomes after implementation. 

This might make you wonder, ‘how much research is sufficient?’ or, ‘what about the quality of research?’ Next we can get into more of these details.

I mentioned that there is not one central authority determining what is ‘evidence-based’ and what is not, as the definition is somewhat subjective. Georgia State University explains more about how to conceptualize the term ‘evidence-based’ and share a few registries and clearinghouses based on topic, diagnosis or sector. For example, the California Evidence-Based Clearinghouse is a searchable registry of EBPs specific to child welfare. The What Works Clearinghouse has specific resources for EBPs within the education system and is maintained by the US Department of Education.

Every field has its own standards for what is considered evidence-based. Education and Medicine for example, have a specific number and type of studies that must exist before something is considered evidence-based. These fields rely heavily on RCTs, which look at large group effect sizes and are a gold-standard in research in most fields. The field of behavior analysis tends to use single-subject experimental designs (SSRDs) that look at the effect of an intervention on an individual or small group to really dial into the components that make it effective. This approach compares an intervention across variables such as participants, time, settings or components of an intervention.

A popular definition in Behavior Analysis of an evidence-based treatment is, “a model of professional decision-making in which practitioners integrate the best available evidence with client values/context and clinical expertise in order to provide services for their clients” (Slocum et al. 2014). Generally speaking, a combination of SSRDs may be used to understand the micro-effects of an intervention or practice and RCTs to look at the macro-level effects. 

How do we know when a treatment or intervention for child behavior has been studied enough to be considered ‘evidence-based’? Often a field will determine a number of independently conducted meta-analyses, randomized-controlled trials, single subject experimental designs and replications of such studies that are required on a topic before it is considered evidence-based. However, we know that the average parent doesn’t have time and resources to be digging into research literature that is often sequestered behind paywalls. Often it is most efficient to consume educational content from professionals who have looked into the research for you and summarized their findings.

For this reason, it is important for families to know how to be discerning consumers of educational content. For example, just because something is funded through social services or public health doesn’t necessarily mean it’s evidence-based — or that it has an effect great enough that it’s worth your time (and perhaps money!). Or simply becuase something is published in a peer-reviewed journal doesn’t mean it was done well or has been replicated in an applied setting. There are a few things to look for when considering what is and isn’t evidence-based parenting.

1. Does the content reference research articles ? I’m not expecting you to vet every Instagram post you read but when you’re choosing someone to listen to, consider whether they ever reference research. There of course is a degree of trust you’re putting into a content creator when they reference research, but it’s just not feasible to access and consume the primary research sources. I’d recommend considering academic references, journals, books and perhaps the number of sources (e.g., not just citing ONE researcher or source).

2. Is the research of good quality ? Consider whether it’s published in a peer-reviewed journal and if so, what journal it’s published in. Are the authors of all the main research the same person or group of people? Have there been any independent replications? 

3. Check out a few of the abstracts, and search for meta-analyses or systematic reviews on Google Scholar . Fortunately, quite a bit of research can be found there. Even if a full article is behind a paywall, you can still gain some information from an abstract. A meta-analysis is a thorough review of a topic and can help you quickly determine whether something has legitimate research behind it or not. Are there a number of SSRDs and RCTs that have shown this practice or program to be effective?

If you do choose to try something without research behind it, as a behavior analyst, I challenge you to track the efficacy of the program or advice yourself. Get some sort of measurable data before implementing it and compare this with data collected after implementation. This way you’ll have an objective way to measure whether the tool/strategy/program is working or not and be able to pivot or continue.

5 Reliable Parent Coaches To Follow On Social Media

• Dr. Cindy Hovington of @curious_neuron digs into the research and summarized her findings for you. This is a go-to source of research information for me. Her content is research boiled down into simple summaries that busy parents will find easy to consume and implement right away. The topics covered are wide-ranging from birth through adolescence.
• Dr. Cara Goodwin of @parentingtranslator is another really reliable resource for evidence-based child development research. As a behavior analyst I really appreciate knowing that a content creator has gone through the trouble of scouring the research to summarize it for me. Cara references the research (and often multiple sources) right on the front page of her posts. Her summaries of evidence-based parenting practices are practical and engaging topics that any parent would find useful at some point in their parenting journey. Another go-to for me!
• Michele Shilvock of @micheleshilvockconsulting is always providing bite-size pieces of advice for parents and caregivers that can be implemented right away! She is skilled in supporting play for young children and shares how parents can foster play-based learning and prosocial skill development.
• Michelle Tangeman of @thriving.toddler is currently one of my faves as I’ve got my own little at home. She posts information that I didn’t know I needed to know! Also a great resource for easy-to-digest evidence-based info to send to my partner for quick, relevant tidbits of info 😉 Her way of framing strategies for raising little humans resonates with me as compassionate, developmentally appropriate and evidence-based so as a softy but a scientist I love this approach.
• Dr. Jenicka of @drjenicka is a no nonsense psychologist who is aimed at providing evidence-based information and debunking many of the parenting myths that are out there. She isn’t afraid to call out parenting content on social media that is simply not true or deceiving. Dr. Jenicka has also has created a ‘safe list’ of other social media accounts that she and a group of colleagues vetted and put together to help parents cut through the noise on social media. Give her a follow for a refreshing yet evidence-based take on parenting.

Are you looking for a behavioral health professional to work with? Check out the BHC FindXpert network!

• The Joy of Parenting by Lisa Coyne, Ph.D., and Amy R. Murrell, Ph.D. . Based on Acceptance and Commitment Therapy (ACT), Coyne and Murrell use their expertise in clinical psychology to provide practical guidance for when parenting gets hard. ACT is rooted in the science of behavior and has a large body of research behind it. Coyne and Murrell illuminate the challenges of parenting and how to acknowledge and accept these challenges, stop struggling against them, and parent in a way that moves you and your family towards your values. If you want an ACT-trained therapist as a parent coach you can search for one here .
• The Power of Showing Up by Daniel Siegel M.d., and Tina Bryson Ph.D. This was first recommended to me by Michele Shilvock , who is a Behavior Analyst I deeply respect due to her compassionate approach to the implementation of behavior science and her eagerness to learn from other fields. It discusses attachment theory and the importance of being emotionally available for your child. Many adults grew up with detached parents. In a world of constant entertainment and distractions, this book provides the evidence-based rationale for parents to be emotionally available and create a secure attachment for their children. It compliments a behavioral science approach nicely.
• Enjoying Parenting by Leanne Page of @parentingwithaba . This is a quick read (only 105 pages) that packs a powerful punch of practical strategies that help parents leverage behavioral science to find balance in their parenting and take the struggle out of everyday routines. Leanne is a parent and Behavior Analyst who translates the science of behavior into really clear and relatable pointers that will help you create a positive relationship with your children and take some of the stress out of parenting.

The following programs and organizations are listed in order of the intensity of behavior they have shown to support through research and self-reporting, from least intense to most. 

The UN Office on Drugs and Crime recommend and utilize both Triple P and The Incredible Years in their efforts to support child welfare and prevent substance abuse through preventative family training programs that are delivered in a standardized manner. Balance and RAPID are designed to support families in a more personalized way by individualizing goals and using direct parent-coaching.

Preschool Life Skills Program

• Summary: This program is designed to build prosocial skills for young children in a group setting, with the intent of preventing challenging behavior from emerging. Thirteen social skills that have been identified as important in the early elementary years are taught through the PLS curriculum. Although it was not originally designed as a parent-training program, recent research has used it with parents, showing a positive effect in terms of increases in age-appropriate life skills and a reduction in challenging behaviors. Furthermore, this study was done independent of FTF consulting (the original creator’s consulting business), further enhancing the legitimacy of their research.
• Target Audience: Staff are trained by a professional from FTF Consulting, the behavior analytic consulting company of Dr. Hanley, who completed the initial research behind PLS and Balance (see below).
• Child Profile/Presenting Concerns: None. This is designed as a preventative program to equip children with the skills they need to be successful in a school setting.
• Model: Staff initially attend a full-day seminar, followed by a full-day workshop with practical steps for implementation. Once staff have been trained in the program, they deliver the lessons in a group classroom setting with support from an FTF consultant via weekly Zoom coaching sessions. Adults complete behavior skills training which involve a description of the skill, a model or demonstration, the opportunity to practice it, and feedback. 

Related Read: What Is Online Parent Coaching, And How Can It Help Me?

• Summary: This positive parenting program is intended to train caregivers and parents in the basic skills of positive behavior interventions with the goal of preventing behavior problems from emerging. It claims to provide parents with the building blocks for effective parenting.
• Target Audience: Parents of children ages 2-16. 
• Child Profile/Presenting Concerns: There are various Triple P courses to suit the needs and concerns of your family whether it be minor behavior challenges, significant behavior problems, teens with challenging behavior , kids with disabilities , families going through separation or divorce , or families seeking a more active and healthy lifestyle for their family. A recent program review showed that it had the greatest effects on children with mild to moderate behavior concerns rather than severe behavior, when compared to The Incredible Years program (Saunders et al. 2020).
• Model: Trained facilitators take parents through the 8-session course which can be done in-person with a trained Triple P provider from their national registry , or online at your own pace.
• Consumer Considerations: There is a lot of variability in the research behind Triple P. Independent review and meta-analyses of this program indicate that most of the research studies supporting it were conducted either by Dr. Sanders who initiated Triple P or affiliates of the program (Wilson et al. 2012). These reviews also revealed independent studies that showed little difference in outcomes between Triple P participants and waitlisted or standard service participants in the control group (McConnell et al. 2011). However, other meta-analyses have indicated its effectiveness in terms of both parent practices and child behavior (Degraaf et al. 2008).

The Incredible Years

• Summary: This parenting program may be one of your first parenting interventions to try in order to prevent challenging behavior with your child. It is based on the idea that caregivers need to consider and manage their own behavior to facilitate positive behavior with the child. It integrates Attachment Theory to foster a positive parent-child relationship. The Incredible Years specifically targets coercive parenting strategies and negative reinforcement, which create the cyclical trap parents often find themselves in.
• Consumer Protection: This program has less research behind it than Triple P.
• Target Audience: Children up to age 12 and their parents. Parents and children attend the course with a trained professional. There is also a shorter teacher-training version to support the same principles in the classroom.
• Child Profile/Presenting Concerns: Young children, children with ADHD, or conduct challenges. A program review from Scotland showed that The Incredible Years (when compared to Triple P) was more effective for children with ‘severe’ behavior concerns (Saunders et al. 2020).
• Model: Video modelling, rehearsal, and self-reflection are employed in this standardized parenting course. Parents go through 12-20 two-hour sessions and children go through 18-22 two-hour sessions.

Balance Program  

• Summary: This is a prevention program for early childhood. It is designed to give parents and caregivers the skills they need to create a balance in the home between child-led and adult-led activities. If you are noticing that your child is starting to dictate family routines to the detriment of other siblings and the overall family, the Balance Program may be a good fit for you. While it was originally researched with autistic children, it can be applied to children with other behavioral or developmental concerns. 
• Target Audience: The Balance Program is designed to be implemented by a behavior specialist such as a behavior analyst (BCBA). The intention is for the BCBA to equip and coach the parents in developing the skills they need to support their child in their home. 
• Child Profile/Presenting Concerns: Young children with emerging behavior problems such as minor aggression, tantrums, oppositional behavior, or trouble giving up technology. Children at risk for developing behavior problems may also benefit.
• Model: This parent-coaching model involves active parent participation through a behavioral skills training approach including a description, model/demonstration, and the opportunity to practice, followed by specific feedback.
• Contact this Facebook group of practitioners to find a professional delivering Balance in your area. The program can be delivered via telehealth, so you can find a practitioner outside of your local area to serve you.
• Consumer Considerations: During the original study, all participants showed a decrease in challenging behavior from baseline to follow-up. While the designers of this program call for an independent randomized controlled trial to still be done on the complete treatment program, it is based on behavioral principles and strategies that have been well researched in behavior science.

RAPID Skills Training (RST) Or The RST Facebook Group

• Summary: RST is based on well-researched practices from Clinical Behavior Analysis and Applied Behavior Analysis. It is user-friendly and equips the adult with the skills they need to support positive interactions and behavior. Here is a short summary flyer.  
• Target Audience: Parents, caregivers, teachers, educators.
• Child Profile/Concerns: Generally designed for caregivers of children displaying high-risk, externalizing behavior problems including aggression, elopement, conduct challenges, and property destruction. However, the foundational principles do apply more broadly.
• Model: Designed for families or teachers to implement at home or school. Goals are individually determined based on the needs of the family, although the structure of the program is standardized. It is delivered using an evidence-based instructional practice called behavioral skills training. In this model, a skill is described to participants, then modelled, and then participants can practice and receive feedback. 
• Contact the organization that delivers RAPID Skills training through their Facebook group if you are outside the US and their website if you are within the US. No referral is needed; simply get in touch to find out more.
• Consumer Considerations: While there is no research on the RAPID program as a package, the components of this program are all based on behavior analysis and are considered evidence-based practices in the field. CBA has simply arranged these strategies in a usable, structured parenting program.

Not all parenting programs are created equal. If you are simply looking to avoid challenging behavior and get some positive parenting practices in place, Triple P or the Incredible Years might work for you and your child as a preventative measure.

If you are experiencing significant behavior challenges with your child, you might need something more intensive with personalized goals and strategies. Check out Balance and RAPID in this case. Balance specifically can be helpful for young children with emerging problem behavior. RAPID may be useful for families of children with more complex needs. To receive individualized parent-coaching with an evidence-based perspective, you may want to find a behavior analyst to coach you directly with your parenting.

You may have taken a parent training program and even have implemented some of the strategies you learned. However, you might notice that you still are facing behavioral challenges with your child. Or you might find there are still some concerning challenges in your parent-child relationship. 

What Is Behaviorist Theory? Understanding Its Influence on the Work of a Behavior Analyst

If this is the case, hiring a professional to help you out might be the best course of action. In addition to seeking out mental health services from a counsellor or clinical psychologist, you might also benefit from working with a behavior analyst (BCBA) to coach you through specific situations. 

Related Podcast: Counseling And Behavior Analysis (with Dr. Katie Saint, BCBA)

Wrapping It Up

There’s a lot of information out there and the best take-away I can give you is to empower you to question the content you read, and seek out the best available evidence for parenting. Being a knowledgeable and discerning consumer of parenting content will not only help you be a more confident parent, but will also result in better outcomes for your family. 

To keep learning, here’s one of our podcasts we’re sure you’ll like: Providing Behavioral Health Services On A Multidisciplinary Team (with Michele Shilvock, Behavior Analyst at Paramount Pediatrics)

De Graaf, I., Speetjens, P., Smit, F., De Wolff, M. and Tavecchio, L. (2008), Effectiveness of the Triple P Positive Parenting Program on Parenting: A Meta‐Analysis. Family Relations, 57: 553-566. https://doi.org/10.1111/j.1741-3729.2008.00522.x

Gunning, C., Holloway, J. and Grealish, L. (2020), An evaluation of parents as behavior change agents in the Preschool Life Skills program. Jnl of Applied Behav Analysis, 53: 889-917. https://doi.org/10.1002/jaba.660

McConnell, David & Breitkreuz, Rhonda & Savage, Amber. (2011). Independent evaluation of the Triple P Positive Parenting Program in family support service settings. Child & Family Social Work. 17. 43 – 54. 10.1111/j.1365-2206.2011.00771.x. 

Saunders, R., Marita, B., Renz, B., Thomson, J., & Pilling, S. (2020). An evaluation of parent training interventions in scotland: The psychology of parenting project (PoPP). Journal of Child and Family Studies, 29(12), 3369-3380. doi: http://dx.doi.org/10.1007/s10826-020-01817-y  

United Nations Office on Drugs and Crime. (2019) Compilation of evidence-based family skills training programs. Retrieved from: https://www.unodc.org/documents/prevention/family-compilation.pdf  

Wilson, P., Rush, R., Hussey, S. et al. How evidence-based is an ‘evidence-based parenting program’? A PRISMA systematic review and meta-analysis of Triple P. BMC Med 10, 130 (2012). https://doi.org/10.1186/1741-7015-10-130

Hi Ms. Ng, Anything on Parenting teens? I’ve been looking everywhere, I have to do a report on this subject and need evidence base research.

Hi Ivette, I’m sorry that I missed this message for so long! My apologies. Finding specifics on teens may be more difficult but I would look into Ross Greene’s Collaborative and Proactive Solutions method. It’s very adaptable across age groups and respectful towards older kids in a way that won’t make them feel controlled or demeaned. There is also research behind it, listed on the website for your reference. https://livesinthebalance.org/our-solution/

Parenting Now has an evidence-based curriculum called Make Parenting A Pleasure. https://parentingnow.org/parenting-educators/make-parenting-a-pleasure-second-edition/

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What’s positive parenting? 10 tips for navigating parenthood

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What’s positive parenting?

7 benefits of positive parenting, 10 positive parenting tips, examples of positive parenting, positive parenting benefits everyone.

Parenting is easy — said no one ever. 

You want to be the best parent, but there’s no step-by-step manual, and making the right decisions is never clear-cut. Positive daily choices require consistency, self-discipline, and care — not to mention a lot of patience. 

Positive parenting is a framework for nurturing healthy behaviors in your children without losing sight of your own wellness . It helps set the foundation to build sustainable parent-child bonds and avoid stressful family conflicts.

And this framework provides your children with the tools necessary to build valuable interpersonal skills , create healthy relationships, and positively contribute to their communities.

Positive parenting is an approach to raising children that focuses on developing strong emotional connections and helping children embrace themselves.

Research from Austrian psychologist Alfred Adler, founder of the school of individual psychology, set the stage for positive parenting in the 1900s. He specifically explored the role of parenting in the prevention of future psychological problems — and how positive parenting helps kids thrive.

It’s a parenting style that includes activities, attitudes, and behaviors that encourage positive child development. This positive atmosphere supports effective parenting, helping children flourish as young individuals and act responsibly in their community as they grow. 

A positive atmosphere doesn’t mean a free-for-all. Positive parenting consists of a mixture of authoritative parenting and positive reinforcement . This means striking a balance between being assertive of values without acting domineering and staying consistent with rules and discipline while being responsive to your child’s specific developmental needs. 

To build your own routines and parenting practices, it’s essential to understand a few core principles of positive parenting techniques:

A safe and engaging environment: Creating a safe and supervised environment is essential to encouraging positive play, experimentation, and exploration. Studies show that clear rules are crucial to maintaining safe spaces that promote healthy development. 

A positive learning environment: You’re your child’s most influential teacher. And positive parenting strategies are most effective in supportive environments that reinforce the value of learning healthy behaviors and new skills. Positive reinforcement, like showing gratitude and recognizing desired behaviors , can help bolster self-control and self-confidence in learning .

Assertive discipline: In your professional life, you might have protocols to deal with specific situations. Raising children gets hectic, and a set process for specific circumstances can help you overcome challenges as they arise.

Learning to set boundaries , offer clear and calm communication, and develop logical consequences to actions are a few ways to provide healthy discipline and avoid feeling overwhelmed .

• Realistic expectations: Patience and self-regulation are vital parenting skills. All children learn at their own speed, and setting realistic expectations for their capabilities helps you step back and see the bigger picture during tantrums and other parenting challenges. 

Parental self-care: Active parenting doesn’t start and stop with taking care of your child’s needs. Self-care offers you the energy, mental strength, and positive attitude you need to teach good behavior. Be conscientious about prioritizing your wellness. 

Regular meditation , active hobbies , and healthy nutrition are just a few strategies to be the best version of yourself, allowing you to handle challenges more positively. It’s com mon for parents to struggle with guilt when prioritizing themselves, but your positive habits and attitude will rub off on your child’s behaviors.

Consistent and mindful parenting helps kids grow into well-rounded and considerate young adults. That doesn’t mean it’s an easy journey. When the going gets tough, here are a few benefits to keep in mind to help you be the best parent you can be. 

1. Encourages positive skill building

An obvious objective of positive parenting is encouraging better behavior. This practice focuses on reinforcing good behavior instead of punishing bad behavior, which helps children understand what you expect of them and encourages them to embrace healthy habits . 

Positive reinforcement emphasizes choice, which can facilitate an internal locus of control . When children choose to exercise desirable behaviors and receive praise and recognition as a reward, they may feel more in control of their actions.

And people who feel more in control of their life tend to have a stronger sense of personal responsibility and accountability . This self-efficacy will likely have a positive impact throughout their life, encouraging them to set goals and put in the work to achieve them . 

2. Better mental well-being

No matter what good parenting looks like in your family, your relationship with your child plays a key role in brain development . Warm and supportive parenting positively affects behavioral and psychological development, influencing mental health and wellness throughout a child’s lifetime.

Positive parenting also promotes soft skills like playfulness, curiosity, and empathy . These invaluable transferable skills set your child up for success in their continued personal and professional development . 

3. Improved brain health

Studies show that children raised in stressful environments have an increased risk of depression, anxiety, and other behavioral problems later in life. Chronic stress can reduce the size of the hippocampus , an area of the brain important to learning and memory.

Parents who use positive parenting solutions to problem-solve and reinforce good behavior help children develop resilience and positive coping mechanisms to common stressors , like illness or relationship troubles. 

4. A closer relationship with your child

Healthy interpersonal relationships are built on trust , whether it’s a manager-teammate or parent-child connection. Openness and compassion create a safe space that helps children connect and be comfortable feeling vulnerable . 

As your child matures and develops their unique identity, the foundation of trust you build can foster self-acceptance and self-esteem . Positive reinforcement and empathy signal that they can turn to you for advice throughout their life, continuously strengthening your relationship. 

5. Guides romantic relationships

Studies show that parenting styles impact a child’s future romantic relationships . Children who receive consistent praise and positive physical touch tend to experience higher relationship satisfaction than those who experience more aggressive parenting.

Romantic relationships play a key role in life satisfaction . Healthier partnerships can lead to more relatedness and general fulfillment. And your parenting approach demonstrates acceptable and undesirable relationship dynamics. Consistent open communication and boundary setting might encourage your children to learn and use the same relationship-building skills . 

6. Fosters healthy communication skills

Positive parenting creates an open dialogue between you and your child, making space to talk about positive and negative emotions . This open communication encourages your child to talk about their feelings , which teaches them that it’s normal and healthy to express emotions. 

Modeling and reinforcing healthy communication also teaches children vital emotional intelligence skills like active listening , respect, and self-reflection . These skills extend far beyond the family unit, helping your child succeed in their personal and professional relationships later in life. 

7. Parental well-being

Between professional development, household chores, and life’s unexpected challenges, it’s easy to place your well-being at the end of your to-do list. Positive parenting can help reduce stress by encouraging calm and open communication, which may lead to fewer power struggles and conflicts. And seeing your child’s positive development can also boost your confidence in your parenting capabilities. 

Positive parenting also emphasizes the need for a self-care plan . When you’re in a healthy emotional state, you can share the good vibes with your family, so remember to prioritize your wellness as much as your kid’s soccer schedule.

There’s no “right” way to parent, as each child requires flexibility and unique learning strategies. But here are 10 simple positive parenting tips that’ll be effective in most scenarios. 

• Encourage children to openly express their positive and negative feelings without fear of judgment or punishment
• Acknowledge and validate emotions, illustrating that it’s normal and okay to have a wide range of feelings
• Use active listening skills to show sincere interest in your child’s thoughts and experiences by setting aside time for listening, mainta ining eye contact , and asking clarifying questions
• Provide specific, genuine praise to support their efforts and encourage continued learning
• Use your actions to teach children how to treat and communicate with others
• Give them opportunities to act independently to bolster their self-reliance, like dressing themselves, completing family chores on their own, and preparing their own breakfast
• Consistently enforce rules and boundaries to create structure and teach self-control
• Prioritize quality time with one-on-one and family bonding activities to foster trust and positivity
• Be kind but firm about rules and consequences to establish clear expectations of acceptable and unacceptable behaviors
• Set aside time to relax and practice self-care, whether it’s a weekly book club, daily swim, or nightly skin routine

Being a child’s caregiver is a 24/7 job filled with opportunities to practice positive parenting. Here are a few examples: 

• Your child is upset: You attentively listen to your child recount a difficult day at school. You set aside potential distractions, nod along, and ask open-ended questions to help them express themselves. You validate how they feel and express how you appreciate that they shared this information with you, making them feel valued and understood. 
• A conflict arises over technology time: Your child wants to spend the weekend playing video games despite an established two-hour rule. You acknowledge their frustration, explain the importance of balancing video games with other activities, and remind them of the rule. You also give them suggestions for other activities, like riding their bike or reading a book. Your rule enforcement helps build respect for boundaries and teaches other skills, like time management . 
• Your child leaves toys all over the living room despite agreeing to tidy up: Rather than scolding, you put a positive spin on discipline. Positive discipline examples include setting clear “when and then” expectations (When you clean your toys, you can play with your video games), validating their feelings (I understand that cleaning up isn’t very fun, but everyone must help around the house), and positive reinforcement (I really appreciate you helping me keep the place clean). 

There’s no such thing as being a perfect parent. But it’s never a bad idea to learn better techniques to deal with the challenges of raising children. 

Positive parenting focuses on creating a positive environment for the entire family. It fosters deeper communication and trust, allowing your child to become the best version of themself, whatever they decide that means. And while the going will sometimes get tough, you’ll be able to channel a positive vibe to get through it all as a family.

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Elizabeth Perry is a Coach Community Manager at BetterUp. She uses strategic engagement strategies to cultivate a learning community across a global network of Coaches through in-person and virtual experiences, technology-enabled platforms, and strategic coaching industry partnerships. With over 3 years of coaching experience and a certification in transformative leadership and life coaching from Sofia University, Elizabeth leverages transpersonal psychology expertise to help coaches and clients gain awareness of their behavioral and thought patterns, discover their purpose and passions, and elevate their potential. She is a lifelong student of psychology, personal growth, and human potential as well as an ICF-certified ACC transpersonal life and leadership Coach.

Improve these 12 parenting skills and watch your kids thrive

Conscious parenting: raise your children by parenting yourself, how to work from home with kids: 12 tips for remote and hybrid work, slow down: how mindful parenting benefits both parents and kids, parenting styles: learn how you influence your children’s future, empty nest syndrome: how to cope when kids fly the coop, what do working parents need a supportive manager is a good start, how to help working parents navigating back-to-school, when it comes to caregiving benefits, parents value time and money most, 110 random acts of kindness: ideas for the workplace and beyond, parent coaching: what it is and how it can help your family, what’s generativity vs. stagnation it's a step closer to your goals, how to be a working mom: 10 tips to have the best of both worlds, stay connected with betterup, get our newsletter, event invites, plus product insights and research..

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September 2017

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Positive Parenting

Building Healthy Relationships With Your Kids

Parents have an important job. Raising kids is both rewarding and challenging. You’re likely to get a lot of advice along the way, from doctors, family, friends, and even strangers. But every parent and child is unique. Being sensitive and responsive to your kids can help you build positive, healthy relationships together.

“Being a sensitive parent and responding to your kids cuts across all areas of parenting,” says Arizona State University’s Dr. Keith Crnic, a parent-child relationship expert. “What it means is recognizing what your child needs in the moment and providing that in an effective way.”

This can be especially critical for infants and toddlers, he adds. Strong emotional bonds often develop through sensitive, responsive, and consistent parenting in the first years of life. For instance, holding your baby lovingly and responding to their cries helps build strong bonds.

Building Bonds

Strong emotional bonds help children learn how to manage their own feelings and behaviors and develop self-confidence. They help create a safe base from which they can explore, learn, and relate to others.

Experts call this type of strong connection between children and their caregivers “secure attachment.” Securely attached children are more likely to be able to cope with challenges like poverty, family instability, parental stress, and depression.

A recent analysis shows that about 6 out of 10 children in the U.S. develop secure attachments to their parents. The 4 out of 10 kids who lack such bonds may avoid their parents when they are upset or resist their parents if they cause them more distress. Studies suggest that this can make kids more prone to serious behavior problems. Researchers have been testing programs to help parents develop behaviors that encourage secure attachment.

Being Available

Modern life is full of things that can influence your ability to be sensitive and responsive to your child. These include competing priorities, extra work, lack of sleep, and things like mobile devices. Some experts are concerned about the effects that distracted parenting may have on emotional bonding and children’s language development, social interaction, and safety.

If parents are inconsistently available, kids can get distressed and feel hurt, rejected, or ignored. They may have more emotional outbursts and feel alone. They may even stop trying to compete for their parent’s attention and start to lose emotional connections to their parents.

“There are times when kids really do need your attention and want your recognition,” Crnic explains. Parents need to communicate that their kids are valuable and important, and children need to know that parents care what they’re doing, he says.

It can be tough to respond with sensitivity during tantrums, arguments, or other challenging times with your kids. “If parents respond by being irritable or aggressive themselves, children can mimic that behavior, and a negative cycle then continues to escalate,” explains Dr. Carol Metzler, who studies parenting at the Oregon Research Institute.

According to Crnic, kids start to regulate their own emotions and behavior around age three. Up until then, they depend more on you to help them regulate their emotions, whether to calm them or help get them excited. “They’re watching you to see how you do it and listening to how you talk to them about it,” he explains. “Parents need to be good self-regulators. You’re not only trying to regulate your own emotions in the moment, but helping your child learn to manage their emotions and behavior.”

As kids become better at managing their feelings and behavior, it’s important to help them develop coping skills, like active problem solving. Such skills can help them feel confident in handling what comes their way.

“When parents engage positively with their children, teaching them the behaviors and skills that they need to cope with the world, children learn to follow rules and regulate their own feelings,” Metzler says.

“As parents, we try really hard to protect our kids from the experience of bad things,” Crnic explains. “But if you protect them all the time and they are not in situations where they deal with difficult or adverse circumstances, they aren’t able to develop healthy coping skills.”

He encourages you to allow your kids to have more of those experiences and then help them learn how to solve the problems that emerge. Talk through the situation and their feelings. Then work with them to find solutions to put into practice. 

Meeting Needs

As children grow up, it’s important to remember that giving them what they need doesn’t mean giving them everything they want. “These two things are very different,” Crnic explains. “Really hone in on exactly what’s going on with your kid in the moment. This is an incredibly important parenting skill and it’s linked to so many great outcomes for kids.”

Think about where a child is in life and what skills they need to learn at that time. Perhaps they need help managing emotions, learning how to behave in a certain situation, thinking through a new task, or relating to friends.

“You want to help kids become confident,” Crnic says. “You don’t want to aim too high where they can’t get there or too low where they have already mastered the skill.” Another way to boost confidence while strengthening your relationship is to let your kid take the lead.

“Make some time to spend with your child that isn’t highly directive, where your child leads the play,” advises Dr. John Bates, who studies children’s behavior problems at Indiana University Bloomington. “Kids come to expect it and they love it, and it really improves the relationship.”

Bates also encourages parents to focus on their child’s actual needs instead of sticking to any specific parenting principles.

It’s never too late to start building a healthier, more positive relationship with your child, even if things have gotten strained and stressful. “Most importantly, make sure that your child knows that you love them and are on their side,” Metzler says. “For older children, let them know that you are genuinely committed to building a stronger relationship with them and helping them be successful.”

By being a sensitive and responsive parent, you can help set your kids on a positive path, teach them self-control, reduce the likelihood of troublesome behaviors, and build a warm, caring parent-child relationship.

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Parenting that works

Seven research-backed ways to improve parenting.

By Amy Novotney

October 2012, Vol 43, No. 9

Print version: page 44

Search for parenting books on Amazon.com, and you get tens of thousands of titles, leaving new parents awash in a sea of often conflicting information. But thanks to the accumulated results of decades of empirical research, psychologists know more than ever before about what successful parenting really is.

The Monitor asked leaders in child psychology for their best empirically tested insights for managing children's behavior. Here's what they said.

1. Embrace praise

Simply put, giving attention to undesired behaviors increases undesired behaviors, while giving attention to good behaviors increases good behaviors, says Alan E. Kazdin, PhD, a Yale University psychology professor and director of the Yale Parenting Center and Child Conduct Clinic.

"When it comes to nagging, reprimand and other forms of punishment, the more you do it, the more likely you are not going to get the behavior you want," says Kazdin, APA's 2008 president. "A better way to get children to clean their room or do their homework, for example, is to model the behavior yourself, encourage it and praise it when you see it."

But parents shouldn't offer that praise indiscriminately, says Sheila Eyberg, PhD, a psychology professor at the University of Florida who conducts research on parent-child relationships. Eyberg recommends parents provide their children with a lot of "labeled praise"—specific feedback that tells the child exactly what he or she did that the parent liked. By giving labeled praise to the child, such as, "I really like how quietly you're sitting in your chair," when a child is having trouble calming down. The parent is focusing on what's relevant to the behavior problem, Eyberg says. Several studies back her up: Psychologist Karen Budd, PhD, found that training preschool teachers to use labeled praise improves the teacher-child relationship and helps teachers better manage behavior in the classroom ( Education and Treatment of Children , 2010).

Kazdin also recommends reinforcing the praise with a smile or a friendly touch. And feedback should be honest, says David J. Palmiter Jr., PhD, a practitioner in Clarks Summit, Pa., and author of the 2011 book, " Working Parents, Thriving Families ."

"I was at a girls' softball game recently and I started to get a headache from all the praising going on for poor performance," he says. "This can often deprive a child of the wonderful learning that comes from failure."

2. Look the other way

Research also suggests that parents should learn to ignore minor misbehaviors that aren't dangerous, such as whining about a sibling not sharing or a toddler throwing food on the floor.

In several studies, Kazdin and his team found that when parents changed their responses to behaviors—for example, they ignored screams but gave a lot of attention to their children when they asked nicely for something—the child learned that asking nicely is the better, more reliable way to get attention (" The Kazdin Method for Parenting the Defiant Child ," 2008).

3. Learn about child development

Parents are also more effective when they read up on child development to understand the misbehaviors that are common for each developmental stage, says Eyberg. Often, when a child displays a behavior that a parent doesn't like, such as making a mess while eating, it's because the child is simply learning a new skill, she says.

"If parents understand that the child isn't making a mess on purpose, but instead learning how to use their developing motor skills in a new way, they're more likely to think about praising every step the child takes toward the ultimate goal," she says. Parents who know what a child is capable of understanding, feeling and doing at different ages and stages of development can be more realistic about what behaviors to expect, leading to less frustration and aggression.

4. Do time-out right

Three decades of research on time-outs show that they work best when they are brief and immediate, Kazdin says. "A way to get time-out to work depends on ‘time-in'—that is, what the parents are praising and modeling when the child is not being punished," Kazdin says.

Research also suggests that parents need to remain calm when administering time-outs—often a difficult feat in the heat of the misbehavior—and praise compliance once the child completes it. In addition, he says, parents shouldn't have to restrain a child to get him or her to take a time-out because the point of this disciplinary strategy is to give the child time away from all reinforcement. "If what is happening seems more like a fight in a bar, the parent is reinforcing inappropriate behaviors," Kazdin says.

5. Prevent misbehavior

John Lutzker, PhD, who directs the Center for Healthy Development at Georgia State University, has even stopped advising parents to use time-outs. Instead, he teaches parents to plan and structure activities to prevent a child's challenging behaviors, based on previous research:

Plan ahead to prevent problems from arising.

Teach children how to cope effectively with the demands of the situation.

Find ways to help children stay engaged, busy and active when they might otherwise become bored or disruptive."We've found in our work over the past 20 years that if you do a good job teaching parents planned activities training, there's no need for time-outs," Lutzker says.

6. Take care of yourself first

Parents receive some of the best parenting advice every time they take off on an airplane, says Palmiter: If the cabin loses pressure and you must put on an oxygen mask, put one on yourself first before you help your child.

"I see households all across America where the oxygen masks have long since dropped and all of the oxygen is going to the children," says Palmiter.

Yet the research makes it clear that children are negatively affected by their parents' stress. According to APA's 2010 Stress in America survey, 69 percent of respondents recognized that their personal stress affects their children, and only 14 percent of children said their parents' stress didn't bother them. In addition, 25 percent to 47 percent of tweens reported feeling sad, worried or frustrated about their parents' stress. Another study published last year in Child Development found that parents' stress imprints on children's genes—and the effects last a very long time.

That's why modeling good stress management can make a very positive difference in children's behavior, as well as how they themselves cope with stress, psychologists say.

Palmiter recommends that parents make time for exercise, hobbies, maintaining their friendships and connecting with their partners. That may mean committing to spending regular time at the gym or making date night a priority.

"Investing in the relationship with their partner is one of the most giving things a parent can do," Palmiter says. Single parents should establish and nurture meaningful connections in other contexts. A satisfying relationship with a colleague, neighbor, family member or friend can help to replenish one's energy for parenting challenges.

7. Make time

Too often, Palmiter says, the one-on-one time parents offer their children each week is the time that's left over after life's obligations, such as housework and bill-paying, have been met.

"We often treat our relationships—which are like orchids—like a cactus, and then when inevitably the orchid wilts or has problems, we tend to think that there's something wrong with the orchid," he says.

To combat this issue, Palmiter recommends that each parent spend at least one hour a week—all at once or in segments—of one-on-one time with each child, spent doing nothing but paying attention to and expressing positive thoughts and feelings toward him or her.

"It literally works out to about .5 percent of the time in a week," he says. The most effective time for a parent to create those special moments is when the child is doing something that she or he can be praised for, such as building with Legos or shooting baskets. During that time, parents should avoid teaching, inquiring, sharing alternative perspectives or offering corrections.

Palmiter says many families he's recommended the strategy to over the years have told him that adding an hour of special time in addition to the quality time they spend with their children—such as attending a baseball game together—has significantly improved the parent-child relationship. In addition, a study published in January in the Proceedings of the National Academy of Sciences shows that, particularly among younger children, a parent's demonstration of love, shown through nurturing behavior and expressions of support, can improve a child's brain development and lead to a significantly larger hippocampus, a brain component that plays a key role in cognition.

"The metaphor I use is, what an apple is to the physician—'an apple a day keeps the doctor away'—special time is to the child psychologist," Palmiter says.

Amy Novotney is a writer in Chicago.

APA’s Violence Prevention Office offers the ACT Raising Safe Kids program, which provides parenting skills classes nationwide through a research-based curriculum delivered by trained professionals. The program teaches parents and caregivers how to raise children without violence through anger management, positive child discipline and conflict resolution. For more information, visit the  ACT website or the ACT Facebook page or contact Julia da Silva , the program’s national director.

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National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Board on Children, Youth, and Families; Committee on Supporting the Parents of Young Children; Breiner H, Ford M, Gadsden VL, editors. Parenting Matters: Supporting Parents of Children Ages 0-8. Washington (DC): National Academies Press (US); 2016 Nov 21.

Parenting Matters: Supporting Parents of Children Ages 0-8.

• Hardcopy Version at National Academies Press

2 Parenting Knowledge, Attitudes, and Practices

This chapter responds to the first part of the committee's charge—to identify core parenting knowledge, attitudes, and practices that are associated with positive parent-child interactions and the healthy development of children ages birth to 8. The chapter also describes findings from research regarding how core parenting knowledge, attitudes, and practices may differ by specific characteristics of children and parents, as well as by context. The chapter begins by defining desired outcomes for children that appear frequently in the research literature and inform efforts by agencies at the federal, state, and local levels to promote child health and well-being. It then reviews the knowledge, attitudes, and practices identified in the literature as core—those most strongly associated with healthy child development—drawing primarily on correlational and experimental studies. This is followed by brief discussion of the family system as a key source of additional determinants of parenting. The chapter concludes with a summary. The core knowledge, attitudes, and practices identified in this chapter serve as a foundation, along with contextual factors that affect parenting, for the committee's review of the effectiveness of strategies for strengthening parenting capacity in subsequent chapters of this report.

• DESIRED OUTCOMES FOR CHILDREN

To determine the salient features of core parenting knowledge, attitudes, and practices, the committee first identified desired outcomes for children. Identifying these outcomes grounds the discussion of core parenting knowledge, attitudes, and practices and helps researchers, practitioners, and policy makers establish priorities for investment, develop policies that provide optimal conditions for success, advocate for the adoption and implementation of appropriate evidence-based interventions, and utilize data to assess and improve the effectiveness of specific policies and programs.

Child outcomes are interconnected within and across diverse domains of development. They result from and are enhanced by early positive and supportive interactions with parents and other caregivers. These early interactions can have a long-lasting ripple effect on development across the life course, whereby the function of one domain of development influences another domain over time. In the words of Masten and Cicchetti (2010, p. 492) , “effectiveness in one domain of competence in one period of life becomes the scaffold on which later competence in newly emerging domains develops . . . competence begets competence.” From the literature, the committee identified the following four outcomes as fundamental to children's well-being. While the committee focused on young children (ages 0-8), these outcomes are important for children of all ages.

Physical Health and Safety

Children need to be cared for in a way that promotes their ability to thrive and ensures their survival and protection from injury and physical and sexual maltreatment. While such safety needs are important for all children, they are especially critical for young children, who typically lack the individual resources required to avoid dangers ( National Research Council and Institute of Medicine, 2000 ). Rather, young children rely on parents and other primary caregivers, inside and outside the home, to act on their behalf to protect their safety and healthy development ( Institute of Medicine and National Research Council, 2015 ). At the most basic level, children must receive the care, as reflected in a number of emotional and physiological protections, necessary to meet normative standards for growth and physical development, such as guidelines for healthy weight and receipt of recommended vaccinations ( Institute of Medicine and National Research Council, 2015 ). Physical health and safety are fundamental for achieving all of the other outcomes described below.

Emotional and Behavioral Competence

Children need care that promotes positive emotional health and well-being and that supports their overall mental health, including a positive sense of self, as well as the ability to cope with stressful situations, temper emotional arousal, overcome fears, and accept disappointments and frustrations. Parents and other caregivers are essential resources for children in managing emotional arousal, coping, and managing behavior. They serve in this role by providing positive affirmations, conveying love and respect and engendering a sense of security. Provision of support by parents helps minimize the risk of internalizing behaviors, such as those associated with anxiety and depression, which can impair children's adjustment and ability to function well at home, at school, and in the community ( Osofsky and Fitzgerald, 2000 ). Such symptoms as extreme fearfulness, helplessness, hopelessness, apathy, depression, and withdrawal are indicators of emotional difficulty that have been observed among very young children who experience inadequate parental care ( Osofsky and Fitzgerald, 2000 ).

Social Competence

Children who possess basic social competence are able to develop and maintain positive relationships with peers and adults ( Semrud-Clikeman, 2007 ). Social competence, which is intertwined with other areas of development (e.g., cognitive, physical, emotional, and linguistic), also may include children's ability to get along with and respect others, such as those of a different race or ethnicity, religion, sexual orientation, or economic background ( Institute of Medicine and National Research Council, 2015 ). Basic social skills include a range of prosocial behaviors, such as empathy and concern for the feelings of others, cooperation, sharing, and perspective taking, all of which are positively associated with children's success both in school and in nonacademic settings and can be fostered by parents and other caregivers ( Durlak et al., 2011 ; Fantuzzo et al., 2007 ). These skills are associated with children's future success across a wide range of contexts in adulthood (e.g., school, work, family life) ( Elias, 2006 ; Fantuzzo et al., 2007 ).

Cognitive Competence

Cognitive competence encompasses the skills and capacities needed at each age and stage of development to succeed in school and in the world at large. Children's cognitive competence is defined by skills in language and communication, as well as reading, writing, mathematics, and problem solving. Children benefit from stimulating, challenging, and supportive environments in which to develop these skills, which serve as a foundation for healthy self-regulatory practices and modes of persistence required for academic success ( Gottfried, 2013 ).

• PARENTING KNOWLEDGE, ATTITUDES, AND PRACTICES

The child outcomes described above provide the context for considering the range of parenting knowledge, attitudes, and practices and identifying those that research supports as core. As noted in Chapter 1 , the term “knowledge” for the purposes of this report refers to facts, information, and skills gained through experience or education and understanding of an issue or phenomenon. “Attitudes” refers to viewpoints, perspectives, reactions, or settled ways of thinking about aspects of parenting or child development, including parents' roles and responsibilities. Attitudes may be related to cultural beliefs founded in common experience. And “practices” refers to parenting behaviors or approaches to childrearing that can shape how a child develops. Generally speaking, knowledge relates to cognition, attitudes relate to motivation, and practices relate to ways of engaging or behavior, but all three may emanate from a common source.

These three components are reciprocal and intertwined theoretically, empirically, and bidirectionally, informing one another. For example, practices are related to knowledge and attitudes, and often involve the application of knowledge. According to behavior modification theory ( Ajzen and Fishbein, 1980 ; Fishbein et al., 2001 ), a person's attitude often determines whether he or she will use knowledge and transform it into practice. In short, if one does not believe in or value knowledge, one is less likely to act upon it. What parents learn through the practice of parenting can also be a source of knowledge and can shape parents' attitudes. Parenting attitudes are influenced as well by parenting self-efficacy, which has been broadly defined as the level of parents' self-belief about their ability to succeed in the parenting role ( Jones and Prinz, 2005 ).

Parenting knowledge, attitudes, and practices are shaped not only by each other but also by a number of contextual factors, including children's characteristics (e.g., gender, temperament); parents' own experiences (e.g., those from their own childhood) and circumstances; expectations learned from others, such as family, friends, and other social networks; and cultural systems. Of particular relevance to this study, the contextual factors that influence parenting knowledge, attitudes, and practices also include the supports available within the larger community and provided by institutions, as well as by policies that affect the nature and availability of supportive services.

In response to the study charge ( Box 1-2 in Chapter 1 ), this chapter presents the evidence on core parenting knowledge, attitudes, and practices separately. However, it should be noted that in the research literature, the distinctions among these concepts, especially knowledge and attitudes, are not well-delineated and that the applications of these concepts to parenting often are equally informed by professional wisdom and historical observation.

Parenting Knowledge

Parenting is multidimensional. To respond to the varied needs of their children, parents must develop both depth and breadth of knowledge, ranging from being aware of developmental milestones and norms that help in keeping children safe and healthy to understanding the role of professionals (e.g., educators, child care workers, health care providers, social workers) and social systems (e.g., institutions, laws, policies) that interact with families and support parenting. This section describes these areas of knowledge, as well as others, identified by the available empirical evidence as supporting core parenting practices and child outcomes. It is worth noting that the research base regarding the association between parental knowledge and child outcomes is much smaller than that on parenting practices and child outcomes ( Winter et al., 2012 ). Where data exist, they are based largely on correlational rather than experimental studies.

Knowledge of Child Development

Parent voices.

[Some parents recognized the need for education related to providing care for young children.]

“I am a new parent and even though I have a bachelor's degree from India, I do not have a particular education in child care. Just because I have a degree, it does not mean it is a degree on how to take care of a child.”

—Father from Omaha, Nebraska

The importance of parents' knowledge of child development is a primary theme of many efforts to support parenting. Evidence-based recommendations issued by the American Psychological Association Task Force on Evidence-Based Practice with Children and Adolescents (2008) , the Centers for Disease Control and Prevention (CDC) (2015b) , and the World Health Organization (WHO) (2009) emphasize the need for policy and program initiatives to promote parenting knowledge. As they suggest, to optimize children's development, parents need a basic understanding of infant and child developmental milestones and norms and the types of parenting practices that promote children's achievement of these milestones ( Belcher et al., 2007 ; Benasich and Brooks-Gunn, 1996 , p. 1187; Bond and Burns, 2006 ; Bornstein and Cote, 2004 ; Hess et al., 2004 ; Huang et al., 2005 ; Larsen and Juhasz, 1985 ; Mercy and Saul, 2009 ).

A robust body of correlational research demonstrates tremendous variation in parents' knowledge about childrearing. Several of these studies suggest that parents with higher levels of education tend to know more about child developmental milestones and processes ( Bornstein et al., 2010 ; Conrad et al., 1992 ; Hess et al., 2004 ; Huang et al., 2005 ), as well as effective parenting strategies ( Morawska et al., 2009 ). This greater knowledge may reflect differential access to accurate information, differences in parents' trust in the information or information source, and parents' comfort with their own abilities, among other factors. For example, research shows that parents who do not teach math in the home tend to have less knowledge about elementary math, doubt their competence, or value math less than other skills ( Blevins-Knabe et al., 2000 ; Cannon and Ginsburg, 2008 ; Vukovic and Lesaux, 2013 ). However, parents' knowledge and willingness to increase their knowledge may change; thus, they can acquire developmental knowledge that can help them employ effective parenting practices.

[Some parents recognized the need for comprehensive parenting education.]

“I always prefer education for the parents, from the beginning to the end. From pregnancy, some don't know when to go to the doctor, and after birth, when to go to the hospital or the doctor. So we need education from the beginning to the end.”

—Mother from Omaha, Nebraska

The focus on parental knowledge as a point of intervention is important because parents' knowledge of child development is related to their practices and behaviors ( Okagaki and Bingham, 2005 ). For example, mothers who have a strong body of knowledge of child development have been found to interact with their children more positively compared with mothers with less knowledge ( Bornstein and Bradley, 2012 ; Huang et al., 2005 ). Parents who understand child development also are less likely to have age-inappropriate expectations for their child, which affects the use of appropriate discipline and the nature and quality of parent-child interactions ( Goodnow, 1988 ; Huang et al., 2005 ).

Support for the importance of parenting knowledge to parenting practices is found in multiple sources and is applicable to a range of cognitive and social-emotional behaviors and practices. Several correlational studies show that mothers with high knowledge of child development are more likely to provide books and learning materials tailored to children's interests and age and engage in more reading, talking, and storytelling relative to mothers with less knowledge ( Curenton and Justice, 2004 ; Gardner-Neblett et al., 2012 ; Grusec, 2011 ). Fathers' understanding of their young children's development in language and literacy is associated with being better prepared to support their children ( Cabrera et al., 2014 ). And parents who do not know that learning begins at birth are less likely to engage in practices that promote learning during infancy (e.g., reading to infants) or appreciate the importance of exposing infants and young children to hearing words and using language. For example, mothers who assume that very young children are not attentive have been found to be less likely to respond to their children's attempts to engage and interact with them ( Putnam et al., 2002 ).

Stronger evidence of the role of knowledge of child development in supporting parenting outcomes comes from intervention research. Randomized controlled trial interventions have found that parents of young children showed increases in knowledge about children's development and practices pertaining to early childhood care and feeding ( Alkon et al., 2014 ; Yousafzai et al., 2015 ).

Some studies have found a direct association between parental knowledge and child outcomes, including reduced behavioral challenges and improvements on measures of cognitive and motor performance ( Benasich and Brooks-Gunn, 1996 ; Dichtelmiller et al., 1992 ; Hunt and Paraskevopoulos, 1980 ; Rowe et al., 2015 ). In an analysis of data from a prospective cohort study that controlled for potential confounders, children of mothers with greater knowledge of child development at 12 months were less likely to have behavior problems and scored higher on child IQ tests at 36 months relative to children of mothers with less developmental knowledge ( Benasich and Brooks-Gunn, 1996 ). This and other observational studies also show that parental knowledge is associated with improved parenting and quality of the home environment, which, in turn, is associated with children's outcomes ( Benasich and Brooks-Gunn, 1996 ; Parks and Smeriglio, 1986 ; Winter et al., 2012 ), in addition to being contingent on parental attitudes and competence ( Conrad et al., 1992 ; Hess et al., 2004 ; Murphy et al., 2015 ).

Experimental studies of parent education interventions support these associational findings. In an experimental study of parent education for first-time fathers, fathers, along with home visitors, reviewed examples of parental sensitivity and responsiveness from videos of themselves playing with their children ( Magill-Evans et al., 2007 ). These fathers showed a significant increase in parenting competence and skills in fostering their children's cognitive growth as well as sensitivity to infant cues 2 months after the program, compared with fathers in the control group, who discussed age-appropriate toys with the home visitor ( Magill-Evans et al., 2007 ). Another experimental study examined a 13-week population-level behavioral parenting program and found intervention effects on parenting knowledge for mothers and, among the highest-risk families, increased involvement in children's early learning and improved behavior management practices. Lower rates of conduct problems for boys at high risk of problem behavior also were found ( Dawson-McClure et al., 2015 ).

Knowledge of Parenting Practices

Parents' knowledge of how to meet their children's basic physical (e.g., hunger) and emotional (e.g., wanting to be held or soothed) needs, as well as of how to read infants' cues and signals, can improve the synchronicity between parent and child, ensuring proper child growth and development. Specifically, parenting knowledge about proper nutrition, safe sleep environments, how to sooth a crying baby, and how to show love and affection is critical for young children's optimal development ( Bowlby, 2008 ; Chung-Park, 2012 ; Regalado and Halfon, 2001 ; Zarnowiecki et al., 2011 ).

For many parents, for example, infant crying is a great challenge during the first months of life. Parents who cannot calm their crying babies suffer from sleep deprivation, have self-doubt, may stop breastfeeding earlier, and may experience more conflict and discord with their partners and children ( Boukydis and Lester, 1985 ; Karp, 2008 ). Correlational research indicates that improvement in parental knowledge about normal infant crying is associated with reductions in unnecessary medical emergency room visits for infants ( Barr et al., 2015 ). That knowledge leads to changes in behavior is further supported in systematic reviews by Bryanton and colleagues (2013) of randomized controlled trials and Middlemiss and colleagues (2015) of studies with various design types, with both groups reporting that increases in mother's knowledge about infant behavior is associated with positive changes in the home environment, as well as improvements in infant sleep time.

Specific knowledge about health and safety—including knowledge about how to access health care, protect children from physical harm (e.g., the importance of wearing a seat belt or a helmet), and promote good hygiene and nutrition—is a key parenting competency. Experimental studies show, for example, a positive link between parents' knowledge of nutrition and both children's intake of nutritious foods and reduced calorie and sodium intake ( Campbell et al., 2013 ; Katz et al., 2011 ). In a randomized controlled trial, Campbell and colleagues (2013) found that children whose parents received knowledge, skills, and social support related to infant feeding, diet, physical activity, and television viewing consumed fewer sweet snacks and spent fewer minutes daily viewing television relative to children whose parents were in the control group ( Campbell et al., 2013 ). Also associated with children's intake of nutritious foods is parents' modeling of good eating habits and nutritional practices ( Mazarello Paes et al., 2015 ).

In addition, although limited in scope, correlational evidence shows that parents with knowledge about immunization are more likely to understand its purpose and comply with the timetable for vaccinations ( Smailbegovic et al., 2003 ); that parents with more knowledge about effective injury prevention practices are more likely to create safer home environments for their children and reduce unintentional injuries ( Corrarino, 2013 ; Dowswell et al., 1996 ; Middlemiss et al., 2015 ; Morrongiello and Kiriakou, 2004 ); and that parents with knowledge about asthma are more likely to use an asthma management plan ( Bryant-Stephens and Li, 2004 ; DeWalt et al., 2007 ; Harrington et al., 2015 ). Other studies have found that parents with more information about the purpose of vaccinations had greater knowledge of immunization than parents in the control group ( Hofstetter et al., 2015 ; Jackson et al., 2011 ), and parents with more knowledge about sun safety provided sunscreen and protective clothing for their children, who presented with fewer sunburns ( Crane et al., 2012 ).

Still, knowledge alone may not be sufficient in some cases. For example, knowing about the importance of using car seats does not always translate into good car seat practices ( Yanchar et al., 2012 , 2015 ), and knowledge about the advantages of vaccines may not result in parents choosing to vaccinate their children. Some findings suggest that using multiple modes of delivery is important to advancing parents' knowledge. In an experimental study, for example, Dunn and colleagues (1998) found that parents who received educational information about child vaccinations via videotape as well as in written form showed greater gains in understanding about vaccinations than parents who received the information in written form alone.

The evidence linking parental knowledge about the specific ways in which parents can help children develop cognitive and academic skills, including skills in math, is limited. However, the available correlational data show that parents who know about how children develop language are more likely to have children with emergent literacy skills (e.g., letter sound awareness) relative to parents who do not ( Ladd et al., 2011 ). Several studies over the past 20 years have described parents' increasing knowledge and use of approaches for supporting children's literacy ( Clark, 2007 ; National Research Council, 1998 ; Sénéchal and LeFevre, 2002 ). Much of this work has focused on book reading and parent-child engagement around reading ( Hindman et al., 2008 ; Mol et al., 2008 ; Morrow et al., 1990 ). As early as the 1960s, Durkin (1966) and others referred to the important role of the home literacy environment and parents' beliefs about reading in children's early literacy development.

Knowledge of Supports, Services, and Systems

Little is known about parents' knowledge of various supports—such as educators, social workers, health care providers, and extended family—and the relationship between their conceptions of the roles of these supports and their use of them.

To take an example, parents' knowledge about child care and their school decision-making processes are informed in a variety of ways through these different supports. In their literature review of child care decision making, Forry and colleagues (2013) found that many low-income parents learn about their child care options through their social networks rather than through professionals or referral agencies. While many parents say they highly value quality, their choices also may reflect a range of other factors that are valued. Parents tend to make child care decisions based on structural (teacher education and training) and process (activities, parent-provider communication) features, although their choices also vary by family income, education, and work schedules. Sosinsky and Kim (2013) , for example, found that higher maternal education and income and being white were associated with the likelihood of parents choosing higher-quality child care programs that were associated with better child outcomes. Based on a survey of parents of children in a large public school system, Goldring and Phillips (2008) found that parents' involvement, not satisfaction with their child's school, was associated with school decision making. It should be noted that while parents may know what constitutes high-quality child care and education, structural (availability of quality programs and schools), individual (work, income, belief), and child (temperament, age) factors also influence these decision-making processes ( Meyers and Jordan, 2006 ; Shlay, 2010 ).

Taking another example, limited studies have looked at parental awareness of services for children with special needs. A study that utilized a survey and qualitative interviews with parents of children with autism indicated that parents' autism spectrum disorder service knowledge partially mediates the relationship between socioeconomic status and use of services for their children ( Pickard and Ingersoll, 2015 ).

Parenting Attitudes

Although considerable discussion has focused on attitudes and beliefs broadly, less research attention has been paid to the effects of parenting attitudes on parents' interactions with young children or on parenting practices. Few causal analyses are available to test whether parenting attitudes actually affect parenting practices, positive parent-child interaction, and child development. Even less research exists on fathers' attitudes about parenting. Given this limited evidence base, the committee drew primarily on correlational and qualitative studies in examining parenting attitudes.

Parents' attitudes toward parenting are a product of their knowledge of parenting and the values and goals (or expectations) they have for their children's development, which in turn are informed by cultural, social, and societal images, as well as parents' experiences and their overall values and goals ( Cabrera et al., 2000 ; Cheah and Chirkov, 2008 ; Iruka et al., 2015 ; Okagaki and Bingham, 2005 ; Rogoff, 2003 ; Rosenthal and Roer-Strier, 2006 ; Whiting and Whiting, 1975 ). People in the United States hold several universal, or near universal, beliefs about the types of parental behaviors that promote or impair child development. For example, there is general agreement that striking a child in a manner that can cause severe injury, engaging in sexual activity with a child, and failing to provide adequate food for and supervision of young children (such as leaving toddlers unattended) pose threats to children's health and safety and are unacceptable. At the same time, some studies identify differences in parents' goals for child development, which may influence attitudes regarding the roles of parents and have implications for efforts to promote particular parenting practices.

While there is variability within demographic groups in parenting attitudes and practices, some research shows differences in attitudes and practices among subpopulations. For example, qualitative research provides some evidence of variation by culture in parents' goals for their children's socialization. In one interview study, mothers who were first-generation immigrants to the United States from Central America emphasized long-term socialization goals related to proper demeanor for their children, while European American mothers emphasized self-maximization ( Leyendecker et al., 2002 ). In another interview study, Anglo American mothers stressed the importance of their young children developing a balance between autonomy and relatedness, whereas Puerto Rican mothers focused on appropriate levels of relatedness, including courtesy and respectful attentiveness ( Harwood et al., 1997 ). Other ethnographic and qualitative research shows that parents from different cultural groups select cultural values and norms from their country of origin as well as from their host country, and that their goal is for their children to adapt and succeed in the United States ( Rogoff, 2003 ).

Similarly, whereas the larger U.S. society has historically viewed individual freedom as an important value, some communities place more emphasis on interdependence ( Elmore and Gaylord-Harden, 2013 ; Sarche and Spicer, 2008 ). The importance of intergenerational connections (e.g., extended family members serving as primary caregivers for young children) also varies among and within cultural communities ( Bertera and Crewe, 2013 ; Mutchler et al., 2007 ). The values and traditions of cultural communities may be expressed as differences in parents' views regarding gender roles, in parents' goals for children, and in their attitudes related to childrearing.

[One parent described differences between men and women in parenting roles.]

“Mothers play the main role as parents in [certain cultures]. Culturally men aren't that involved. The dad is the outer worker; the mother is the inner worker. If you are talking about the mom, they are the ones who care about the kids. They aren't typically working outside the home. But now, in the United States, the mothers are working outside the home.”

Although slowly changing, attitudes about the roles of men and women in the raising of young children often differ between men and women and among various communities in the United States. Longitudinal research on mothers' attitudes toward fathers' involvement in childrearing has made reference to the “gatekeeping” role of mothers of children with nonresidential fathers ( Fagan and Barnett, 2003 ; Schoppe-Sullivan et al., 2008 ). Research has shown that fathers of young children participate in child caregiving activities in increasing numbers ( Cabrera et al., 2011 ), but has not examined the specific attitudes that fathers bring to particular parenting behaviors across the life span. Parents' values and goals related to childrearing, both overall and for specific demographic groups, also may shift from one generation to the next in the United States based on changing norms and viewpoints within social networks and cultural communities, as well as parents' knowledge of and access to new research and information provided by educators, health care providers, and others who work with families.

Relatively little research has been conducted on parents' attitudes toward specific parenting-related practices. Much of the extant research focuses on practices related to promoting children's physical health and safety. Studies of varying designs indicate that parental attitudes and beliefs about the need for and safety of vaccination influence vaccination practices ( Mergler et al., 2013 ; Salathé and Bonhoeffer, 2008; Vannice et al., 2011 ; Yaqub et al., 2014 ). Maternal attitudes and beliefs about breastfeeding (e.g., views about breastfeeding in public, the belief that it will be uncomfortable) are associated with initiation and continuation of breastfeeding and appear to factor into differences in breastfeeding rates and practices observed across cultural and other demographic groups in cross-sectional survey and qualitative research ( Vaaler et al., 2010 ; Wojcicki et al., 2010 ). Other studies have found differences among parents (e.g., those living in rural versus urban areas) in attitudes about the importance of monitoring children's activities and whereabouts ( Armistead et al., 2002 ; Jones et al., 2003 ) and parents' beliefs about young children's literacy development ( Lynch et al., 2006 ).

Parental involvement in children's education has been linked to academic readiness ( Fan and Chen, 2001 ). However, parents differ in their attitudes about the role of parents in children's learning and education ( Hammer et al., 2007 ). Some see parents as having a central role, while others view the school as the primary facilitator of children's education and see parents as having less of a role ( Hammer et al., 2007 ). These attitudinal differences may be related to cultural expectations or parents' own education or comfort with teaching their children certain skills. Some parents, for example, may have lower involvement in their children's education because of insecurity about their own skills and past negative experiences in school ( Lareau, 1989 ; Lawrence-Lightfoot, 2003 ). And as discussed above, some parents view math skills as less important for their children relative to other types of skills and therefore are less likely to teach them in the home.

Parents within and across different communities vary in their opinions and practices with respect to the role and significance of discipline. Some of the parenting literature notes that some parents use control to discipline children, while others aim to correct but not to control children ( Nieman and Shea, 2004 ). In a small cross-cultural ethnographic study, Mosier and Rogoff (2003) found that some parents regard rules and punishment as inappropriate for infants and toddlers. The approach valued by these parents to help children understand what is expected of them is to cooperate with them, perhaps distracting them but not forcing their compliance. In contrast, many middle-class U.S. parents display a preference for applying the same rules to infants and toddlers that older children are expected to follow, although with some lenience ( Mosier and Rogoff, 2003 ). And ethnographic research provides some evidence of differences in African American and European American mothers' beliefs about spoiling and infant intentionality (whether infants can intentionally misbehave) related to the use of physical punishment with young children ( Burchinal et al., 2010 ).

Parents' attitudes not only toward parenting but also toward providers in societal agencies—such as educators, social service personnel, health care providers, and police—which can be shaped by a variety of factors, including discrimination, are important determinants of parents' access to and ability to obtain support. Studies show a relationship between parents' distrust of agencies and their likelihood of rejecting participation in an intervention. For example, in systematic reviews of studies of various types, parents who distrust the medical community and government health agencies are less likely to have their children vaccinated ( Brown et al., 2010 ; Mills et al., 2005 ). Racial and ethnic minority parents whose attitudes about appropriate remedies for young children vary from those of the Western medical establishment often distrust and avoid treatment by Western medical practitioners ( Hannan, 2015 ). While not specific to parents, studies using various methodologies show that individuals who have experienced racial and other forms of discrimination, both within and outside of health care settings, are less likely to utilize various health services or to engage in other health-promoting behaviors ( Gonzales et al., 2013 ; Institute of Medicine, 2003 ; Pascoe and Smart Richman, 2009 ; Shavers et al., 2012 ). In a survey study, African American parents' racism awareness was negatively associated with involvement in activities at their children's school ( McKay et al., 2003 ). Longitudinal studies, mostly involving families with older children, indicate that, like other sources of stress, parents' experience of discrimination can have a detrimental effect on parenting and the quality of the parent-child relationship ( Murray et al., 2001 ; Sanders-Phillips et al., 2009 ). Adverse outcomes for youth associated with their own experience of discrimination may be weakened by more nurturing/involved parenting ( Brody et al., 2006 ; Gibbons et al., 2010 ; Simons et al., 2006 ).

As noted earlier, attitudes are shaped in part by parenting self-efficacy—a parent's perceived ability to influence the development of his or her child. Parenting self-efficacy has been found to influence parenting competence (including engagement in some parenting practices) as well as child functioning ( Jones and Prinz, 2005 ). Studies show associations between maternal self-efficacy and children's self-regulation, social, and cognitive skills ( Murry and Brody, 1999 ; Swick and Hassell, 1990 ). Self-efficacy also may apply to parents' confidence in their capacity to carry out specific parenting practices. For example, parents who reported a sense of efficacy in influencing their elementary school-age children's school outcomes were more likely to help their children with school activities at home ( Anderson and Minke, 2007 ). A multimethod study of African American families found that maternal self-efficacy was related to children's regulatory skills through its association with competence-promoting parenting practices, which included family routines, quality of mother-child interactions based on observer ratings, and teachers' reports of mothers' involvement with their children's schools ( Brody et al., 1999 ). Henshaw and colleagues (2015) found in a longitudinal study that higher breastfeeding self-efficacy predicted exclusive breastfeeding at 6 months postpartum, as well as better emotional adjustment of mothers in the weeks after giving birth.

Parenting Practices

Parenting practices have been studied extensively, with some research showing strong associations between certain practices and positive child outcomes. This section describes parenting practices that research indicates are central to helping children achieve basic outcomes in the areas discussed at the beginning of the chapter: physical health and safety, emotional and behavioral competence, social competence, and cognitive competence. While these outcomes are used as a partial organizing framework for this section, several specific practices—contingent responsiveness of parents, organization of the home environment and the importance of routines, and behavioral discipline practices—that have been found to influence child well-being in more than one of these four outcome areas are discussed separately.

Practices to Promote Physical Health and Safety

Parents influence the health and safety of their children in many ways. However, the difficulty of using random assignment designs to examine parenting practices that promote children's health and safety has resulted in a largely observational literature. This section reviews the available evidence on a range of practices in which parents engage to ensure the health and safety of their children. It begins with breastfeeding—a subject about which there has historically been considerable discussion in light of generational shifts and commercial practices that have affected children in poor families.

Breastfeeding Breastfeeding has myriad well-established short- and long-term benefits for both babies and mothers. Breast milk bolsters babies' immunity to infectious disease, regulates healthy bacteria in the intestines, and overall is the best source of nutrients to help babies grow and develop. Breastfeeding also supports bonding between mothers and their babies. According to a meta-analysis by the WHO ( Horta and Victora, 2013 ), breastfeeding is associated with a small increase in performance on intelligence tests in children and adolescents, reduced risk for the development of type 2 diabetes and overweight/obesity later in life, and a potential decreased risk for the development of cardiovascular disease. Breastfeeding may benefit mothers' health as well by lowering risk for postpartum depression, certain cancers, and chronic diseases such as diabetes ( U.S. Department of Health and Human Services, 2011 ). Current guidelines from the American Academy of Pediatrics (2012) and the WHO (2011) recommend mothers breastfeed exclusively until infants are 6 months old. Thereafter and until the child is either age 1 year ( American Academy of Pediatrics, 2012 ) or 2 years ( World Health Organization, 2011 ), it is recommended that children continue to be breastfed while slowly being introduced to other foods.

According to 2011 data from the CDC (2015a) , about 80 percent of babies born in the United States are breastfed (including fed breast milk) for some duration, and about 50 percent and 27 percent are breastfed (to any extent with or without the addition of complementary liquids or solids) at 6 and 12 months, respectively. Forty percent and 19 percent are exclusively breastfed through 3 and 6 months, respectively.

Mothers in the United States often cite a number of reasons for not initiating or continuing breastfeeding, including lack of knowledge about how to breastfeed, difficulty or pain during breastfeeding, embarrassment, perceived inconvenience, and return to work ( Hurley et al., 2008 ; Ogbuanu et al., 2009 ; U.S. Department of Health and Human Services, 2011 ). Low-income women with less education are less likely than women of higher socioeconomic status to breastfeed ( Heck et al., 2006 ). Some research with immigrant mothers shows that rates of breastfeeding decrease with each generation in the United States, possibly because of differences in acceptance of bottle feeding here as compared with other countries (e.g., Sussner et al., 2008 ).

Nutrition and physical activity Parents play an important role in shaping their young children's nutrition and physical activity levels ( Institute of Medicine, 2011 ; Sussner et al., 2006 ). Among toddlers and preschool-age children, parents' feeding practices are associated with their children's ability to regulate food intake, which can affect weight status ( Faith et al., 2004 ; Farrow et al., 2015 ). Parents' modeling of healthful eating habits for their children and offering of healthful foods, particularly during toddlerhood, when children are often reluctant to try new foods, may result in children being more apt to like and eat such foods ( Hill, 2002 ; Natale et al., 2014 ; Sussner et al., 2006 ). The extant observational research generally shows that children's dietary intake (particularly fruit and vegetable consumption) is associated with food options available in the home and at school, and that parents are important role models for their children's dietary behaviors ( Cullen et al., 2003 ; Pearson et al., 2009 ; Wolnicka et al., 2015 ). Conversely, the presence of less nutritious food and beverage items in the home may increase children's risk of becoming overweight. For example, Dennison and colleagues (1997) and Welsh and colleagues (2005) found positive associations between overweight in children and their consumption of sugar-sweetened beverages. On the other hand, there are some indications that overly strict diets may increase children's preferences for high-fat, energy-dense foods, perhaps causing an imbalance in children's self-regulation of hunger and satiety and increasing the risk that they will become overweight ( Birch and Fisher, 1998 ; Farrow et al., 2015 ).

A few cross-sectional and longitudinal studies, coupled with conventional wisdom, suggest that eating dinner together as a family is associated with increased consumption of fruits, vegetables, and whole grains and reduced consumption of fats and soda ( Gillman et al., 2000 ), as well as with reduced risk for overweight and obesity ( Gable et al., 2007 ; Taveras et al., 2005). However, these studies involved primarily older children and adolescents.

Physical activity is a complement to good nutrition. Even in young children, physical activity is essential for proper energy balance and prevention of childhood obesity ( Institute of Medicine, 2011 ; Kohl and Hobbs, 1998 ). It also supports normal physical growth. Parents may encourage activity in young children through play (e.g., free play with toys or playing on a playground) or age-appropriate sports. Children who spend more time outdoors may be more active (e.g., Institute of Medicine, 2011 ; Sallis et al., 1993 ) and also have more opportunity to explore their community and interact with other children. For many parents living in high-crime neighborhoods, however, most of whom are racial and ethnic minorities, the importance of safety overrides the significance of physical activity. In some neighborhoods, safety issues and lack of access to parks and other places for safe recreation make it difficult for families to spend time outdoors, leading parents to keep their children at home ( Dias and Whitaker, 2013 ; Gable et al., 2007 ; Powell et al., 2003 ).

Although more of the research on screen time and sedentary behavior has focused on adolescents than on young children, several cross-sectional and longitudinal studies on younger children show an association between television viewing and overweight and inactivity ( Ariza et al., 2004 ; Carson et al., 2016 ; Dennison et al., 2002 ; DuRant et al., 1994 ; Gable et al., 2007 ; Tremblay et al., 2011 ). An analysis of data on 8,000 children participating in a longitudinal cohort study showed that those who watched more television during kindergarten and first grade were significantly more likely to be clinically overweight by the spring semester of third grade ( Gable et al., 2007 ). Although television, computers, and other screen media often are used for educational purposes with young children, these findings suggest that balancing screen time with other activities may be one way parents can promote their children's overall health. As with diet, children's sedentary behavior can be influenced by parents' own behaviors. For example, De Lepeleere and colleagues (2015) found an association between parents' screen time and that of their children ages 6-12 in a cross-sectional study.

Vaccination Parents protect their own and other children from potentially serious diseases by making sure they receive recommended vaccines. Among children born in a given year in the United States, childhood vaccination is estimated to prevent about 42,000 deaths and 20 million cases of disease ( Zhou et al., 2014 ). In 2013, 82 percent of children ages 19-35 months received combined-series vaccines (for diphtheria, tetanus, and pertussis [DTP]; polio; measles, mumps, and rubella [MMR]; and Haemophilus influenzae type b [Hib]), up from 69 percent in 1994 ( Child Trends Databank, 2015b ). Vaccination rates are lower among low-income children; 71 percent of children ages 19-35 months living below the poverty level received the combined-series vaccines listed above in 2014 ( Child Trends Databank, 2015b ). Although much of the media coverage on this subject has focused on middle-income parents averse to having their children vaccinated, it is in fact poverty that is thought to account for much of the disparity in vaccination rates by race and ethnicity ( Hill et al., 2015 ). As discussed earlier in this chapter, parental practices around vaccination may be influenced by parents' knowledge and interpretation of information on and their attitudes about vaccination.

Preconception and prenatal care The steps women take with their health care providers before becoming pregnant can promote healthy pregnancy and birth outcomes for both mothers and babies. These include initiating certain supplements (e.g., folic acid, which reduces the risk of birth defects), quitting smoking, attaining healthy weight for women who are obese, and treating preexisting physical and mental health conditions ( Aune et al., 2014 ; Gold and Marcus, 2008 ; Institute of Medicine and National Research Council, 2009 ).

During pregnancy, receipt of recommended prenatal care can help parents reduce the risk of pregnancy complications and poor birth outcomes by promoting healthy behaviors (e.g., smoking cessation, adequate rest and nutrition), as well as identifying and managing any complications that do arise. Prior to the birth of a child, health care providers also can educate parents on the importance of breastfeeding, infant injury and illness prevention, and other practices.

Infants born to mothers who do not receive prenatal care or who do not receive it until late in their pregnancy are more likely than those born to mothers who receive such care early in pregnancy to be born premature and at a low birth weight and are more likely to die. Since the 1970s, there has been a decline in the number of women in the United States receiving late or no prenatal care, with the majority of pregnant women now receiving recommended prenatal care ( Child Trends Databank, 2015a ). Yet disparities among subgroups persist. In 2014, American Indian and Alaska Native (11% of births), black (10% of births), and Hispanic (8% of births) women were more than twice as likely as white mothers (4% of births) to receive late or no prenatal care ( Child Trends Databank, 2015a ). The proportion of women receiving timely prenatal care increases with age: in 2014, 25 percent of births to females under age 15 and 10 percent of births to females ages 15-19 were to mothers receiving late or no prenatal care, compared with 7.8 percent for females ages 20-24 and 5.6 percent for those ages 25-29 ( Child Trends Databank, 2015a ). Women whose pregnancies are unintended also are less likely to receive timely prenatal care. Despite the importance of timely and quality prenatal care, moreover, many parents experience barriers to receiving such care, including poor access and rural residence, limited knowledge of its importance, and mental illness ( Heaman et al., 2014 ).

Injury prevention Unintentional injuries are the leading cause of death among children ages 1-9 ( Centers for Disease Control and Prevention, 2015c ) and a leading cause of disability for both younger and older children in the United States. In addition to motor vehicle-related injuries, children sustain unintentional injuries (due, for example, to suffocation, falls, poisoning, and drowning) in the home environment. About 1,700 children under age 9 in the United States die each year from injuries in the home ( Mack et al., 2013 ).

Parents can protect their children from injury through various measures, such as ensuring proper use of automobile passenger restraints, insisting that children wear helmets while bike riding and playing sports, and creating a safe home environment (e.g., keeping medicines and cleaning products out of children's reach, installing safety gates to keep children from falling down stairs). Yet the limited available research on parents' use of safety measures suggests there is room for improvement in some areas. For instance, appropriate use of child restraint systems is known to reduce the risk of child motor vehicle-related injuries and deaths ( Arbogast et al., 2009 ; Durbin, 2011 ); nonetheless, data show that many children ride in automobiles without appropriate restraints ( Greenspan et al., 2010 ; Lee et al., 2015 ; Macy et al., 2014 ). Likewise, using data from a national survey conducted during 2001-2003, Dellinger and Kresnow (2010) show that less than one-half of children ages 5-14 always wore bicycle helmets while riding, and 29 percent never did so. More recent data on parents' home safety practices and on helmet usage among young children are lacking.

Evidence that families' home safety practices affect child safety comes from intervention research. A large meta-analysis of randomized and nonrandomized controlled trials of home safety education interventions for families ( Kendrick et al., 2013 ) showed that the education was generally effective in increasing the proportion of families that stored medicines and cleaning products out of reach and that had fitted stair gates, covers on unused electrical sockets, safe hot tap water temperatures, functional smoke alarms, and a fire escape system. There was also some evidence for reduced injury rates among children. As discussed in Chapter 4 , helping parents reduce hazards in the home is a component of some home visiting programs.

Parents also protect their children's safety by monitoring their whereabouts and activities to prevent them from both physical and psychological harm. The type of supervision may vary based on a child's needs and age as well as parents' values and economic circumstances. For all young children, monitoring for the purposes of preventing exposure to hazards is an important practice. As children grow older, knowing their friends and where the children are when they are not at home or in school also becomes important. As noted previously, research suggests the importance of monitoring screen time to children's well-being. And monitoring of children's Internet usage may prevent them from being exposed to online predators ( Finkelhor et al., 2000 ).

Practices to Promote Emotional and Behavioral Competence and Social Competence

Fundamental to children's positive development is the opportunity to grow up in an environment that responds to their emotional needs ( Bretherton, 1985 ) and that enables them to develop skills needed to cope with basic anxieties, fears, and environmental challenges. Parents' ability to foster a sense of belonging and self-worth in their children is vital to the children's early development. In much the same way, parents contribute to children's emerging social competence by teaching them skills—such as self-control, cooperation, and taking the perspective of others—that prepare them to develop and maintain positive relationships with peers and adults. Parents can promote the learning and acquisition of social skills by establishing strong relationships with their children. The importance of early parent-child interactions for children's social competence is embedded in many theoretical frameworks, such as attachment ( Ainsworth and Bowlby, 1991 ), family system theories ( Cox and Paley, 1997 ), and ecocultural theories ( Weisner, 2002 ). Parents socialize their children to adopt culturally appropriate values and behaviors that enable them to be socially competent and act as members of a social group.

Research suggests that children who are socially competent are independent rather than suggestible, responsible rather than irresponsible, cooperative instead of resistive, purposeful rather than aimless, friendly rather than hostile, and self-controlled rather than impulsive ( Landy and Osofsky, 2009 ). In short, the socially competent child exhibits social skills (e.g., has positive interactions with others, expresses emotions effectively), is able to establish peer relationships (e.g., being accepted by other children), and has certain individual attributes (e.g., shows capacity to empathize, has coping skills). Parents help children develop these social skills through parenting practices that include fostering and modeling positive relationships and providing enriching and stimulating experiences and opportunities for children to exercise these skills ( Landy and Osofsky, 2009 ). Parents also help their children acquire these skills by having them participate in routine activities (e.g., chores, taking care of siblings) and family rituals (e.g., going to church) ( Weisner, 2002 ). These activities are shared with and initiated by parents, siblings, and other kin; unfold within the home; and are structured by cultural and linguistic practices, expectations, and behaviors ( Rogoff, 2003 ; Weisner, 2002 ). In this context, young children interact with their mothers, fathers, siblings, and grandparents who teach them implicitly or explicitly to acquire appropriate social behaviors, adapt to expected norms, and learn linguistic conventions and cognitive skills ( Sameroff and Fiese, 2000 ).

Another important aspect of parent-supported social development pertains to parents aiding their children in acquiring executive function skills needed to adapt to changing needs of the environment and regulate their impulses and responses to distressing situations ( Blair and Raver, 2012 ; Malin et al., 2014 ; Thompson, 1994 ). Evidence, primarily from correlational research, suggests that parents who help their children regulate the difficulty of tasks and who model mature performance during joint participation in activities are likely to have socially competent children ( Eisenberg et al., 1998 ). Parents also facilitate their children's development of friendships by engaging in positive social interaction with them and by creating opportunities for them to be social with peers ( McCollum and Ostrosky, 2008 ). In one correlational study, children whose parents initiated peer contacts had more playmates and more consistent play companions in their preschool peer networks ( Ladd et al., 2002 ). Research also shows that children who have increased opportunities for playing or interacting with children from diverse backgrounds are likely to develop less prejudice and more empathy toward others ( Bernstein et al., 2000 ; Perkins and Mebert, 2005 ; Pettigrew and Tropp, 2000 ).

Findings from experimental studies on parent training provide evidence of the types of parental practices that are associated with child emotional and behavioral health (i.e., fewer internalizing and externalizing problems) and social competence (i.e., relationship building skills, moral dispositions, and prosocial behaviors such as altruism). In one study for example, parent training designed to decrease the use of harsh discipline and increase supportive parenting reduced mother-reported child behavior problems in children ages 3-9 ( Bjørknes and Manger, 2013 ). In another randomized study, mothers who received parent training to improve their empathy toward their children became less permissive with their 2- to 3-year-olds, who became less aggressive ( Christopher et al., 2013 ).

These relationships have been found to hold in experimental studies involving diverse samples. Brotman and colleagues (2005) found that a program designed to reduce parents' use of negative parenting and increase their provision of stimulation for child learning increased social competence with peers in young African American and Latino children who had a sibling who had been involved in the juvenile justice system. In a European study, Berkovits and colleagues (2010) studied ethnically diverse parents participating in an abbreviated parent skills training delivered in pediatric primary care aimed at encouraging children's prosocial behavior. The findings show significant increases in effective parenting strategies and in parents' beliefs about personal controls, as well as declines in child behavior problems. Improvements in child behavior as a consequence of parent training have been found not only for programs emphasizing better and more consistent discipline and contingency management, but also for those providing training that led to parents' greater emotional support for their children ( McCarty et al., 2005 ). In addition, Stormshak and colleagues (2000) found that punitive interactions between parents and children were associated with higher rates of child disruptive behavior problems, and that low levels of warm involvement were characteristic of parents of children who showed oppositional behaviors.

Internalizing disorders in young children include depression (withdrawal, persistent sadness) and anxiety ( Tandon et al., 2009 ). They may occur simultaneously with and/or independently of externalizing disorders (e.g., noncompliance, aggression, coercive behaviors directed at the environment and others) ( Dishion and Snyder, 2016 ). Studies focusing exclusively on the causes of internalizing disorders in young children are relatively limited. However, the results of the available studies lead to similar conclusions about the relationships among training, changes in parenting practices, and child internalizing problems. First, there is evidence that parental behaviors matter for child emotional functioning. Specifically, parents' sense of personal control and behaviors such as autonomy granting are inversely related to child anxiety in cross-sectional research ( McLeod et al., 2007 ). Similarly, in another nonexperimental study, Duncombe and colleagues (2012) show that inconsistent discipline, parents' negative emotion, and mental health are related to child problems with emotion regulation. Second, there is evidence that parent training interventions can modify the parenting practices that matter. Third, some parent training interventions have positive effects on children's emotional functioning. In a review of randomized controlled studies of the effects of group-based parenting programs on behavioral and emotional adjustment, Barlow and colleagues (2010) found significant effects of the programs on parent-reported outcomes of children under age 4. Herbert and colleagues (2013) conducted a randomized clinical trial of parent training and emotion socialization for hyperactive preschool children in which the target outcome was emotion regulation. Not only did the intervention group mothers report lower hyperactivity, inattention, and emotional lability in their children, but also changes in children's functioning were correlated with more positive and less negative parenting and with less verbosity, greater support, and use of emotion socialization practices on the part of mothers.

With respect to social competence, a number of studies point to a relationship with parenting practices and suggest that parent training may have an impact on both parenting practices related to and children's development of social competence. An experimental evaluation of the Incredible Years Program (discussed further in Chapter 5 ), for instance, found that parent training contributed to improved parenting practices, defined as lower negative parenting and increased parental stimulation for learning ( Brotman et al., 2005 ), which, in turn, are related to children's social competence. Gagnon and colleagues (2014) found that preschool children with a combination of reactive temperament and authoritarian parents demonstrated low social competence (high levels of disruptive play and low levels of interactive play). In a community trial by Havighurst and colleagues (2010) , training focused on helping parents tune in to their own and their children's emotions resulted in significant improvement in the parents' emotion awareness and regulation, as well as the practice of emotion coping. The intervention decreased emotionally dismissive beliefs and behaviors among parents, who also used emotion labels and discussed the causes and consequences of emotions with their children more often than was the case prior to the training. The program improved parental beliefs and relationships with their children, and these improvements were related to reductions in child behavior problems ( Havighurst et al., 2010 ).

Practices to Stimulate Cognitive Development

As explained in the National Research Council (2000) report How People Learn: Brain, Mind, Experience, and School , individuals learn by actively encountering events, objects, actions, and concepts in their environments. For an individual to become an expert in any particular knowledge or skill area, he or she must have substantial experience in that area which is usually guided ( Dweck and Leggett, 2000 ; National Research Council, 2000 ). As children's first teachers, parents play an important role in their cognitive development, including their acquisition of such competencies as language, literacy, and numerical/math skills that are related to future success in school and society more generally. Enriching and stimulating sets of experiences for children can help develop these skills.

Evidence of the potential importance of parenting for language development is found across studies of parent talk. This research offers compelling correlational evidence that providing children with labels (e.g., for objects, numbers, and letters) to promote and reinforce knowledge, responding contingently to their speech, eliciting and sustaining conversation with them, and simply talking to them more often are related to vocabulary development ( Hart and Risley, 1995 ; Hirsh-Pasek et al., 2015 ; Hoff, 2003 ). In addition to the frequency of talking with children, research is beginning to show that the quality of language used by parents when interacting with their children may matter for children's vocabulary development. Studies using various types of designs have shown that children whose fathers are more educated and use complex and diverse language when interacting with them develop stronger vocabulary skills relative to other children ( Malin et al., 2012 ; Pancsofar and Vernon-Feagans, 2006 ; Rowe et al., 2004 ).

Language development studies have found that providing an instructional platform in a child's early language experience, such as offering a social context for communication and asking more “what,” “where,” and “why” questions, is associated with language acquisition ( Baumwell et al., 1997 ; Bruner, 1983 ; Leech et al., 2013 ). Similar findings are provided by experimental research on dialogic reading, in which adults engage children in discussion about the reading material rather than simply reading to them ( Mol et al., 2008 ; Whitehurst et al., 1988 ). A meta-analytic review of 16 interventions by Mol and colleagues (2008) showed that, relative to reading as usual, dialogic reading interventions, especially use of expressive language, were more effective at increasing children's vocabulary. The effect was stronger for children ages 2-3 and more modest for those ages 4-5 and those at risk for language and literacy impairment ( Mol et al., 2008 ).

Frequency of shared book reading by mothers and fathers is linked to young children's acquisition of skills and knowledge that affect their later success in reading, writing, and other areas ( Baker, 2014 ; Duursma et al., 2008 ; Malin et al., 2014 ). Studies demonstrate that through shared book reading, young children learn, among other skills, to recognize letters and words and develop understanding that print is a visual representation of spoken language, develop phonological awareness (the ability to manipulate the sounds of spoken language), begin to understand syntax and grammar, and learn concepts and story structures ( Duursma et al., 2008 ; Malin et al., 2014 ). Shared literacy activities such as book reading also expose children to new words and words they may not encounter in spoken language, stimulating vocabulary development beyond what might be obtained through toy-play or other parent-child interactions ( Isbell et al., 2004 ; Ninio, 1983 ; Whitehurst et al., 1988 ). Regular book reading also may play a role in establishing routines for children and shaping wake and sleep patterns, as well as provide them with knowledge about relationships and coping that can be applied in the real world ( Duursma et al., 2008 ).

Children of low socioeconomic status and minority children frequently have smaller vocabularies relative to children of higher socioeconomic status and white children, and these differences increase over time ( Markman and Brooks-Gunn, 2005 ). Some experts have theorized that this differential arises from variations in “speech cultures” of families, which are linked to socioeconomic status and race/ethnicity. The middle- and upper-class (primarily white) speech culture is associated with more and more varied language and more conversation, which contributes to bigger vocabularies and improved school readiness among children in these homes ( Hart and Risley, 1999 ). Little research has focused on whether reducing these variations would help close the racial/ethnic gap in school readiness, however ( Markman and Brooks-Gunn, 2005 ). Relative to their middle- and upper-class, mainly white, counterparts, low-income and immigrant parents are less likely to report that they read to their children on a regular basis and to have books and other learning materials in the home ( Markman and Brooks-Gunn, 2005 ). Besides culture, this difference may be due to such factors as access to books (including those in parents' first language), parents' own reading and literacy skills, and erratic work schedules (which could interfere with regular shared book reading before children go to bed, for example).

As discussed in Chapter 4 , limited experimental research suggests that interventions designed to promote parents' provision of stimulating learning experiences support children's cognitive development, primarily on measures of language and literacy ( Chang et al., 2015 ; Garcia et al., 2015 ; Mendelsohn et al., 2005 ; Roberts and Kaiser, 2011 ). In one study, for example, interactions between high-risk parents and their children over developmentally stimulating, age-appropriate learning material (e.g., a book or a toy), followed by review and discussion between parents and child development specialists, were found to improve children's cognitive and language skills at 21 months compared with a control group, and also reduced parental stress ( Mendelsohn et al., 2005 ).

Early numeracy and math skills also are building blocks for young children's academic achievement ( Claessens and Engel, 2013 ). To instill early math skills in young children, parents sometimes employ such strategies as playing with blocks, puzzles, and legos; assisting with measuring ingredients for recipes; solving riddles and number games; and playing with fake money ( Benigno and Ellis, 2008 ; Hensen, 2005 ). Such experiences may facilitate children's math-related competencies, but compared with the research on strategies to foster children's language development, the evidence base on how parenting practices promote math skills in young children is small.

A growing literature identifies general aspects of home-based parental involvement in children's early learning—such as parents' expectations and goals for their children, parent-child communication, and support for learning—that appear to be associated with greater academic achievement, including in math ( Fan and Chen, 2001 ; Galindo and Sonnenschein, 2015 ; Ginsburg et al., 2010 ; Jeynes, 2003 , 2005 ). More work is needed, however, to distill specific actions parents can take to promote math-related skills in their young children. At the same time, as noted earlier, some parents appear to be reluctant to engage their children in math learning—some because they lack knowledge about early math and may engage in few math-related activities in the home relative to activities related to language, and some because they view math skills as less important than other skills for their children ( Blevins-Knabe et al., 2000 ; Cannon and Ginsburg, 2008 ; Vukovic and Lesaux, 2013 ). Given the demonstrated importance of early math skills for future academic achievement and the persistent gap in math knowledge related to socioeconomic status ( Galindo and Sonnenschein, 2015 ), additional research is needed to elucidate how parents can and do promote young children's math skills and how they can better be supported in providing their children with these skills.

Finally, there is some evidence for differences across demographic groups in the United States with respect to parents' use of practices to promote children's cognitive development. Barbarin and Jean-Baptiste (2013) , for example, found that poor and African American parents employed dialogic practices less often than nonpoor and European American parents in a study that utilized in-home interviews and structured observations of parent-child interactions.

Contingent Responsiveness of Parents

Broadly defined, contingent responsiveness denotes an adult's behavior that occurs immediately after and in response to a child's behavior and is related to the child's focus of attention ( Roth, 1987 ). Dunst and colleagues (1990) argue that every time two or more people are together, there is a communicative exchange in which the behavior (nonverbal or verbal) affects the other person, is interpreted, and is responded to with a “discernible outcome” (p. 1). Such communication exchanges between parents and their children are considered foundational for building healthy relationships between parents and children, as well as between parents ( Cabrera et al., 2014 ).

Within the multiple relationships and systems that surround parents and children, the quality of the relationship they share is vital for the well-being of both ( Bronfenbrenner and Morris, 1998 ). The science is clear on the importance of positive parent-child relationships for children. Emotionally responsive parenting, whereby parents respond in a timely and appropriate way to children's needs, is a major element of healthy relationships, and is correlated with positive developmental outcomes for children that include emotional security, social facility, symbolic competence, verbal ability, and intellectual achievement ( Ainsworth et al., 1974 ). The majority of children who are loved and cared for from birth and develop healthy and reciprocally nurturing relationships with their caregivers grow up to be happy and well adjusted ( Armstrong and Morris, 2000 ; Bakermans-Kranenburg et al., 2003 ). Conversely, children who grow up in neglectful or abusive relationships with parents who are overly intrusive and controlling are at high risk for a variety of adverse health and behavioral outcomes ( Barber, 2002 ; Egeland et al., 1993 ).

The development of health-promoting relationships between parents and their children is rooted in evolutionary pressures that lead children to be born wired to interact with their social environment in ways that will ensure their survival and promote their eventual development ( Bowlby, 2008 ). Through reaching out, babbling, facial expressions, and gestures, very young children signal to caregivers when they are ready to engage with them. Caregivers may respond by producing similar vocalizations and gestures to signal back to infants that they have heard and understood ( Masataka, 1993 ). Cabrera and colleagues (2007) found that children of fathers who react to their behavior in a sensitive way by following their cues, responding, and engaging them are more linguistically and socially competent relative to children of fathers who do not react in these ways ( Cabrera et al., 2007 ).

This “serve and return” interaction between caregivers and children, which continues throughout childhood, is fundamental for growth-promoting relationships ( Institute of Medicine and National Research Council, 2015 ; National Research Council and Institute of Medicine, 2000 ). A consistent give and take with responsive caregivers provides the child with tailored experiences that are enriching and stimulating; forms an emotional connection between caregiver and child; builds on the child's interests and capacities; helps the child develop a sense of self; and stimulates the child's intellectual, social, physical, and emotional and behavioral growth ( Institute of Medicine and National Research Council, 2015 ; National Research Council and Institute of Medicine, 2000 ). This give and take is particularly important for language development. It is believed that through this process, the child learns that she or he is loved and will love others in return, and that she or he is accepted and cared for and will also eventually accept and care for others.

For infants, social expectations and a sense of self-efficacy in initiating social interactions are influenced by their early interactions with their caregivers. McQuaid and colleagues (2009) found that mothers' contingent smiles (i.e., those in response to infant smiles) in an initial interactive study phase predicted infant social bids when mothers were still-faced in a subsequent study phase, a finding consistent with results of earlier research ( Bigelow, 1998 ). The adult's response to the child's overtures for interaction needs to be contingent on the child's behaviors. Infants' spontaneous vocalizations are characterized by pauses that enable caregivers to respond vocally. Children who have experience with turn taking are able to vocalize back to the caregiver in a synchronized manner ( Masataka, 1993 ). Young children's social and emotional development is influenced by the degree to which primary caregivers engage them in this kind of growth-promoting interaction ( Cassidy, 2002 ).

As described in Chapter 1 , securely attached infants develop basic trust in their caregivers and seek the caregiver's comfort and love when alarmed because they expect to receive protection and emotional support. Infants who trust their caregivers to respond to their needs in a sensitive and timely manner are able to explore and learn freely because they can return to their “safe base” if they encounter unfamiliar things and events ( Bowlby, 2008 ; Cassidy, 2002 ). In the face of the demands of daily life, with parents being unable to offer individualized responsiveness and synchronized, attuned interactions all of the time, sensitive caregiving makes it possible to manage and repair disruptions that inevitably occur in day-to-day parenting.

High-quality “serve and return” parenting skills do not always develop spontaneously, especially during infancy and toddlerhood, before children have learned to speak. Some research indicates that lower-income families are at higher risk for not engaging in these types of interactions with their children ( Paterson, 2011 ), but there is variability within and across economic and cultural groups ( Cabrera et al., 2006 ). Differences among racial/ethnic groups in mothers' interactive behaviors with their young children have also been noted (e.g., Brooks et al., 2013 ; Cho et al., 2007 ). In a study of mothers of premature infants, for example, American Indian mothers relative to African American mothers looked and gestured more with their infants based on observer ratings ( Brooks et al., 2013 ). Such differences may be related to variation in sociocultural norms or to other factors. Parents who experience such stressors as low income, conflict with partners or other adults, depression, and household chaos face more challenges to engaging in emotionally responsive parenting because of the emotional toll these stressors can exact ( Conger and Donnellan, 2007 ; Markman and Brooks-Gunn, 2005 ; McLoyd, 1998 ). Building the capacities of all caregivers to form responsive and nurturing relationships with their children is crucial to promoting child well-being.

As detailed in Chapters 4 and 5 , experimental studies largely confirm evidence from correlational studies showing that sensitive parenting and attachment security are related to children's social-emotional development ( Van Der Voort et al., 2014 ). One international study found that an intervention focused on responsive stimulation could promote positive caregiving behaviors among impoverished families ( Yousafzai et al., 2015 ). Another study found that home visiting for parents of preterm infants that entailed promotion of more sensitive and responsive parenting skills modestly improved parent-infant interactions ( Goyal et al., 2013 ).

These and other interventions that successfully promote positive parent-child interactions, secure attachment, and healthy child development have been developed for parents of both infants ( Armstrong and Morris, 2000 ) and preschoolers ( Bagner and Eyberg, 2007 ). Some research shows that such an intervention provided first in infancy, followed by a second dose during the toddler/preschool years, is most effective at improving maternal behaviors and child outcomes ( Landry et al., 2008 ). However, the success of preventive interventions in improving the quality of parent-infant attachment, a parent's relationship with her or his child, and the resulting child mental and physical outcomes depends upon the quality of the intervention ( Chaffin et al., 2004 ), the number of sessions (a moderate number may be better than either more or less) ( Moss et al., 2011 ), and the degree to which other parts of the parent-child system (e.g., separation due to parental incarceration or other reasons) are considered ( Barr et al., 2011 ). Although much of the literature has focused on non-Hispanic white and black families, and mainly on mothers, preventive interventions with successful maternal and child outcomes have also been developed for Hispanic and Asian families ( Ho et al., 2012 ; McCabe and Yeh, 2009 ) and can be designed to include fathers ( Barr et al., 2011 ).

Organization of the Home Environment and the Importance of Routines

Observational research suggests that children's development is enhanced by parents' use of predictable and orderly routines. Family routines, such as those related to feeding, sleeping, and learning, help structure children's environment and create order and stability that, in turn, help children develop self-regulatory skills by teaching them that events are predictable and there are rewards for waiting ( Evans et al., 2005 ; Hughes and Ensor, 2009 ; Martin et al., 2012 ). Conversely, an unpredictable environment may undermine children's confidence in their ability to influence their environment and predict consequences, which may in turn result in children's having difficulty with regulating their behavior according to situational needs ( Deater-Deckard et al., 2009 ; Evans and English, 2002 ).

Although family routines vary widely across time and populations, studies have associated such routines with children's developmental outcomes ( Fiese et al., 2002 ; Spagnola and Fiese, 2007 ). It is particularly difficult, however, to infer causal effects of routines on child outcomes in correlational studies because of the many contextual factors (e.g., parental depression or substance abuse, erratic work schedules) or factors related to economic strain (e.g., homelessness, poverty) that may make keeping routines difficult and at the same time adversely affect child development in other ways.

Several literatures have developed around routines thought to promote particular developmental targets. For example, Mindell and colleagues (2009) describe results from a randomized controlled trial in which mothers instructed in a specific bedtime routine reported reductions in sleep problems for their infants and toddlers (see also Staples et al., 2015 , for a recent nonexperimental analysis of bedtime routines and sleep outcomes). De Castilho and colleagues (2013) found in a systematic review of randomized controlled trials consistent associations between children's oral health and elements of their family environment such as parents' toothbrushing habits. And in a nationally representative cross-sectional study, Anderson and Whitaker (2010) report strong associations between exposure to various household routines, such as eating meals as a family, obtaining adequate sleep, and limiting screen time, and risk for obesity in preschool-age children. As discussed above, a growing body of literature also reports associations between more general aspects of children's healthy development, such as social competence, and the organization and predictability of a broader set of day-to-day experiences in the home (see Evans and Wachs, 2010 ).

In some cases, however, routines are difficult to establish because of demands on parents, such as the nonstandard work schedules some parents are forced to keep. Reviewing the cross-sectional and longitudinal literature on nonstandard work schedules, for example, Li and colleagues (2014) found that 21 of the 23 studies reviewed reported associations between nonstandard work schedules and adverse child developmental outcomes. They found that while parents working nonstandard schedules, particularly those who work night or evening shifts, may be afforded more parent-child time during the day, such schedules can lead to fatigue and stress, with detrimental effects on the parent's physical and psychological capacity to provide quality parenting.

Other research has looked at the impacts on children of living in home environments that are marked by high levels of “chaos,” or instability and disorganization ( Evans and Wachs, 2010 ; Vernon-Feagans et al., 2012 ). A few studies have found a relationship between measures of household instability and disorganization and risk of adverse cognitive, social, and behavioral outcomes in young children. In a longitudinal study, for example, Vernon-Feagans and colleagues (2012) found that a higher level of household disorganization in early childhood (e.g., household density, messiness, neighborhood and household noise) was predictive of poorer performance on measures of receptive and expressive vocabulary at age 3. This finding held after taking into account a wide range of variables known to influence children's language development. Household instability (e.g., number of people moving in and out of the household, changes in residence and care providers) was not predictive of adverse language outcomes ( Vernon-Feagans et al., 2012 ). In another longitudinal study, a questionnaire was used to assess household chaos based on whether parents had a regular morning routine, whether a television was usually on in the home, how calm the home atmosphere was, and the like when children were in kindergarten. Parent-reported chaos accounted for variations in child IQ and conduct problems in first grade beyond other home environment predictors of these outcomes such as lower parental education and poorer home literacy environment ( Deater-Deckard et al., 2009 ). In other studies, children rating their homes as more chaotic have been found to earn lower grades ( Hanscombe et al., 2011 ) and to show more pronounced conduct and hyperactivity problems ( Fiese and Winter, 2010 ; Hildyard and Wolfe, 2002 ; Jaffee et al., 2012 ; Repetti et al., 2002 ; Sroufe et al., 2005 ).

Household chaos has strong negative associations with children's abilities to regulate attention and arousal ( Evans and Wachs, 2010 ). Children raised in chaotic environments may adapt to these contexts by shifting their attention away from overstimulating and unpredictable stimuli, essentially “tuning out” from their environment ( Evans, 2006 ). In the short term, this may be an adaptive solution to reduce overarousal. In the long term, however, it may also lessen children's exposure to important aspects of socialization and, in turn, negatively affect their cognitive and social-emotional development.

Emerging evidence suggests that the relationship between household chaos and poorer child outcomes may involve other aspects of the home environment, such as maternal sensitivity. In chaotic environments, for example, longitudinal research shows that parents' abilities to read, interpret, and respond to their children's needs accurately are compromised ( Vernon-Feagans et al., 2012 ). Furthermore, supportive and high-quality exchanges between caregivers and young children, thought to support young children's abilities to maintain and volitionally control their attention, are fewer and of lower quality in such environments ( Conway and Stifter, 2012 ; Vernon-Feagans et al., 2012 ). This association is likely to be of particular importance in infancy, when children lack the self-regulatory capacities to screen out irrelevant stimuli without adult support ( Conway and Stifter, 2012 ; Posner and Rothbart, 2007 ).

Even ambient noise from the consistent din of a television playing in the background is associated with toddlers' having difficulty maintaining sustained attention during typical play—a building block for the volitional aspects of executive attentional control ( Blair et al., 2011 ; Posner and Rothbart, 2007 ). Studies with older children and adults show that chronic exposure to noise is related to poorer attention during visual and auditory search tasks (see Evans, 2006 ; Evans and Lepore, 1993 ).

In addition, household chaos likely serves as a physiological stressor that undermines higher-order executive processes. Theoretical and empirical work indicates that direct physiological networks link the inner ear with the myelinated vagus of the 10th cranial nerve—a key regulator of parasympathetic stress response ( Porges, 1995 ). Very high or very low frequencies of auditory stimuli such as those present in ambient and unpredictable noise directly trigger vagal responses indicative of parasympathetic stress modulation ( Porges et al., 2013 ). In the same way, novel unpredictable and uncontrollable experiences can activate the hypothalamic-pituitary-adrenal (HPA) 1 axis ( Dickerson and Kemeny, 2004 ). General levels of chaos play a role in children's autonomic nervous system and HPA axis functioning ( Blair et al., 2011 ; Evans and English, 2002 ) in ways that may negatively affect executive functioning ( Berry et al., 2012 ; Oei et al., 2006 ).

Highly chaotic environments also may affect children's language and early literacy development through similar mechanisms. Overstimulation, which may overtax children's attentional and executive systems, may challenge young children's ability to encode, process, and interpret linguistic information ( Evans et al., 1999 ). The lack of order in such an environment also may impair children's emerging executive functioning abilities (see Schoemaker et al., 2013 ). Better executive functioning has been found in longitudinal research to be strongly associated with larger receptive vocabularies in early childhood ( Blair and Razza, 2007 ; Hughes and Ensor, 2007 ), as well as with lower levels of externalizing behaviors ( Hughes and Ensor, 2011 ). Other longitudinal studies have found positive relationships between family routines and children's executive functioning skills during the preschool years (e.g., Hughes and Ensor, 2009 ; Martin et al., 2012 ; Raver et al., 2013 ).

Behavioral Discipline Practices

Parental guidance or discipline is an essential component of parenting. When parents discipline their children, they are not simply punishing the children's bad behavior but aiming to support and nurture them for self-control, self-direction, and their ability to care for others ( Howard, 1996 ). Effective discipline is thought to require a strong parent-child bond; an approach for teaching and strengthening desired behaviors; and a strategy for decreasing or eliminating undesired or ineffective behaviors ( American Academy of Pediatrics, 1998 ).

Effective discipline entails some of the parenting practices discussed earlier. In children's earliest years, for example, discipline includes parents' use of routines that not only teach children about the behaviors in which people typically engage but also help them feel secure in their relationship with their parent because they can anticipate those daily activities. As infants become more mobile and begin to explore, parents need to create safe environments for them. Beginning in early childhood and continuing as children get older, positive child behavior may be facilitated through parents' clear communication of expectations, modeling of desired behaviors, and positive reinforcement for positive behaviors ( American Academy of Pediatrics, 2006 ). Over time, children internalize the attitudes and expectations of their caregivers and learn to self-regulate their behavior.

Parents' use of corporal punishment as a disciplinary measure is a controversial topic in the United States. Broadly defined as parents' intentional use of physical force (e.g., spanking) to cause a child some level of discomfort, corporal punishment is assumed to have as its goal correcting children's negative behavior. Many researchers and professionals who work with children and families have argued against the use of physical punishment by parents as well as in schools ( American Psychological Association, 2016 ; Hendrix, 2013 ). Although illegal in several countries, in no U.S. state is parents' use of corporal punishment entirely prohibited, with some variation in where states draw the line between corporal punishment and physical abuse ( Coleman et al., 2010 ; duRivage et al., 2015 ).

The state laws are consistent with the views of many Americans who approve of the use of spanking, used by many parents as a disciplinary measure with their own children ( Child Trends Databank, 2015a ; MacKenzie et al., 2013 ). In a 2014 nationally representative survey of attitudes about spanking, 65 percent of women and 78 percent of men ages 18-65 agreed that children sometimes need to be spanked ( Child Trends Databank, 2015a ). Among parents participating in the Fragile Families and Child Well-Being Study, 57 percent of mothers and 40 percent of fathers reported spanking their children at age 3, and 52 percent of mothers and 33 percent of fathers reported doing so when their children were age 5 ( MacKenzie et al., 2013 ).

Although physical punishment often results in immediate cessation of behavior that parents view as undesirable in young children, the longer-term consequences for child outcomes are mixed, with research showing a relationship with later behavioral problems. In a systematic review of studies using randomized controlled, longitudinal, cross-sectional, and other design types, Larzelere and Kuhn (2005) found that, compared with other disciplinary strategies, physical punishment was either the primary means of discipline or was severe was associated with less favorable child outcomes. In particular, children who were spanked regularly were more likely than children who were not to be aggressive as children as well as during adulthood.

More recent analyses of data from large longitudinal studies conducted in the United States show positive associations between corporal punishment and adverse cognitive and behavioral outcomes in children ( Berlin et al., 2009 ; Bodovski and Youn, 2010 ; MacKenzie et al., 2013 ; Straus and Paschall, 2009 ). Using data from two cohorts of young children (ages 2-4 and 5-9) in the National Longitudinal Survey of Youth, Straus and Paschall (2009) found that children whose mothers reported at the beginning of the study that they used corporal punishment performed worse on measures of cognitive ability 4 years later relative to children whose mothers stated that they did not use corporal punishment. In the Early Head Start National Research and Evaluation Project, Berlin and colleagues (2009) found that spanking at age 1 predicted aggressive behavior problems at age 2 and lower developmental scores at age 3, but did not predict childhood aggression at age 3 or development at age 2. The overall effects of spanking were not large. In the Fragile Families and Child Well-Being Study, MacKenzie and colleagues (2013) found that children whose mothers spanked them at age 5 relative to those whose mothers did not had higher levels of externalizing behavior at age 9. High-frequency spanking by fathers when the children were age 5 was also associated with lower child-receptive vocabulary at age 9. These studies controlled for a number of factors besides parents' use of physical punishment (e.g., parents' education, child birth weight) that in other studies have been found to be associated with negative child outcomes.

Some have proposed that the circumstances in which physical discipline takes place (e.g., whether it is accompanied by parental warmth) may influence the meaning of the discipline for the child as well as its effects on child outcomes ( Landsford et al., 2004 ). Using data from a large longitudinal survey, McLoyd and Smith (2002) found that spanking was associated with an increase in problem behaviors in African American, white, and Hispanic children when mothers exhibited low levels of emotional support but not when emotional support from mothers was high.

Time-out is a discipline strategy recommended by the American Academy of Pediatrics for children who are toddlers or older ( American Academy of Pediatrics, 2006 ), and along with redirection appears to be used increasingly by parents instead of more direct verbal or physical punishment ( Barkin et al., 2007 ; LeCuyer et al., 2011 ). Yet for some parents, use of time-out may not be optimal, and parents who consult the Internet for how best to use this disciplinary technique may find the information to be incomplete and/or erroneous ( Drayton et al., 2014 ). Research on best practices for the use of time-out continues to emerge, generally pointing to relatively short time-outs that are shortened further if the child responds rapidly to the request to go into time-out and engages in appropriate behavior during time-out ( Donaldson et al., 2013 ), or may be lengthened if the child engages in inappropriate behavior during time-out ( Donaldson and Vollmer, 2011 ). However, these studies are limited by very small sample sizes. States, seeking to shape briefer and more effective uses of the technique and to avoid prolonged seclusion, are just beginning to prescribe how time-out should be administered in schools ( Freeman and Sugai, 2013 ).

• PARENTING WITHIN FAMILY SYSTEMS

As discussed in Chapter 1 , while focusing on the parenting knowledge, attitudes, and practices that can help children develop successfully, the committee recognized that “human development is too complicated, nuanced, and dynamic to assert that children's parents alone determine the course and outcome of their ontogeny” ( Bornstein and Leventhal, 2015, p. 107 ). Parenting knowledge, attitudes, and practices are embedded in various ecologies that include family composition, social class, ethnicity, and culture, all of which are related to how parents treat their children and what they believe about their children as they grow, and all of which affect child outcomes.

Family systems theory offers a useful perspective from which to view parenting behavior, to understand what shapes it, and to explain its complex relation to child outcomes. As a system, the family operates according to an evolving set of implicit rules that establish routines, regulate behavior, legitimate emotional support and expression, provide for communication, establish an organized power structure or hierarchy, and provide for negotiating and problem solving so that family tasks can be carried out effectively ( Goldenberg and Goldenberg, 2013 ). Families as systems also create a climate or internal environment with features that shape parenting behavior and influence child outcomes. Family climates can be characterized along various dimensions, such as cohesive-conflictual, supportive-dismissive, tightly or loosely controlled, orderly-chaotic, oriented toward academic achievement or not, expressive of positive or negative emotions, hierarchical-democratic, fostering autonomy versus dependence, promoting stereotypical gender roles or not, and fostering strong ethnic and cultural identity or not.

Roles are defined within the family system in ways that may influence parenting. Family members may operate with a division of labor based on their own personal resources, mental health, skills, and education, in which one member specializes in and is responsible for one set of functions, such as garnering economic resources needed by the family, and another takes responsibility for educating the children. When these differences work well, family members complement and compensate for one another in ways that may soften the rough edges of one and make up for the inadequacies of another.

As discussed in this chapter and throughout the report, children do best when they develop sustaining and supportive relationships with parents. Yet while attachment theory has been useful in understanding mainly how mothers form relationships with children, it has been less useful at guiding research with fathers ( Grossmann et al., 2002 ), and relatively little research has examined other relations of the family system and microsystems where family members spend time (e.g., school, church, work). As systems, however, families are interdependent with the broader world and thus are susceptible to influences and inputs from their environments. Actions occurring in one system can result in reactions in another. For example, children who have not developed healthy relationships with their parents may have difficulty developing positive relationships with teachers.

In short, family systems are influenced by the evolving cultural, political, economic, and geographic conditions in which they are embedded. Members of a cultural group share a common identity, heritage, and values, which also reflect the broad economic and political circumstances in which they live. An understanding of salient macrolevel societal shifts (e.g., rates of cohabitation or divorce), along with microsystem influences (e.g., attachments with multiple caregivers and shifts in attachment patterns across childhood into adulthood) that are the subject of more recent research, can be helpful for rethinking parenting processes, what influences them, and how they matter for children. This rethinking in turn highlights the need to understand how complex living systems function and how they reorganize to accommodate changes in their environments ( Wachs, 2000 ).

The following key points emerged from the committee's examination of core parenting knowledge, attitudes, and practices:

• Parental knowledge of child development is positively associated with quality parent-child interactions and the likelihood of parents' engagement in practices that promote their children's healthy development. Research also indicates that parents with knowledge of evidence-based parenting practices, especially those related to promoting children's physical health and safety, are more likely than those without such knowledge to engage in those practices. Although there is currently limited empirical evidence on how parents' knowledge of available services affects uptake of those services, parenting, and child outcomes, parents with this knowledge are likely better equipped to access services for their families.
• As mediators of the relationship between knowledge and practice, parental attitudes about the roles of parents and others in the raising of young children, as well as about specific practices (e.g., breastfeeding, immunization), can contribute to some variation in practices and in the uptake of services among individuals and subpopulations. The committee found that empirical studies on parenting attitudes do not allow for the identification of core parenting attitudes consistently associated with positive child outcomes. However, the available evidence points to a need for taking parents' attitudes and beliefs into consideration in the design and implementation of programs and services in order to improve their reach.

contingent responsiveness (serve and return);

showing warmth and sensitivity;

routines and reduced household chaos;

shared book reading and talking to children;

practices related to promoting children's health and safety—in particular, receipt of prenatal care, breastfeeding, vaccination, ensuring children's adequate nutrition and physical activity, monitoring, and household/vehicle safety; and

use of appropriate (less harsh) discipline.

• Much of the existing research is focused on mothers. A lack of research exists on how parenting knowledge, attitudes, and practices may differ for fathers and other caregivers (e.g., grandparents). Studies suggest some variation in parenting knowledge, attitudes, and practices among racial/ethnic, cultural, and other demographic groups, but more attention is needed to whether and how these differences matter for child outcomes.
• With regard to practices that promote children's cognitive skills, research to date has examined primarily the effect of parenting on children's language and literacy skills. Research on how parenting affects other cognitive domains, such as math and problem-solving skills, would deepen understanding of the relationship between parenting and children's cognitive development.
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The HPA axis “regulates the release of cortisol, an important hormone associated with psychological, physiological, and physical health functioning” (Dickerson and Kemeny, 2004, p. 355).

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How to manage conflicts and set examples when parenting your teenagers in a digital era

Associate Professor, Department of Psychology, King's University College, Western University

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Teenagers’ needs for independence and privacy increase dramatically during adolescence. Today, many parents struggle with concerns about their teens’ screen time and digital safety, and for good reason. There is widespread opinion that technology and social media use is harmful for young people .

However, as many parents will know, getting teens to reduce their screen time is often far easier said than done. Conflict often results when parents voice their concerns and institute their authority over teens . Our research team has been examining the role of the family and technology in adolescent development over the last 20 years.

Our research with Canadian parents and youth has indicated that 85 per cent of parents say that conflict with their teens over technology use negatively impacts the whole family. Teens are likely to shut down or hide their activities from family members. We found that 70 per cent of teens admitted to keeping secrets about their online behaviour.

This cycle of family conflict and teen secrecy plays out in households around the country and parents are unsure about how to protect teens from online harms and maintain open family communication.

Read more: School board social media lawsuits: For too long we've sought individual solutions to a collective problem

Teen tech use

Almost 95 per cent of adolescents have smartphone access, and about 50 per cent of teens say they use the internet “almost constantly.” During the early teen years, when the brain is going through rapid transformations, children seek more freedom, belongingness with peers and self-discovery, and they tend to take more risks.

Unlike any generation before, 21st century teens may be trying to fulfill these developmental needs using technology. This was especially true during the pandemic , when Canadian teens were forced to connect to others online, with both positive and negative consequences for well-being. To date, we do not fully understand how pandemic restrictions have impacted teens. We also do not know how technology affects teens in the long-term.

However, some experts have warned that everyday technology use and screen time alone does not indicate a teen is experiencing dysfunction . Instead, specific behaviours and motivations for teens’ technology and social media use, including cyberbullying or problematic and deceptive uses , may provide a better understanding of negative consequences.

Research has found that parents’ and teens’ online behaviour patterns are similar to one another . In our research, presented at the 2024 Canadian Psychological Association in Ottawa, we found parents who spend more time online have teens who spend more time online. Parents who reported experiencing addictive online behaviours had teens who also reported similar levels of addictive online behaviours. Teens who reported more pressure to gain likes and followers had parents who reported similar levels of social media pressure.

This indicates that online behaviour may be modelled intergenerationally. Parents model online behaviour that their teens are likely to emulate, and vice versa. It also means that if parents are more aware of their own technology and social media use, they can model balanced online and offline engagement.

What can parents do?

Parents have been given many recommendations to help their teens. At present, there is mixed support that any specific parental practices can mitigate problematic technology use during adolescence

However, cultivating family warmth, cohesion and communication helps teens manage their social media and technology use . Our research shows that high levels of parent-child communication, strong parent-child relationships and self-regulation corresponded with lower levels of problematic social media use and less secrecy between parents and teens.

To support teens’ autonomy, families that foster open dialogues about online activities, and establish trust and rules about social technology, are likely to alter the negative impacts on teens.

Together, parents and teens could discuss their perspectives on this topic . Here are some questions to ask yourself and your teens about their behaviour and move beyond simply checking in on screen time:

How do I/my teen spend time online?

Genuine and positive interactions with others online can be beneficial for well-being. However, teens who spend long periods of time scrolling through social media might engage in negative social comparisons or enact false self-presentations that can lead to insecurity .

What am I/my teen doing online?

Spending time online to maintain close relationships and inspire creativity (in person or digitally) appear to be adaptive motives for engaging with social technology. But motivations to engage with it stemming from anxiety, fear of missing out , or addiction tend to be maladaptive. Motives to increase perceived social status and seek attention can also be harmful .

Who am I/my teen spending time online with?

Are you or your teen spending time online alone, with friends or strangers? Are you watching content together? While spending time online together can be fun and a great conversation starter, co-using media may also be associated with problematic use , possibly by encouraging more time online.

Reflecting on our own technology use as parents, and encouraging our teens to do the same, can enhance self-regulation, communication and cohesion within the family and, in turn, increase digital well-being.

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What Research Says About Being a Stay-at-Home Parent

Ask people what they think about  stay-at-home moms  (SAHMs) and stay-at-home parents in general, and you'll likely get a variety of answers. Some might say they've got it easy, or that life at home with the kids would be boring. Some might think they're lazy or not contributing much to society. Others contend that stay-at-home parents are making the best decision of their lives and that they're making a noble, worthwhile sacrifice to stay home and nurture their kids day in and day out.

If you're contemplating whether or not to be a stay-at-home parent, what matters most is what works best for your family. So, first and foremost, consider your personal beliefs, priorities, finances, and lifestyle. However, there is also a wealth of research on the subject that you can consult when making your decision. The findings on life as a stay-at-home parent may surprise you.

Brianna Gilmartin

Pros and Cons of Staying at Home

There are, of course, many personal reasons for or against staying home with your kids. Benefits may include more opportunities for quality time with your children and having more direction over their learning and development. You may not want to miss a minute of their childhoods. You also might not trust others to care for your little loves. Drawbacks include the big hit to your family's income and the trajectory of your career as well as the big change to your lifestyle.

While there is no right or wrong answer, this research may help inform your choice. Remember that each of these benefits and drawbacks may or may not apply to you. There are many different factors, such as budget, lifestyle, priorities, social support, relationship status, spousal involvement, and your kids' specific needs, to consider before making your final decision.

Evidence-Based Benefits of Being a Stay-At-Home-Parent

There are many reasons that parents choose to stay at home with their children. Studies have shown that many people think this is the best option for kids when financially plausible. According to a Pew Research Center study, about 18% of American parents stayed home with their children in 2021.

According to Pew Research Center's Social and Demographic Trends, 60% of Americans say a child is better off with at least one parent at home. While 35% of responders said that kids are just as well off with both parents working outside the home.

Benefits for Children of Stay-at-Home-Parents

A 2014 study found that the benefits of having a parent at home extend beyond the early years of a child's life. The study measured the educational performance of 68,000 children. Researchers found an increase in school performance to high school-aged children. However, the biggest educational impact was on kids ages 6 and 7.

Most  homeschooled students  also have an at-home parent instructing them. A compilation of studies provided by the National Home Education Research Institute supports the benefits of a parent at home for educational reasons. Some research has found homeschoolers generally score 15 to 30 percentile points above public school students on standardized tests and achieve above-average scores on the ACT and SATs.

Regardless of whether parents stay home or work outside the home, research shows that parent involvement in schools makes a difference in children's academic performance and how long they stay in school.  Some kids with learning differences and/or special needs may do better in a school (vs. homeschooling) to access any required services .

Decreased Stress and Aggression in Kids

Some studies link childcare with increased behavioral problems and suggest that being at home with your children offers benefits to their development compared with them being in  being in childcare  full-time.  This may be reassuring news for stay-at-home parents knee-deep in diapers and temper tantrums.

Studies have found that children who spend a large amount of their day in daycare experience high stress levels, particularly at times of transition, like drop-off and pick-up.

Subsequent studies also showed higher levels of stress in children in childcare settings compared with those who are cared for at home. But that doesn't mean you have to keep your children with you every minute until they're ready to go to school. Look for a nanny or babysitting co-op that allows your kids to play with others while giving you some time alone.

Greater Control of Children's Upbringing

The ability to directly protect, spend time with, and nurture their children each day is often cited as a primary benefit of not working outside the home. Studies show that some parents stay home specifically to have greater first-hand control over the influences their child is exposed to. Others simply see it as their duty to be the one who provides daily care to their little ones.

More Parents Want to Stay Home

According to the Pew Research Center, more people are becoming stay-at-home parents—and 60% of Americans believe that choice is best for children. The number of stay-at-home parents jumped from a low of 23% in 1999 to 29% in less than 15 years. However, today's rates don't match those of the 1970s and earlier when around 50% of women (and very few men) were stay-at-home parents.

While the number of men taking on this role is far lower than that of women (around 210,000 compared with over 5.2 million), the rate of men becoming stay-at-home dads is on an upswing, too. Between 2010 and 2014, the prevalence of men choosing to stay home increased by 37%.

Downsides of Being a Stay-at-Home Parent

Regardless of the increasing numbers and some important benefits, a decision to quit your job to become a stay-at-home parent shouldn't be made out of guilt or peer pressure. While there are many great reasons to be a stay-at-home parent, it's not necessarily right or beneficial (or financially plausible) for everyone. For some families, the drawbacks significantly outweigh any positives.

Some People Miss Working

Research shows that many stay-at-home parents miss working outside the home and think about  going back to work  someday.  It can be tough to leave behind the tangible rewards and results of a job, especially one you enjoyed and were good at.

If you stay home when your kids are little but plan to return to the workforce, you can take some steps to bridge that employment gap, such as taking classes, earning licenses or certificates that enhance your resume, or even taking a part-time job.  You might also consider at-home business opportunities as well as  remote jobs  that let you stay home while also earning money and reclaiming some of what you missed about your career.

Costs to Your Career and Wallet

The decision to stay at home with your kids means giving up income. Research shows that stay-at-home parents must contend with lost wages now and decreased wages when returning to work. This "wage penalty" often amounts to 40% less in earned income over time.

There is also a big hit to the stay-at-home parent's career trajectory. Some parents can regain their previous work roles upon reentering the workforce, while others struggle to get a foothold professionally after taking time off.

The direct impact on your family's finances will depend on your personal earning potential, skills, and career choices—as well as the income of your partner if you have one. However, studies show that mothers who reenter work after having children experience between a 5% and 10% pay gap compared with their childless peers. This is in addition to the gender pay gap.

Adverse Impacts on Physical and Mental Health

Studies show that stay-at-home parents experience poorer physical and mental health compared with parents who work outside the home. Effects include higher rates of mental health conditions, such as depression and anxiety, as well as higher rates of chronic illness. A 2012 Gallup poll surveyed 60,000 women including women with no children, working moms, and stay-at-home moms who were or were not looking for work, and found more negative feelings among SAHMs. There are likely several reasons for this, including experiencing more parental and financial stress. Working parents tend to have access to more robust health insurance plans than stay-at-home parents. They also tend to benefit from greater self-worth, personal control over their life, economic security, and more dynamic socio-economic support.

However, it's worth noting that significant research shows that whether they work outside the home or not, parents generally are less happy than their childless counterparts.  Of course, the joy you get from parenting (and staying home with the kids) is likely to be highly individual.

More Social Isolation

A 2015 study found that many moms are spending lots of time with their kids, more so than in years past. Researchers believe this extra kid-focus results in a higher potential for social isolation. Interestingly, the research found no scientifically proven difference in outcomes for the children with this additional parental attention.

Some stay-at-home parents may feel isolated or undervalued by what some call the " mommy wars, " which pit parents against each other. This social dynamic can create perceived judgments or pressures that leave some stay-at-home parents feeling like they're not respected as worthy members of society. On the flip side, some working parents may feel criticized for not spending as much time with their children. Both groups can end up feeling socially isolated.

A 2021 study found that around a third of all parents experience loneliness. That's why it's so important for all parents (whether they stay at home or work outside the home) to find the right balance of social activities, exercise, sleep, hobbies, and self-care. Additionally, it's helpful to make the most of your family time, including  creating gadget-free zones  and planning fun activities you can all enjoy.

It's also key to take care of your own emotional well-being and let your children spend some time away from you. Whether it's a date night with your spouse or scheduling a day off so you can have some alone time, you're not going to shortchange your child because you didn't spend every minute with them. Giving yourself parenting breaks and opportunities to socialize is important for your well-being, particularly during times of stress.

Parenthood and well-being: A decade in review .  J Marriage Fam .

Stay at home moms and dads account for about 1-in-5 U.S. parents . Pew Research Center. 

After decades of decline, a rise in stay-at-home mothers . Pew Research Center. 

Home with mom: The effects of stay-at-home parents on children’s long-run educational outcomes .  J Labor Econ. 

National Home Education Research Institute.  Research facts on homeschooling .

Effect of parental involvement on children’s academic achievement in chile .  Front Psychol.  

School performance among children and adolescents during COVID-19 pandemic: A systematic review .  Children (Basel) .

The NICHD study of early child care and youth development . U.S. Department of Health and Human Services. 

Toddlers’ stress during transition to childcare .  European Early Childhood Education Research Journal .

Examining change in cortisol patterns during the 10-week transition to a new child-care setting .  Child Dev .

7 key findings about stay-at-home moms . Pew Research Center. 

The mother's perspective: Factors considered when choosing to enter a stay-at-home father and working mother relationship .  Am J Mens Health .

The relationships between mothers' work pathways and physical and mental health .  J Health Soc Behav .

The motherhood penalty at midlife: Long-term effects of children on women's careers .  J Marriage Fam .

Parents' work schedules and time spent with children .  Community Work Fam .

Gallup.  Stay-at-home moms report more depression, sadness, anger .

Parenthood and happiness: Effects of work-family reconciliation policies in 22 OECD countries .  AJS .

Does the amount of time mothers spend with children or adolescents matter? .  J Marriage Fam.

Experiencing loneliness in parenthood: A scoping review .  Perspect Public Health .

  First things first: Parent psychological flexibility and self-compassion during COVID-19.   Behav Anal Pract .

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• Published: 05 August 2024

An investigation of the association between parenting style and child’s dental caries: a cross-sectional study

• Solafa Ayoub 1 ,
• Matthew D. Finkelman 2 ,
• Gerald J. Swee 3 ,
• Mohamed Hassan 4 &
• Cheen Y. Loo 3  

Scientific Reports volume  14 , Article number:  18134 ( 2024 ) Cite this article

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To investigate the association between parenting style and child’s dental caries. Parents presenting with their children to the Department of Pediatric Dentistry at Tufts University School of Dental Medicine for an initial exam or re-care appointment completed a demographic survey and the parenting styles and dimensions questionnaire. Recruitment of subjects started in May 2019 and ended in February of 2020. Child’s decayed, missing, and filled teeth (dmft) index, diet score, sex, and age were recorded, as were parent’s race, education level, and form of payment. Adjustment for confounders was done using multivariable negative binomial regression. The sample size was 210 parent/child dyads. In the multivariable analysis, parenting style and child’s dmft were not significantly associated ( p  > 0.05). Parents with an education level less than high school ( p  = 0.02) and at the high school graduate level ( p  = 0.008) were significantly associated with children who had higher dmft, compared to parents with a college degree or higher. Children with excellent diet scores had significantly lower dmft than children with a diet score in the “needs improvement” category ( p  = 0.003). There was no significant evidence that parenting style is associated with child’s dental caries. Parent’s education level and child’s diet score were significantly associated with child’s dmft, less than high school ( p  = 0.02) and at the level of high school graduate ( p  = 0.008). Pediatric dental professionals should be aware of these risk indicators.

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Ethnic inequalities in child oral health behaviours among five- and eight-year-old children from England, Wales and Northern Ireland

Introduction.

Dental caries is the most common chronic disease of childhood that can affect the well-being of children and their quality of life. 1 The 2022  Global Oral Health Status Report stated that more than 500 million children around the world have caries in their primary teeth. 2 The disease can result in pain, infection, problems with eating, poor speech development, low self-esteem, trouble sleeping, missed school days, and failure to thrive. 3 , 4 , 5 .

As dental caries is multifactorial, a conceptual model was developed by Fisher-Owens et al. to identify the interactive causes that contribute to it. This model indicates that numerous factors affect a child’s oral health, including factors at the family level. 6 Because children’s behaviors are shaped from a young age and are influenced by their parents, parenting style may play a role in the development of dental caries in children. 7 In Baumrind’s pioneering work on parenting style, she defined three specific styles: authoritative, authoritarian, and permissive. 8 An authoritative parenting style (which is characterized by high control and warmth, and includes demandingness and responsiveness; the setting and enforcing of limits; the granting of autonomy where appropriate; emotional support; and bidirectional communication) assists children and adolescents in developing independence, self-control, and a balance of societal and individual needs and responsibilities. 9 , 10 , 11 The authoritarian style is characterized by high control and low warmth (including strict discipline along with a lack of bidirectional communication or sensitivity to the child’s emotional needs), while the permissive style is characterized by low control and typically high warmth (including a tendency to indulge the child and a lack of limits). 8 , 10 , 12 Both the authoritarian and permissive styles have been found to be significantly associated with negative indicators of psychological health in children, as compared to the authoritative style. 12 A fourth type of parenting style, neglectful, is characterized as having low warmth and low control. Neglectful parents are often emotionally detached and not involved in their children’s lives; sparse research has been done on this parenting style, because these parents frequently do not make themselves available to participate in studies involving their children. 13 .

Parenting styles are changing, with some authors suggesting that a permissive style has become more common in the United States. 14 , 15 , 16 Pediatric dentists should be mindful of risk indicators of poor oral health in order to be well-prepared to treat each patient in the most efficacious manner. Therefore, if a certain parenting style is a risk indicator for a high level of dental caries in children, dentists should be aware of this association, as it may influence the frequency of visits, monitoring patterns, and other elements of treatment planning.

Some evidence supports a potential relationship between parenting style and dental caries, but limited research has investigated this topic. Furthermore, conflicting results have been published. A 2019 study conducted in Saudi Arabia identified two parenting styles among their sample: authoritative and permissive parenting styles. The study found no statistically significant association between parenting style and child’s dental caries. 17 On the other hand, a 2020 study conducted in India found a significant association between parenting style and child’s dental caries, with children of permissive parents exhibiting the highest level of caries. 18 In a study performed in the United States, Howenstein et al. found that authoritative parents had children with less dental caries, in comparison with children of authoritarian and permissive parents. 7 A limitation of this study’s design was that it simply grouped patients based on the presence or absence of dental caries and therefore could not draw inferences about the magnitude of dental caries.

The primary aim of this study was to investigate the association between parenting style and child’s magnitude of dental caries. The secondary aim was to explore associations between other potential risk indicators and child’s magnitude of dental caries. It was hypothesized that children with authoritative parents have less dental caries than children with authoritarian and permissive parents.

A sample size of at least 20 parent–child dyads per parenting style was reached after a total sample size of 210 dyads had been obtained. Of the 210 parents, 159 (75.7%) were classified by the PSDQ as having an authoritative parenting style, while 31 (14.8%) were classified as permissive and 20 (9.5%) were classified as authoritarian (Table 1 ). The majority of parents identified as female (77.6%) and non-Hispanic (83.8%); nearly half of parents identified as Asian (48.1%). Most parents were married (65.7%), lived in urban locations (67.1%), and had insurance coverage through the MassHealth program (70.5%). The most common number of children per parent was two (46.7%), while the most common education level was high school graduate (37.1%) and the most common annual household income was < $25,000 (26.2%). The mean (SD) age of parents was 35.5 (6.0) years (Table 1 ). Most children in the sample were female (55.2%), were visiting the dental clinic for cleaning (re-care) (72.9%), and were categorized as having an excellent diet (57.1%). The most common child age was three years old (31.4%), while the most common birth order was second child (34.8%) (Table 1 ).

Table 2 shows results related to the bivariate association between parenting style and child’s dmft, and Fig.  1 presents side-by-side box plots comparing the dmft of children from the three parenting styles. The median dmft score and IQR for the authoritative, authoritarian, and permissive parenting styles were 3.0 (0.0, 8.0), 6.5 (0.5, 10.0) and 8.0 (4.0, 12.0), respectively. The highest median dmft was exhibited by children of permissive parents, while the lowest median dmft was exhibited by children of authoritative parents. The difference between parenting styles was statistically significant based on the Kruskal–Wallis test ( p  = 0.01). In post-hoc comparisons, the only significant difference was between the permissive and authoritative parenting styles ( p  = 0.004).

Box plots showing the relationship between parenting style and child’s dmft score.

Table 3 presents results from the multivariable negative binomial regression model. When adjusting for confounding, parenting style was no longer significantly associated with child’s dmft ( p  > 0.05). However, parent’s education level and child’s diet score were significantly associated with child’s dmft. Specifically, parents with an education level less than high school ( p  = 0.02) and at the level of high school graduate ( p  = 0.008) were significantly associated with children who had higher dmft, compared to parents with a college degree or higher. Children with excellent diet scores had significantly lower dmft than children with a diet score in the “needs improvement” category ( p  = 0.003). No other variable in the model was significantly associated with child’s dmft.

The question of association between parenting style and the dmft remains unanswered. In the current study, our bivariate analysis found a statistically significant association between parenting style and child’s dmft, in which children of authoritative parents had lower dmft than children of permissive parents. This finding is consistent with the results of Howenstein et al. 7 and Viswanath et al. 18 On the other hand, Alagla et al. found no significant association between parenting style and caries experience in bivariate analysis, although there was a trend for children of authoritative parents to be less likely to have caries experience than children of permissive parents. 17 The ability of Alagla et al.’s study to detect an association may have been limited by their sample, in whom nearly all children had caries. 17 .

A high dmft among children of permissive parents could potentially be due to a dynamic in which the parents allow their children to decide for themselves whether to brush their teeth. Permissive parents may also allow their children to have a cariogenic diet with more frequent snacking in between meals. Parents may also be using cariogenic drinks or food as a reward or bribe to achieve good child behavior. On the other hand, authoritative parents may act as role models and explain to their children the importance of brushing their teeth and eating a healthy diet, making them more likely to perform those behaviors.

Nevertheless, it must be emphasized that there was no longer a significant association between parenting style and dmft once statistical adjustment for confounding was done via multivariable modeling, and inferences from our research must reflect this lack of significance. While the non-significant findings of our multivariable analysis may be counter-intuitive, it is important not to dismiss negative results, as a tendency to ignore such results leads to publication bias in meta-analyses. 22 , 23 .

The multivariable analysis also revealed that parent’s education level and child’s diet score were significantly associated with dmft, adjusting for the other independent variables in the model. Parents with an education level of less than high school, and high school graduate, had children with higher dmft than children of parents who had an education level of college degree or higher. These findings align with the results of Nourijelyani et al., who found that in Iran, higher education in mothers was significantly associated with better oral health status in children. 24 Parents with greater educational qualifications are more likely to be knowledgeable about the importance of toothbrushing and healthy dietary habits from a young age, which may result in their children having a lower dmft. 25 , 26 , 27 In the current study, significantly higher dmft was also found among children with a diet score that needs improvement, compared with a diet score of excellent. The connection between dental caries and cariogenic diets is well-known; children with better eating habits and healthier diets are less likely to develop early childhood caries in comparison with those with poor dietary habits and unhealthy diets. 28 , 29 , 30 .

The link between parenting style and child’s dental caries has been understudied thus far. An important aspect of the current research is that it is one of the first studies to investigate the relationship between parenting style and dmft. Another strength of the study is that it had a large sample size that was based upon a formal sample size calculation. Nevertheless, future studies should aim to include higher sample sizes in the authoritarian and permissive parenting styles, which had low representation compared with the authoritative parenting style. Previous studies had exhibited similar differential representation among the parenting styles. 7 , 17 , 18 Increasing the sample sizes of future studies will aid in either confirming or refuting our results.

One of the limitations of our study, and similar studies, is that some parents may tend to answer questions in a way that is socially desirable, so they might not be completely honest in their answers. This could result in misclassification bias, whereby a parent could in fact be a member of the authoritarian or permissive category but be classified as an authoritative parent by the PSDQ. Such a phenomenon might partially explain how our study and previous studies on parenting style included a substantially higher percentage of parents classified as authoritative, compared with the other styles. Another limitation of this study is that its design can only support inferences about association, not causation. In addition, our sample was a convenience sample obtained from parents bringing their children for a dental visit at a single academic institution. The study was conducted among a largely low-income group of subjects, and the sample had a higher percentage of parents identifying as Asian than the general United States population. Results might not generalize to other populations. It is also noted that in the conceptual model of Fisher-Owens et al., a child’s oral health is influenced by individual-level factors, family-level factors, and community-level factors. 6 Fisher-Owens et al. suggested employing hierarchical data analysis techniques when using their model. However, they acknowledged some challenges in applying their model in actual practice, for instance, the difficulty in finding datasets with all independent and dependent variables that would be pertinent to a given study. Fisher-Owens et al. noted that “a truly complete database would include a longitudinal component to adequately measure the time factor” 6 and recognized that this would be difficult to obtain. In the current research, the variables collected were limited and did not incorporate a longitudinal aspect. The inclusion of only one child per family also precluded the study of the correlation between children in the same family within a hierarchical statistical model. If a hierarchical model had been used, the findings vis-à-vis statistical significance might have been different, and this can be considered a further limitation of the study.

In addition to the recommendations above, future research could consider administering the survey to a more diverse population. Furthermore, future studies could collect additional information such as tooth brushing frequency, use of fluoridated toothpaste, ingestion of fluoridated water, and dental anxiety of parents and children. Qualitative research, such as interviews and focus groups with parents about their parenting style and the oral health care of their children, could also be performed. Such qualitative research would complement the quantitative results presented herein and provide further insight into the potential link between parenting style and child’s dental caries.

In Conclusions, we found no significant evidence that parenting style is a risk indicator for child’s dental caries when accounting for confounding variables. However, pediatric dental professionals should be aware that parent’s educational level and the child’s diet are risk indicators for child’s dental caries.

This cross-sectional study was conducted using a convenience sample obtained from parents bringing their children to a dental visit at the Department of Pediatric Dentistry at the Tufts University School of Dental Medicine, which is in the downtown area of Boston close to Chinatown making it easily accessible from that neighborhood. Most of our participants were Asian and many of the parents did not speak English, which limited their ability to participate in the study and made the recruitment phase longer. The study was approved by the Tufts Health Sciences Institutional Review Board (Study #13,222), and all methods were carried out in accordance with relevant guidelines and regulations. Inclusion criteria were English-speaking parent/legal guardian-child dyads presenting to the Tufts Pediatric Dentistry Clinic for the child’s initial dental examination or re-care visit and child’s age between 3–6 years old. Preschool is a crucial time for the establishment of dietary choices, oral health habits and behaviors. Children’s behaviors can be greatly influenced by their parents at a young age, which can significantly impact their oral health outcomes. Therefore, it is valuable to examine the association between parenting style and dental caries among children aged 3–6 years old. 17 , 18 Exclusion criteria were medically compromised patients with a physical or intellectual disability that could impact oral health in the opinion of the investigator (ASA III, ASA IV) and patients presenting for a dental emergency such as pain, infection, or trauma. A maximum of one child per family was included.

The patient population served at Tufts University School of Dental Medicine is diverse including individuals from various backgrounds and communities coming mainly from urban and suburban areas. During the initial exam or re-care dental visit for the child the following services were provided: medical and dental history review, clinical examination, taking dental radiographs if needed, treatment planning, professional cleaning, fluoride varnish application, diet counseling and oral hygiene instructions.

Informed consent was obtained from all participants’ legal guardian. One parent of each child was asked to complete a survey using a hard copy format. If a child presented with both parents, the parent who spent more time with the child, based on the parents’ judgment, was asked to fill out the survey. Before any survey item was administered, an information sheet regarding the study was provided by the principal investigator and/or co-investigator to each potential subject. The information sheet met all required elements of consent; the potential subject was given as much time as they desired to read it and consider the study. After the potential subject read the information sheet, any questions were answered. Potential subjects were reminded that their participation was voluntary, that they could choose to stop participating at any time without penalty, and that participation or the refusal to participate would have no effect on the child’s care.

The first part of the survey involved demographic data about the child and the family, including parent’s age, gender, ethnicity, race, marital status, number of children, education level, annual household income, location (urban, rural or suburban), and form of payment (self-pay, private insurance, MassHealth or other), as well as child’s sex, age, birth order, and reason for dental visit. The second part of the survey included questions from the shortened version of the Parenting Style and Dimensions Questionnaire (PSDQ), which has been developed and validated as a reliable instrument to classify parents as authoritative, authoritarian, or permissive. 19 , 20 , 21 The original instrument consists of 62 items, and the shortened version consists of 32 items. 20 , 21 Each item relates to one of the three parenting styles; in the shortened version, there are 15 items corresponding to the authoritative style, 12 items corresponding to the authoritarian style, and five items corresponding to the permissive style. Each item asks the respondent how often they (or they and their significant other, if applicable) exhibit a specified parenting behavior, using a Likert scale (1 = “Never”, 2 = “Once in a while,” 3 = “About half the time,” 4 = “Very often,” and 5 = “Always”). The score for each parenting style is defined as the mean of the item-level scores in that parenting style. Once such a mean has been computed for each of the styles, the parent’s style is defined as the style with the highest mean. The shortened version has been found to exhibit adequate Cronbach’s α values. 10 Apart from the survey, the child’s decayed, missing, and filled teeth (dmft) index and diet score (scored with three categories: excellent, good, and needs improvement) from their first dental visit to the Tufts Pediatric Dentistry Clinic were obtained from their axiUm record and had been determined by the treating well-trained pediatric dental resident under the supervision of faculty attending dentists. The diet questionnaire was based on a standardized scale used at Tufts University School of Dental Medicine, which was developed by nutritionist Carole A. Palmer, EdD, RD. While it shares similarities with components of the Healthy Eating Index (HEI) focusing on specific food groups beverages and eating behaviors, the questions were not adopted from it. This questionnaire aims to evaluate the dietary intake of the child, by asking questions about their consumption of fruits, vegetables, grains, dairy, proteins, beverages, snacks, and desserts. Furthermore, there are additional questions about the frequency and preferences of snacks. The responses provide insight about the quality of the child’s diet and areas that needs improvement.

Data collection occurred from May 2019 to February 2020. A sample size calculation was conducted using the computer program nQuery Advisor (Version 7.0) (Statistical Solutions Ltd., Cork, Ireland). The calculation followed the guidelines of the DELTA 2 project, which state that an assumed effect size can be based on findings in the literature regarding what difference may be considered realistic (and does not necessarily need to be based on the minimal clinically important difference (MCID)). 31 This methodological approach also received further support in the literature subsequently. 32 In the research of Howenstein et al., 7 20% of children in the authoritative parenting group exhibited caries, compared with 97% in the permissive parenting group and 91% in the authoritarian parenting group. Based on these empirically observed differences, a sample size of at least n = 20 per parenting style would be adequate to obtain power greater than 99% to detect a difference in the presence/absence of caries between parenting styles in conjunction with a Type I error rate of α = 0.05. Furthermore, because the dichotomization of continuous variables into binary “present or absent” categories results in a loss of information 33 (and conversely, the use of continuous variables provides a gain of information compared with binary variables), the comparison of parenting styles in terms of a continuous dmft variable provides this same power or more (again, greater than 99%) a fortiori in conjunction with the same Type I error rate and sample size. As the parenting style of a subject was not known until after they had completed the survey, recruitment proceeded until at least 20 subjects of each parenting style were obtained; the additional subjects recruited in two of the three groups could only enhance the power of the study.

Descriptive statistics were calculated including means, standard deviations (SDs), medians, and interquartile ranges (IQRs) for continuous variables and counts and percentages for categorical variables. In bivariate analyses, the difference in dmft between children with parents of different parenting styles was assessed using the Kruskal–Wallis test due to non-normality of the data; post-hoc comparisons were performed using Dunn’s test with the Bonferroni correction. The assumption of normality was assessed using the Shapiro–Wilk test. To adjust for confounding, multivariable negative binomial regression was also used; exponentiated regression coefficients along with 95% confidence intervals (CIs) were calculated. Analogous to the odds ratio (OR) statistic, a value greater than 1 for the exponentiated coefficient indicates a higher dmft for a given group, compared to a reference group, adjusting for the other variables in the regression model; a value less than 1 indicates a lower dmft for the given group, compared to the reference group, adjusting for the other variables in the model. P -values less than 0.05 were considered statistically significant, with the exception of analyses in which the Bonferroni correction was used. SPSS version 25 (IBM Corp., Armonk, NY, USA) was used in the statistical analysis.

Data availability 

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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(Corresponding Author) Dr. S.A contributed to developing the research question, conducting the research, data collection, interpretation of the results and research write up. Dr. Ayoub confirms the following statements: All authors have made substantive contribution to this study and/or manuscript, and all have reviewed the final paper prior to its submission. The article has not been published and is not being considered for publication elsewhere. Dr. M.F. contributed to the study design, sample size determination, data analysis, interpretation of findings, and manuscript writing. Dr. G.S. contributed to the study design and interpretation of findings. Dr. M.H. contributed to the Study design and manuscript. Dr. C.L. contributed to the study design, interpretation of findings and manuscript.

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Ayoub, S., Finkelman, M.D., Swee, G.J. et al. An investigation of the association between parenting style and child’s dental caries: a cross-sectional study. Sci Rep 14 , 18134 (2024). https://doi.org/10.1038/s41598-024-69154-4

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Home / Parenting, Kids & Teens / The parents’ role in their child’s therapy

The parents’ role in their child’s therapy

Part 3 of a Mayo Clinic Press Series: Navigating therapy for your child

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When your child or teen starts counseling or therapy, it can be unsettling to see a new, unknown adult enter your child’s intimate life. Parents can feel uncertain about how to interact with their child regarding therapy — or how to interact with the therapist regarding their child’s therapy.

“When a child or teenager gets therapy, parents should know at least a little of what the big-picture plan is,” advises Jocelyn R. Lebow, Ph.D., L.P., a pediatric clinical psychologist at Mayo Clinic. “The level of involvement varies depending on the age of the child and the nature of the problem, but if you’re dropping your kid off at therapy and you have absolutely no idea what’s going on, I don’t love that.”

If the therapist practices cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), exposure therapy, or other action- and practice-based therapies, then you should expect to see homework for your child between appointments. With all methods of therapy, you want the therapist to have a plan in place for your child to work through, with clearly outlined goals and clear criteria for ending treatment.

“For me, the biggest thing is for therapy to have a goal,” explains Dr. Lebow. “Ask your child and ask the therapist, ‘What are you doing?’ Both should be able to very clearly articulate what they are working on. So it’s not, ‘We just talk.’ Teenagers will sometimes say this. But the therapist should be able to articulate it better: ‘We’re trying to work on emotion regulation,’ something that feels tangible and correct with your understanding of what your child is going through.”

With younger children — but also with kids and teens as necessary — Dr. Lebow says parents might also reasonably attend part of a therapy session if they have questions. “Parents may want updates on progress, or have concerns about progress, or want to make sure the therapist knows some context or background information,” she explains. “I recommend going to a session and asking to have 5 to 10 minutes with the therapist for updates at the start or end so the kid knows this is happening. Ideally, the therapist will also reach out to keep the parent appropriately in the loop as therapy is going on. For other types of therapy — including FBT, parent management training, PCIT, DBT and parent-coached exposures — parents are actively involved in delivering interventions and should be part of the majority of many or all sessions.”

How to talk to your teen about therapy sessions

When your teenager starts therapy, it’s usual for a parent to feel awkward or self-conscious about knowing the appropriate amount of involvement. It’s a delicate line between wanting your teen to feel supported and respecting that there might be discussions of issues the teen wishes to keep private from you.

“For teens, therapy works best when the adolescent feels like there is some autonomy and privacy,” Dr. Lebow explains. “And the limits to that are well defined by the legal system. For patients under 18, there are limits to confidentiality around reporting thoughts or behaviors related to harming themselves or others, or reports of abuse of vulnerable groups like kids, older people and people with disabilities. It should be explained at the start of therapy that any reports of dangerous behaviors will need to be shared with parents or guardians by the therapist.”

Around this baseline of privacy, a parent can then gently show support, explains Dr. Lebow. “I might suggest being transparent with the child in a way that shows interest without being intrusive. This can be saying something at the start of therapy, like ‘I want you to know I’m always here to talk about your therapy, especially if stuff comes up that you want to discuss, or with which you need my support or help.’ “

Dr. Lebow also then recommends specifically checking that your teen has a good rapport with the therapist before underscoring that this is the teen’s therapy process. “I would say something like this: ‘I want to make sure you feel like you can talk to your therapist openly and to also let you know I’m not going to pry — either by trying to get details out of you or by trying to get them from the therapist.’ “

Once this initial setup is out of the way, parents can move to showing routine support. “You can ask follow-up general questions occasionally without pushing, like ‘How was therapy today?’ ” Dr Lebow says. “And doing this is probably sufficient to keep the door open while respecting your teen’s privacy.”

Your child’s relationship with the therapist

It is common for children and teens of all ages to depend on their therapists and develop close relationships. Therapists are trained to manage this bond with appropriate boundaries. However, if you feel your child has become overly attached to a therapist, Dr. Lebow recommends addressing it straightaway.

“The first step would be to bring it up to the therapist, maybe with the child there so there isn’t any secrecy.”

Parents may feel nervous about raising this topic, but therapists are used to dealing with boundaries and issues within the therapy relationship. “Part of our job as therapists is to identify things like this and discuss them,” Dr. Lebow says. “Your child’s therapist can say something like, ‘It feels like you’re thinking you have to come see me and that you won’t be well without me. Let’s talk about that.’ “

If the therapist takes your inquiry badly, Dr. Lebow says this might be a red flag. “If the therapist is weird about it or defensive or doesn’t seem to be responsive, then that’s a concern. At its most extreme it might indicate you need to consider switching therapists.

“Remember, though, that it is typical and important for your child to connect with the therapist independently, and part of the change we see in therapy is due to having that trust and relationship.”

How long therapy should last and when it should end?

Successful therapy doesn’t always happen quickly. “However, there should be an end point,” Dr. Lebow says. “Kids shouldn’t have to be in therapy for 20 years. Some kids do need a high level of therapy. But especially for life transition issues, a lot of what we are doing in therapy is trying to get kids back into their lives.”

There is also the reality that therapy adds a new item to a family’s schedule, and appointments may only be available during the school day.

“Sometimes therapy is disruptive,” Dr. Lebow adds. “You have to take your child out of school. But it’s a cost-benefit question because if your kid’s not functioning, the disruption may be worth it. If your kid’s functioning pretty well in life and then is suddenly getting pulled out of activities one or two times a week for therapy, that is a concern to me. Rather than being a barrier, therapy should be a tool that helps children get back in their lives.”

Dr. Lebow cautions that children will sometimes say they don’t want to go to therapy, and a parent should not misread this as an indication that it’s time to stop.

“Not wanting to go to therapy is not always a good indicator that something is wrong,” she elaborates. “Sometimes children say this when they’re just getting started and it’s hard. Honestly, most good therapy is a little unpleasant because it’s pushing you to do something you wouldn’t do otherwise.”

Ultimately, all methods of therapy should lift children from what they are having difficulty with and equip them with new skills. It’s important for parents to reinforce that therapy continues outside of sessions and long after therapy stops.

“It’s part of our ethical responsibility, especially with kids, to make it clear that this isn’t something that only works while you’re in it,” Dr. Lebow concludes. “This isn’t something that you’re dependent on your therapist for. This is something where you’re learning skills and eventually you’re going to be able to do it yourself. Therapy solves problems but it also helps build up kids’ resilience.”

Where medication, if applicable, fits in with therapy

“For most things that impact kids, therapy should be the first line treatment,” Dr. Lebow explains. “Therapy requires at least a little bit of action. Medication can be very helpful in giving you a little wiggle room in order to engage with therapy. But most of the data supports therapy as the first line option.”

This can be frustrating for parents who feel that their child has been struggling for some time. “I completely sympathize with families who want something fast,” Dr. Lebow admits. “Therapy does take time, but psychiatric medications are not antibiotics. It’s not like when your child has an ear infection and you want medication immediately because the clock’s ticking on when you child can sleep or go to school again. Psychiatry medications don’t work like that. They typically take 4 to 6 weeks to work (with some exceptions) and they don’t make you ‘happy.’ What they do is create wiggle room for children to be able to participate in therapy if they’re really having trouble doing so. This is something your therapist can weigh in on, as can your primary healthcare professional.”

Related articles in the Mayo Clinic Press Series: Navigating theraply for your child

Part 1: What kind of therapy is right for my child?

Part 2: How do I find the right therapist for my child?

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ORIGINAL RESEARCH article

Finding alternative community-based learning delivery for parenting skills during covid-19 for mothers with children aged 0–3 years.

• 1 Faculty of Psychology, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
• 2 Tanoto Foundation, Jakarta, Indonesia

Parenting training has been considered crucial to improving child development. The Tanoto Foundation's parenting program intervention was started in 2021 when the COVID-19 pandemic impacted government policies in Indonesia. Preventive measures that limit mobility affect the sustainability of face-to-face parenting interventions. The study aimed to explore alternative intervention methods, such as face-to-face, blended, online with facilitators, and self-learning, for parenting skills learning during emergencies. A 1-year non-randomized quasi-field experiment using a mixed quantitative-qualitative approach was conducted to 762 participants. SIGAP Q, the HOME Inventory, and CREDI were used for quantitative measurements, while interviews and focused group discussions (FGDs) provided qualitative data. The quantitative data were analyzed using multiway ANOVA, and the qualitative data were analyzed using thematic analysis. The study found that all intervention modalities delivered positive outcomes. In contrast, face-to-face delivered the largest gain, followed by online with facilitators, blended learning, and online self-learning (a web-based learning management system). As an alternative, online with facilitators is the best for delivering parenting materials, followed by online self-learning (independent) modes of intervention. Blended and online models provide alternative models in emergency contexts. Implications are discussed in this article.

1 Introduction

The COVID-19 pandemic has created an unprecedented global emergency, particularly affecting new middle-income nations such as Indonesia. This country is expected to benefit from a demographic bonus, characterized by high population productivity and low dependency, from 2004 to 2030. However, before the pandemic, the country was already grappling with significant challenges, such as extreme poverty and high rates of stunting and malnutrition among children.

The Strategic Plan of the Health Sector 2020-2024 ( Direktorat Jenderal Kefarmasian dan Alat Kesehatan, 2021 ), based on the 2018 Basic Health Survey [ Kementerian Kesehatan RI, 2018 ], the life expectancy for Indonesians was 71.5 years (74 years for women and 69 for men). However, the Healthy Adjusted Life Expectancy (HALE) was only 62.65, indicating a loss of 8.85 years of quality of life due to illness, disability, and poor environmental conditions. Additionally, the document highlighted a prevalence of underweight children at 17.7% and stunting among Indonesian children under the age of 5 years at 30.8%, ranking Indonesia fifth highest in the world for stunting.

Soon after the COVID-19 pandemic, the Indonesian government responded with a number of policies, starting on March 1, 2020. One of these was the enforcement of stringent social distancing measures and strong recommendations to stay at home and avoid public spaces. Consequently, all public facilities, including market infrastructure, were closed. Schools, malls, entertainment venues, tourist attractions, places of worship, and public transportation activities were either temporarily suspended or severely restricted.

The government was aware that while the poverty alleviation programs had a positive effect, the state was still dealing with 9%−11% of the population living below or just below the poverty line, making them highly vulnerable. The National Economic Survey 2019 suggested that half of the households in this vulnerable population did not have savings ( SMERU, 2021 ). To mitigate the catastrophic impacts of the pandemic, the government launched multi-sectoral programs, including social protection measures such as cash transfers and free healthcare, including medication, especially for COVID-19 patients. Additionally, the monetary and banking sectors provided financial support for family-based and micro-scale businesses ( OECD, 2021 ; SMERU, 2021 ).

Global policies on social distancing and home isolation accelerated the development of digital technology to address emerging issues during the COVID-19 pandemic. This led to the rapid growth of digital platforms, significantly impacting homeschooling, local and global communication, job creation in digital marketplaces, global coordination, and telemedical cooperation, which ultimately contributed to ending the pandemic sooner than expected ( OECD, 2020 ; Vargo et al., 2020 ; Zhao et al., 2021 ; Alghamdi et al., 2022 ).

Advances in communication applications during the pandemic helped keep people connected, maintaining social cohesion, and encouraging social inclusion for citizens with limited access to government social protection and basic services ( Shin and Lin, 2021 ). Digital-based distant learning, developed to reach students who were otherwise deprived of education, was fully utilized as infrastructures were built to facilitate coordination to curb the virus. The Coordinating Ministry of Communication and Information (November 12, 2022) noted positive growth in Indonesia's digital economy (5.5% in 2021). By 2024, the government aims to establish digital connectivity in 12,000 districts across the country.

Early evaluation of the impacts of the COVID-19 pandemic revealed that family finances were the hardest hit due to massive unemployment and loss of family income ( SMERU, 2021 ). Women were disproportionately affected compared to their male counterparts. More women-headed households reported lacking savings (56.7%) to cushion the impact of the crisis compared to men (50.6%). In addition, women were overwhelmed by added stressors, including providing psychosocial support for husbands or partners who lost their jobs and income, managing children who have to study at home, and, notably, finding additional sources of income ( UNICEF, 2020 ; SMERU, 2021 ). Despite all these challenges, mothers were expected to manage children's behavior to mitigate the negative impacts of physical and psychological control, resolve parent–child conflicts, and moderate the negative impacts of controlling children's emotions and behavior ( Marici, 2015 ).

Indonesia could not afford to lose any opportunities to improve its human resource development. Early childhood is a vital period during which rapid physical, social, and mental growth occurs. Appropriate nutritional intake and nurturing experiences at this time significantly affect children's cognitive, language, physical, motor, and socio-emotional development. Healthy development in these domains lays the foundation for future development and contributes to the child's overall quality of life ( Morrison, 2009 ; Essa, 2011 ). As a country facing a “triple burden of malnutrition” among its children, Indonesia's future quality of human resources is seriously at stake ( UNICEF, 2020 ; Dikhtyar et al., 2021 ).

For many years, the Indonesian government has been using various platforms to inform the public about preventing water- and blood-borne diseases, nutrition, and child-rearing practices. The most common method was face-to-face education for mothers or caregivers during clinical visits at POSYANDU (Pos Pelayanan Terpadu/Integrated Health Service organized in the neighborhood). With the growing use of smartphones, the government has also engaged the community through digital platforms. The COVID-19 pandemic highlighted the need for digital communication to inform the public and change their behavior. Digital technology was used to educate the public about the coronavirus and its variants, provide appropriate home care, and identify the most effective prevention methods. In addition, digital platforms were also used to inform and control citizens, ensuring adherence to public safety rules and regulations.

Parenting education is crucial for promoting child development and wellbeing, especially in the first 1,000 days of a child's life. Early brain development is the foundation for future development, and the fulfillment of nutrition and stimulation through parental care significantly influences children's brain development. Therefore, it is important for parents to understand appropriate parenting methods ( Papalia and Martorell, 2021 ). The importance of addressing early childhood issues is also emphasized in the International Sustainable Development Goals (SDGs/TPB) agenda. The TPB agenda includes the issue of children as a global development target for 2030, aiming to ensure that all girls and boys have access to early childhood development, care, and good pre-primary education by 2030 so that they are ready to pursue basic education (Ministry of National Development Planning/Bappenas 2020, in the Central Statistics Agency).

This is especially important to address when families are living in extreme poverty. In the context of poverty, parenting policy recognizes the intricate relationships between structural factors and parental agency in delivering care for the best outcome for child wellbeing. Structural interventions focus on creating an enabling environment and developing skills to address livelihood issues and access basic services such as health and education. In terms of parental agency, policies will be aimed at nurturing or improving parenting skills to enhance responsiveness, feeding practices, parent–child play and dialogues, marital stability, and psychosocial support ( La Place and Corlyon, 2015 ). It is also important to note that parenting education is crucial for poor children's survival, as parents typically have the most direct and powerful influence on their wellbeing than any other caregivers (teachers, friends, or other caregivers). “While it is recognized that not all children are raised by their parents, nonetheless, all children require quality parenting,” as observed by UNESCO ( Evans, 2006 ; Baydar et al., 2014 ). This is even more crucial to mitigate the impacts of child marriage, in line with the amendment of Law No. 1 of 1974 on Marriage, which raised the legal age for girls to marry from 16 years old to 18 years old.

A review of parenting education by the World Bank ( Tomlinson and Andina, 2015 ) showed that social protection programs combined with parenting education (like the Keluarga Harapan Program) are most effective in imparting knowledge on best practices in parenting and helping parents with daily tasks and responsibilities toward their children.

Traditional face-to-face methods of parenting education have serious limitations, particularly in resource-constrained environments. Limited resources result in limited participation. The UNICEF State of the World Children Indonesia (2020) reported that Indonesian law requires 20% of the budget to be allocated to the education sector. Unfortunately, in 2018, spending on education accounted for only 10% of total government expenditures. In social development, this situation is problematic for a middle-income country like Indonesia to address extreme poverty and related conditions, such as climate change.

Realizing the burden that women have to endure at home, the need for flexible, accessible, and scalable modes of delivering parenting education becomes increasingly evident ( Jensen et al., 2021 ). This need became particularly evident during the COVID-19 pandemic, which disrupted conventional educational practices. As societies evolve, the methods through which parenting education is delivered must adapt to changing circumstances, especially with the emergence of digital technologies. This study investigates the feasibility of alternative modes of community-based parenting education in Indonesia, a country with diverse sociocultural contexts.

Several studies show that online education remains quite effective but requires the development of more mature self-regulation from the study participants ( Bonk and Reynolds, 1997 ; Setyawati and Chelsea, 2021 ). Digital technology, which has been successfully utilized in distance learning, can greatly benefit marginalized populations who have been excluded from mainstream education. These populations include children with disabilities, children who migrate seasonally with their parents, girls who are culturally and geographically isolated, housewives who have added physical and psychological burdens because of their husband's lost income, and children who are always at home and need their mothers.

The Tanoto Foundation is an independent philanthropic organization in the field of education, which was founded on the belief that every person should have the opportunity to realize their full potential. The Tanoto Foundation's programs are based on the belief that quality education accelerates equal opportunity. Since its inception in 1981, the Tanoto Foundation has focused on developing educational facilities and various programs to advance Indonesian human resources from an early age, especially in the education sector. Since 2021, the Tanoto Foundation has been developing community units known as Rumah Anak Sigap (RAS), which serve as partners in implementing programs designed by experts who assist the Tanoto Foundation. One such initiative is the education advocacy program for mothers/primary caregivers to develop parenting skills. This program is expected to help the community prevent malnutrition and stunting in children, help parents provide cognitive and social stimulation for school readiness, and foster positive character development. Identifying the most effective intervention modalities will benefit this program.

To this end, the Tanoto Foundation commissioned a team of independent researchers from academic institutions, namely the Faculty of Psychology at Atma Jaya Catholic University of Indonesia and the Faculty of Psychology of Universitas YARSI, both located in Jakarta. The team was tasked with organizing a quasi-field experimentation study to test five modalities of delivering parenting information to mothers/primary caregivers: These modalities are as follows:

• Face-to-face (offline) education with home visits and visits to RAS.

• Blended education combining face-to-face and online sessions (web-based LMS).

• Fully online education with facilitators (web-based LMS-based and messaging app, WhatsApp).

• Fully online self-learning without facilitators (web-based LMS).

• The control group continues the existing parenting education without intervention (TAU).

An LMS consultant redesigned the learning modules, which cover 10 topics, to be delivered online during the intervention period (see Table 1 ).

Table 1 . Titles of learning modules.

In light of the ongoing pandemic and the growing demand for remote learning solutions, our study holds significance for policymakers, educators, and researchers seeking to enhance the accessibility and impact of parenting education. By exploring the potential of digital platforms and alternative learning modalities, we aim to contribute to the development of innovative, adaptable, and effective parenting education programs that can withstand various challenges.

As highlighted by Tomlinson and Andina (2015 , 2016) , who have examined evidence in both developed and developing nations, parenting education programs yield positive impacts. These benefits include enhancing parents' sensitivity, reducing negative interactions with children, improving emotional abilities, responsiveness, and nurturing behaviors, helping parents be less intrusive and better able to foster children's independence, increasing immunization rates, improving child nutrition levels, boosting child height, and weight, as well as enhancing children's emotional abilities, happiness, and secure attachments with caregivers.

To achieve the desired outcomes of the parenting education program, careful attention must be given to the design and delivery mechanisms of the intervention. Clear and explicit objectives should be set, considering factors like appropriate intensity and timing, relevant materials, community acceptability and support, and the involvement of trained facilitators ( Tomlinson and Andina, 2015 ). Additionally, it is crucial to consider participants' characteristics and input behaviors, such as psychological maturity, education level, and digital literacy. Given the ongoing COVID-19 pandemic, it is important to explore various delivery modes, including digital platforms ( Yoshikawa et al., 2020 ).

To address this issue, we conducted a comparative study in two distinct regions of Indonesia: Pandeglang and Jakarta. Pandeglang represents poor rural districts in Banten Province, while Jakarta represents poor urban inner-city districts. These regions were chosen based on their unique socioeconomic and cultural characteristics, allowing us to explore the adaptability of alternative parenting education methods across different contexts. By comparing the effectiveness and acceptability of various learning modalities, we aim to provide insights into designing effective parenting education programs.

The study is guided by “andragogy,” emphasizing adult-focused learning principles ( Knowles, 1984 ; El-Amin, 2020 ). Andragogy highlights the importance of learners' autonomy and self-directed learning, aligning well with the learning needs of adult participants. In andragogy, there are five assumptions for adult learners: (1) adults are goal-oriented, (2) adults are relevancy-oriented (problem-centered), meaning that they need to know why they are learning something, (3) adults are practical and problem-solvers, (4) adults have accumulated life experiences, and (5) adults are autonomous and self-directed.

Therefore, for the learning process to be successful, learning participants need to understand why they must learn the material. They need to learn experientially using a critical thinking approach, and teaching encourages participants' self-confidence. This is because adult learners have previous learning experiences and tend to be practical. Participants should be able to engage in contextual analysis, role-playing, simulations, and self-assessments. Rogers (2001) explains that adult learners usually come to learning programs with various intentions. It is important to consider this and tailor the learning process accordingly. Adult learners are motivated to learn in their own way. Although motivation can be developed, intrinsic motivation will help people learn. Participants in the learning program may be encouraged to learn and persevere through extrinsic influences.

By integrating this approach with digital technology, we seek to design more learner-centric parenting education programs that cater to participants' diverse backgrounds and schedules. Shin and Lin (2021) compared online and offline learning for adult learners. If learning is organized offline, several challenges may arise (e.g., financial problems, lack of time to study, and lack of partner emotional support), dispositional (not believing that the institution can meet students' needs), and institutional (the institution does not have alternative times that suit students). Hence, online learning presents a potential alternative. However, this approach also comes with challenges that adult students may encounter. These challenges include time allocation, financial limitations, difficulties reconciling social and academic aspects, motivational hurdles, and technology-related obstacles ( Bornstein et al., 2022 ; Britto et al., 2022 ). According to Dabbagh (2007) , successful adult learners in online settings tend to possess certain characteristics. These characteristics include digital literacy, a positive self-concept, self-discipline, effective communication skills, interpersonal strengths, foundational knowledge of the subject matter, a commitment to collaborative learning, adept time management, and cognitive learning strategies.

However, to the best of our knowledge, no specific research has investigated effective learning methods that align with Indonesian culture in parenting education. Thus, this article aims to understand which learning modalities or interventions are more effective and may be proposed for further development to cope with similar disruptive situations in the future.

The research questions addressed in this study are as follows:

1. How do different learning modalities impact participants' knowledge acquisition and engagement in parenting education during an emergency such as a pandemic?

2. Are there variations in the effectiveness of learning modalities between the different regions of Pandeglang and Jakarta?

3. What are the perceptions (acceptability) of participants regarding the use of a learning management system (LMS) for parenting education in both regions?

2 Materials and methods

2.1 research design.

This research employed a quasi-experimental approach targeted at parents or caregivers to examine the effectiveness of four learning modalities: offline, blended, online with facilitators, and self-learning. One group served as a control group, receiving no specific intervention. Quasi-experiments are often used when it is impossible or unethical to randomly assign participants to groups, such as in studies of educational programs or social interventions. In some implementation science contexts, policymakers, or administrators may not be willing to have a subset of participating patients or sites randomized to a control condition, especially for high-profile or high-urgency clinical issues. Thus, a quasi-experimental design is used to conduct rigorous studies in these contexts, albeit with certain limitations ( Miller et al., 2020 ). Quasi-experiments are a subtype of non-experiments that attempt to mimic randomized, true experiments in rigor and experimental structure but lack random assignment ( Rogers and Révész, 2019 ). In a non-randomized quasi-field experiment, the researcher does not randomly assign participants to different groups (e.g., treatment and control groups). Instead, the groups are formed based on other criteria, such as pre-existing differences between the groups. The researcher then compares the outcomes between the groups to determine the effect of the independent variable.

2.2 Types of research

This study used mixed quantitative and qualitative methods with a convergent parallel design. The quantitative method was used to address research questions one and two, while the qualitative method was used to answer research question three. A convergence design is beneficial for studying a problem in its entirety and dimensions ( Almeida, 2018 ). It uses two parallel phases: the quantitative approach is used to measure the properties and objective aspects of the problem, and the qualitative approach is applied to understand and describe the subjective aspect. The advantages of this design include its strong theoretical background and the ability to identify both the objective and subjective aspects of a problem.

2.3 Sample and recruitment of participants

Participants were recruited from 18 villages in Banten and Jakarta. The recruitment criteria for the intervention research included: being the primary caregiver of a baby or toddler aged 0–30 months without any special needs; belonging to low-to-middle income families with a salary/wage of < Rp 4,000,000 per month; having sufficient literacy skills in Bahasa Indonesia; consenting, agreeing, and committing to participating in all research activities for 13 months; residing at the research site; and having access to a smartphone and familiarity with the device. During the selection process, participants were briefed about the study, its benefits, and risks, leading to informed consent.

The total number of participants recruited at the commencement of the research (baseline) was 1,146. During the intervention, 89 participants decided not to continue their participation, leaving 1,057 participants at the end of the program. In the final measurement (endline), 866 participants completed the assessment, and after data cleaning, the final number of participants included for analysis was 762. The reasons for dropping out included difficulty synchronizing with phases of the module due to childcare activities, moving to different sites, incomplete data, difficult time allocation for face-to-face meetings at predetermined venues, not meeting the inclusion criteria for analysis (child age), and gadget-related issues (many of which were resolved during project monitoring by field workers) (see Table 2 ).

Table 2 . Learning modalities and sites.

2.4 Measurement instruments

Quantitative data were collected using three standardized questionnaires: SIGAP Q, the HOME Inventory, and the Caregiver Reported Early Development Instruments (CREDI). Qualitative data were collected through interviews and focus group discussions (FGDs). Three experts assessed content validity, while reliability was measured by calculating Cronbach's alpha and test-retest reliability.

The SIGAP parent survey consists of 48 questions designed by the Tanoto Foundation and adjusted by the research team. The questions are based on basic childcare knowledge following a literature review on parenting. The survey questions include binary response options (right or wrong) and have a reliability coefficient (Cronbach's alpha of 0.77). The HOME Inventory is an observation and interview tool used by enumerators during home visits to assess childcare management across various domains, including childcare organization, caregiver involvement, variation in caregiving, caregiving responsiveness, caregiving acceptance, and learning materials (Cronbach's alpha = 0.82). The CREDI assesses early childhood development milestones for children from birth to 3 years old, covering four domains: cognitive development, language development, motor development, and social-emotional development. Test-retest reliability was obtained as follows: cognitive development; r (760) = 0.60, p < 0.01; language development; r (760) = 0.65, p < 0.01; motor development; r (760) = 0.68, p < 0.01; and social-emotional development; r (760) = 0.63, p < 0.01 (see Table 3 ).

Table 3 . Construct and domain of research instruments.

The FGD guidance includes exploring the benefits and challenges encountered by participants and facilitators during intervention processes, their feelings and insights, the support provided, and any other concerns regarding the implementation of the intervention.

2.5 Research procedure

Selection of intervention research sites:

The selection of intervention research sites was conducted through 2 months of scooping visits (May–July 2021) to targeted sites in both Pandeglang and Jakarta. Selection was based on a number of inclusion criteria as follows:

1. General criteria

• Availability of public facilities such as public health centers (Puskesmas) or integrated health service centers (Posyandu).

• Availability of local volunteers and facilitators.

• Support from local leaders/authorities.

• Readiness to engage in all elements of the proposed project.

• Sufficiency of the estimated total number of parents with babies and toddlers (0–3 years old).

2. Specific criteria

• Availability of meeting or classroom venues (for face-to-face and hybrid or blended learning modalities) such as the Rumah Anak Sigap (RAS).

• Availability of digital communication technology infrastructures to support virtual modalities, including caregiver ownership of e-devices (smartphones or tablets).

• Accessible geographic locations, especially during the pandemic.

3. Special inclusion criteria for selecting treatment as usual (TAU) control group

• Ongoing government intervention.

• Ongoing usual intervention.

• History of previous engagements with the Tanoto Foundation.

During the scoping visit, the research team was seriously concerned with the high prevalence of COVID-19 infection and the increasing number of related deaths in Jakarta. Consequently, offline sessions were prohibited. Therefore, due to strong government restrictions, there was no Jakarta-based offline learning intervention model.

2.6 Recruitment and training of local facilitators

The recruitment process for local facilitators was divided into two mechanisms based on location. Facilitators were recruited directly under RAS management following the study protocol for research sites with access to RAS (Rumah Anak Sigap). For non-RAS sites, local government authorities coordinated the selection, screening, and recruitment of facilitators, including selecting the facilitator's coordinator. All facilitators were required to sign a consent form and a working agreement provided by the research team, commit to participating in the study for 14 months, and attend compulsory training.

The total number of recruited facilitators was 115, with 50 in Jakarta and 65 in Pandeglang. Capacity-building seminars were conducted to equip facilitators with essential knowledge on various topics, such as individual and group facilitating skills, research ethics, basic psychology, and disaster preparedness. Training sessions were also available for each module's topic during the research period, except for facilitators who supported online (self-learning) participants. This ensured that all facilitators were adequately prepared to implement the intervention research project.

Quantitative data were collected before (the baseline) and after (the endline) the intervention. Participants were asked to complete the SIGAP Q with paper and pencil, and then a trained enumerator interviewed them regarding the HOME Inventory and CREDI.

All participants signed informed consent forms during every data collection process. The informed consent form outlined voluntary involvement, data confidentiality, the risks and benefits of participation, data management, the duration of the intervention, and the recording and documentation of the process.

The ethical aspects of this study were evaluated and approved by the Research Ethics Commission of the Indonesian Catholic University, Atma Jaya, with approval number 06144/III/LPPM -PM 1.05 pm 10.10.05–PM.10.10.05/05.

2.7 Implementation processes

Prior to the commencement of the intervention, the Tanoto Foundation and the Intervention Research Design Team decided to divide 10 learning modules into three phases for each module, with each lasting 1 week. This approach provided a total of 3 weeks per learning module.

For the offline learning modality, all activities were conducted in face-to-face meetings, assisted by local facilitators who had been recruited and completed a series of capacity-building exercises. The blended modality involved a combination of activities:

• Phase 1 (Week 1): Full web-based LMS module learning.

• Phase 2 (Week 2): Face-to-face meetings with home visits by facilitators.

• Phase 3 (Week 3): Visits to RAS along with independent LMS work.

For both online modalities (with a facilitator and self-learning), there were no face-to-face meetings. The main difference between “with facilitator” and “self-learning” was the absence of a learning companion role by the facilitator in self-learning mode. Facilitators in the self-learning mode only functioned as communication bridges between research participants and the team, providing support for LMS-related technical problems experienced by participants.

2.8 Data analysis

The quantitative data were analyzed using descriptive statistics and inferential statistics (multiway ANOVA). This included central tendency, cross-tabulation, tests of significance such as analysis of variance followed by a post-hoc test, and Cohen's impact statistics.

Qualitative data obtained from the interviews and FGDs were organized according to thematic analysis. Emerging themes and patterns were identified, and connections between the data were interpreted. Then, we conducted data integration, which involved comparing and contrasting the findings from both types of data to gain a comprehensive understanding of the research questions ( Yin, 2016 ).

3.1 RQ-01: How do different learning modalities impact participants' knowledge acquisition and parenting education engagement during an emergency such as a pandemic?

Although all modalities generated learning experiences in all domains, participants were more familiar with offline modalities. Assessment of gain scores across modalities suggested that participants in the offline (face-to-face) modality performed best in learning outcomes on CHILDCARE KNOWLEDGE (SIGAP Q), followed by online assessment with a facilitator. Blended and online self-learning had similar gain scores, and the Treatment as Usual (TAU) modality showed the lowest gain score [ F (4, 757) = 6.51; p < 0.01]. For CHILDCARE MANAGEMENT (HOME), participants in offline modalities performed better than others in terms of responsiveness [ F (4, 757) = 3.46; p < 0.05]. Online with a facilitator and online self-learning demonstrated negative scores (see Table 4 ).

Table 4 . Between-group analysis across gain scores.

Analysis of the post-test confirmed that all modalities, on average, performed better than the control group (TAU), especially on knowledge about childcare [ F (4, 757) = 14.12, p < 0.001]. On HOME observation, participants showed differences in providing variations in caregiving [ F (4, 757) = 3.99, p < 0.001]. Further analysis, with the Games-Howell post-hoc test, found significant differences between TAU (M = 3.22, SD = 1.29), blended (M = 3.71, SD = 1.21), and self-learning (M = 3.66, SD = 1.22). We also found significant differences in how participants in different modalities provided children with learning materials [ F (4, 757) = 3.13, p < 0.05). The Games-Howell post-hoc test found significant differences between online with a facilitator (M = 6.98, SD = 1.65), offline (M = 6.23, SD = 2.19), and TAU (M = 6.44, SD = 1.93) (see Table 5 ).

Table 5 . Between-group analysis across endline scores.

Considering the above analysis, we might conclude that offline intervention created a more conducive learning environment than other modalities. Although all modalities indicated positive development as expected, further analysis informed us that blended modalities had the smallest standard deviation across all modalities, which suggested a small deviation from the means or greater similarities of learning outcomes with other modalities. This was why the blended modality, which contains face-to-face elements, also performed relatively stable (never becoming the least or having negative results compared to other modalities). Many of the learning outcomes of TAU were consistently lower than those of other modalities.

3.2 RQ-02: Are there variations in the effectiveness of learning modalities between different regions, Pandeglang and Jakarta?

In all modalities, it was apparent that participants in Jakarta had better childcare knowledge than those in Pandeglang, especially evident in the TAU [t (160) = 5.01, p < 0.001, Cohen's d = 0.81], blended [t (165) = 4.92, p < 0.001, Cohen's d = 0.76], and self-learning modalities [t (160) = 4.52, p < 0.001, Cohen's d = 0.70]. No significant differences were found among the online facilitators.

In the TAU modality, Jakarta (M = 34.37, SD = 4.62) performed better than Pandeglang (M = 30.46, SD = 4.95). In the blended modality, Jakarta (M = 36.22, SD = 3.43) scored better than Pandeglang (M = 33.38, SD = 4.05), and also in self-learning, Jakarta (M = 35.68, SD = 3.60) scored better than Pandeglang (M = 32.83, SD = 4.43).

Regarding home observation, we found that Pandeglang scored better than Jakarta in all modalities for the organization of childcare. On the contrary, all modalities in Jakarta scored better than Pandeglang in the aspect of learning materials.

In the organization of childcare, in the TAU modality, there were significant differences [t (160) = 3.30, p < 0.001, Cohen's d = 0.53] where Pandeglang scored better (M = 5.48, SD = 0.76) than Jakarta (M = 5.08, SD = 0.73). In the online with facilitators modality, there was a significant difference in childcare organization [t (173) = 3.30, p < 0.001, Cohen's d = 0.50], with Pandeglang scoring better (M = 5.61, SD = 0.65) than Jakarta (M = 5.22, SD = 0.90). This trend was also observed in the self-learning and blended modalities, where Pandeglang scored better than Jakarta in the organization of childcare.

With regard to the learning materials, all modalities in Jakarta scored higher than those in Pandeglang. The TAU in Jakarta (M = 7.24, SD = 1.64) scored significantly higher [t (160) = 4.36, p < 0.001, Cohen's d = 0.70] on learning materials compared to Pandeglang (M = 5.95, SD = 1.95). Moreover, in the online with facilitators modality, there was a significant difference [t (160) = 3.18, p < 0.001, Cohen's d = 0.50] in the availability of learning materials, which were more available in Jakarta (M = 7.17, SD = 1.84) than in Pandeglang (M = 6.16, SD = 2.17). Blended and self-learning modalities also showed similar results, with Jakarta scoring higher in the availability of learning materials than Pandeglang (see Table 6 ).

Table 6 . Comparison of Jakarta and Pandeglang between group analysis across endline scores.

Participants in Jakarta had better childcare knowledge and access to learning materials than participants in Pandeglang. Meanwhile, participants in Pandeglang had better organization of childcare than participants in Jakarta. Participants in Jakarta could access better learning materials because the venues in the study sites were child learning centers newly established by the private sector called RPTRA. This facility lends out toys and learning materials to children in the community. Home observation scores, however, show that differences in organization between participants in Jakarta and Pandeglang may be due to the lack of alternative caregivers in Jakarta. The results also suggested that participants in both Pandeglang and Jakarta were relatively ready to engage in digitally mediated learning on parenting and child development issues.

3.3 RQ-03: What are participants' perceptions (acceptability) regarding using a learning management system (LMS) for parenting education in both regions?

The reception of the research program started during the scoping visit during the preparation phase of the study. Participants were recruited based on their willingness to engage in a 12-month parenting education program. Acceptability refers to learners' positive attitudes after completing all the learning activities. FGDs were conducted with selected participants in different modalities during the midterm and final evaluations. With regard to the modules overall, we have the following remarks:

All participants appreciated the flexibility of the learning module on the digital platform, which was accessible (1) during the intervention period. This flexibility allowed them to revisit learning materials whenever needed.

In addition, they felt that online discussions, chat opportunities, and quizzes made studying online more fun and engaging (2) despite the poor internet signal faced by most participants. In line with the requirements of online learning for adult learners, the material was delivered in various formats, including infographics, audio, and video, which were well received by participants (3).

… More detailed. When taught (only) via Zoom, we only listen, and there are no practical exercises. However, in our module, we did not just listen; reading materials were made available (1). We can listen together, pass it on to husbands, and share with other friends who just gave birth. So it is not just for us. We also share it (the reading materials) with those who just gave birth, and they cannot accuse us of boasting because it is in line with information from scientific journals. So it is more convenient for us to share the link to our module (2)

..The most interesting form of material is infographics. Many participants said the infographics are easily understood and available in the LMS. The videos also helped participants to know what to do… But the audio is too long, needs to be cut to make it more interesting…. Overall is okay.. (3)

Although the module's contents (1–10) were deemed acceptable and useful, participants noted that some reading materials were heavily saturated with foreign technical terms, making both audio and reading materials difficult to comprehend. Materials were easier to understand when they contained examples related to their everyday experiences and were written in simple words or sentences. While the modules were very interesting, they may need to consider incorporating local-specific content to be more relevant to the participants (4).

… Initially, we found difficult words and concepts.. but after our feedback, the explanation is more digestible.. we prefer to use our own language, especially colloquial language …(4)

With regard to learning strategies, the participants felt that the time allotted for each activity could be adjusted to better suit the demands and time constraints of the participants. Although this issue had been resolved during the scoping visit, many participants might have encountered different obstacles that required adjustments in time allocation, especially for offline and blended modalities. In contrast, the online modality did not have time allocation issues, as the participants appreciated the time flexibility it offered. They could arrange their study time in a way that did not interfere with their daily roles at home (5).

..I may say that this online format fits with my schedule. I can arrange the time according to my available time. When we have to meet Offline, like this. I am not sure that I can always have the time (5)

..In the morning, my husband frequently asks me to prepare breakfast, tea, etc., which makes me busy, often until 11 am. I work on my LMS whenever my schedule allows (5)

Regarding the modalities, the participants appreciated but considered the offline format the best. They valued the offline format for its opportunity to maintain contact with neighbors (“silaturahmi”) and for enabling them to share and discuss their experiences directly (6).

.. If online, sometimes we do not have the (internet) signal, and sometimes we do not have our mobile phone in hand (taken by our children). It is better to have an Offline like this one. We can know and greet our neighbors. We also learn better in Offline format. We can exchange our opinions about our child-rearing practices, and we can educate fellow participants…(6)

… If possible, we have our learning session not only at home. We can meet in smaller groups elsewhere. This is not like the present, where we learn only online. When we meet in person, we can share and ask direct questions. In online courses, participants may not know each other. If possible, we may have our own groups that meet occasionally to talk about learning materials (6)

Second, the role of assistants (facilitators) in online learning with facilitators and blended modalities is crucial; therefore, they should be well prepared to conduct their assignments with full awareness of their roles and responsibilities to avoid confusion. Facilitators who engaged in substantive and technical supervision were appreciated by the participants, as they helped participants feel that they were growing during the learning process. The participants were also motivated by the consistent support provided by facilitators to participate in the module's activities, which helped them resolve emerging problems (7).

..Most of the materials are readable. If I could not understand, well I come and visit the facilitator and asked questions.. always like that..(7)

.. I rely on my facilitator whenever I am stuck with my gadget. I borrow wifi from the facilitator, which helps me resolve my homework (7)

the facilitator is always helpful if I am stuck – usually, I send her my problem, and she helps me to resolve it (7)

When asked about future learning opportunities, most participants expressed their interest in participating because they recognized the importance of the materials in becoming better caregivers (8).

I may say it is useful to keep doing it. It helps mothers become understand (8)

... the scope of participation should be larger. I saw the benefits of learning the materials for my own child (now 3 years old). More mothers should be recruited and benefit from this intervention to acquire the latest information on parenting.. especially mothers who just gave birth to their baby to prevent baby blues syndrome.. a lot of women in the village get married but never have any preparations… (8)

They also felt the program was beneficial because it piqued their husband's interest in the platform, which stimulated their husband to help with childrearing (9).

.. my husband said that he is curious about listening to my story and wanted to try working on the learning materials (9)

I like the material about couples – husband and wife- to complement each other. Before I anticipated this learning course, my husband and I did not have much communication. But now we attend to each other more.. (9)

Thank God Almighty, my husband supports my participation wholeheartedly… (9)

In managing the intervention, the project was supported by trained facilitators and enumerators and the availability of safe spaces for learning, such as the SIGAP Learning Center (RAS). The results of the FGD involving cadres and local facilitators revealed that the cadres faced many difficulties when initially participating in the program and guiding the participants (10).

.. it takes time … sometimes more time spent in uploading photos, because the size does not fit and trimming the picture is not so easy.. (10)

.. dealing with a facilitator who is a lactating mother is cumbersome … it is difficult sometimes to fix time, especially when dealing with participants whose wifi signal is up and down… we received a lot of help requests.. sometimes I just said go find yourself a better place for wifi (10)

Taking their issues or needs to the field coordinator or the module manager was an important learning process. However, continuous education and training gradually improved the competency and readiness of the cadres to assist their participants (11).

.. Assist participants with relevant information, connect them with field facilitators when encountering learning problems …(11)

If we haven't had training, we can't answer like that, we don't know yet. Once we've had training, then we can answer about this and that… (11)

Training, workshops, and technical supervision for participants during the project implementation (12) also facilitated useful behavioral changes when utilizing the LMS with the help of cadres (13).

Participants often come to my house for help with Wifi or with the training materials in LMS … (12)

Providing information… if there are any obstacles or issues while we are learning with the LMS, we report it to the facilitator (12)

Everything is running smoothly for the [discussion] forum [in LMS]. It has been discussed previously in the LMS. So, our questions for the facilitators are well understood, so we just need to fill that out..(13)

[When participants were asked about behavior changes that occurred] It really helps us personally if there is an LMS.. (13)

Furthermore, some highlighted the need to improve internet infrastructure (14), support their children in offline and blended modalities, and sustain the facilitators' role (15).

… when the link can be opened , [it did] not always immediately open. There might be a delay until the next day or two, but everything will definitely be done eventually. The main issues are the signal and the phone itself; that's how it needs to be improved (14)

For matters concerning the children, we usually meet during the integrated health ser for matters concerning the vice center. Even when Tanoto is finished, let's not let it just disappear. At least take half an hour or 15 min to share with us because, you know, parenting requires it. Let's entrust it to capable cadres.. (15)

Web-based LMSs or apps developed for learning material are considered beneficial and relevant to their situation during the COVID-19 pandemic. Although many participants still preferred offline intervention for social-cultural and optimal outcomes, most participants in online modalities were able to appreciate the flexibility and achieve acceptable learning outcomes. To improve future digital platform interventions in parenting education, some improvements should be noted, especially in active learning strategies, locally based content, supporting infrastructures, and easy learning.

A number of notes should be considered, especially on foreign language terms, quizzes, and examples. Locally relevant examples (from daily events) may need to be enriched and stored in the Bank of Cases for alternative cases. Trained cadres and facilitators are crucial to the readiness of local participants.

4 Discussion

Indonesia needs to sustain its intervention programs to fight extreme poverty and stunting. Accepting parenting programs to mitigate the loss of quality human resources is critical to fighting poverty. Thus, such programs should be designed to adapt to emerging challenges to retain their benefits for improving the lives and wellbeing of developing children ( Hoghughi, 2004 ; Yoshikawa et al., 2020 ; Bornstein et al., 2022 ). The traditional face-to-face approach to community-based education is difficult to sustain in an emergency, such as at the peak of the COVID-19 pandemic. Thus, providing solutions for community-based learning should be considered, including exploring the effectiveness of methods that allow online interactions, such as blended learning, as shown in this study.

This study revealed that imparting knowledge on parenting strategies virtually can be conducted through informal (center- or community-based) education. Although the offline (face-to-face) modality was not feasible at research sites in Jakarta, all computer-mediated modalities were accepted at all research sites, both in Pandeglang and Jakarta. Digital learning modalities have the potential to sustain parenting intervention into the future despite any difficult trajectories, such as in the COVID-19 pandemic situation. During the intervention program, local facilitators successfully developed problem-solving strategies to address various issues faced by participants, including technical-related matters and maintaining participants' motivation. Online learning also provided more room for time flexibility, with some participants studying after hours or early in the morning before baby care time starts. This is crucial, especially when the participants are caregivers or mothers. In this study, online learning had many advantages for participants as adult learners ( Knowles, 1984 ; OECD, 2021 ; Shin and Lin, 2021 ). In addition, there is potential for greater inclusion in both rural and urban settings.

Both participants and facilitators acquired a better understanding and familiarization with ICT, with most of them adjusting to the early modules and gradually building their own learning strategies. Participants in the blended learning modality appreciated the center visits as they had the opportunity to go out and mingle with peers, providing them with some “me time,” which was not available for pure online learning. Both facilitators and participants appreciated the quality of the module content and the various topics covered. The wide range of topics helped them nurture their children, including positive communication and emotions, which were rare in public health services.

Most of the intervention models were acceptable to their participants. During implementation, there were no serious incidents when participants experienced severe difficulties accessing and learning the parenting module, except for poor internet signal. Module materials and learning activities are appropriate to the characteristics of adult learning participants. The materials are relevant to what is needed, and participants have autonomy in studying the material ( Knowles, 1984 ; Shin and Lin, 2021 ). Activities such as discussion forums and quizzes increase participants' understanding and make learning easier ( Nguyen, 2017 ).

Regarding supporting interventions such as module training for facilitators each month, among the three models with the Internet, the costliest variables will be venue and meals, transportation for participants and trainers, fees for resource persons and facilitators, and administrative management. All these are embedded in both blended and online learning with facilitator modalities as the program runs instead of the one-time cost of creating digital learning content.

However, blended learning meets the criteria related to learning material variation, participant time flexibility, and higher learning independence due to the demands of adult learning. Blended learning still provides space for participants to obtain support from facilitators regarding learning techniques and gadget usage. It also allows for offline discussions with other participants as needed in adult learning. Therefore, blended learning can be the most feasible alternative program in the near future when offline learning is impossible. Alternatively, we can resort to online learning with a facilitator. Participants should be familiarized with ICT in both modalities to enhance their learning experience.

It should be noted that local cadres (facilitators) play a crucial role as partners, technical and substantive advisors, and guardians of the learning process. Virtual learning not only provides more room for time flexibility, allowing participants to study during off-hours, but it also improves inclusiveness, especially for those with geographical challenges, and it provides preselected local issues and practices through digital documentaries. Despite limitations and the need for improvement, this program is suitable for implementation in Indonesia ( Tomlinson and Andina, 2015 ).

5 Conclusion and recommendations

The study found that all intervention modalities delivered positive outcomes. In contrast, face-to-face learning delivered the largest gain, followed by online with facilitators, blended learning, and online self-learning (a web-based learning management system). As an alternative, online with facilitators is the best for delivering parenting materials, followed by online self-learning (independent) modes of intervention. Blended and online models provide alternative models during emergencies.

The following are our recommendations for future implementation:

• Improve module and learning strategies : enhance the relevance of the learning materials in blended and online learning with facilitator modalities. Make assignments and examples more user-friendly, and include local examples of practices and cases in the learning materials.

• Consider a fully online modality : when the learning module has been significantly improved (with a higher participation rate) and digital infrastructure is more accessible and less costly, consider designing a fully online modality.

• Capacity building for local cadres or facilitators : continue capacity building for local cadres or facilitators in conjunction with the design and content of the module. Utilize community centers to support such initiatives in the future.

• Develop a bank of local cases and best practices : create a living document that includes a constructed bank of local cases and best practices to aid in developing learning modules.

Regarding the limitations of this study, the duration of the intervention was relatively short (12 months), and the intervention design did not include a specific program for children that differentiated treatment through four intervention modalities. Therefore, the CREDI outcomes did not show differences related to child development across the four learning modalities. Future studies should consider a longer intervention period combined with treatments for both participants and children to observe the effects on parents and children more distinctly.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, upon reasonable request.

Ethics statement

The studies involving humans were approved by the Ethics Commission of Atma Jaya Catholic University of Indonesia number 06144/III/LPPM -PM 1.05pm 10.10.05- PM.10.10.05/05. The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation in this study was provided by the participants. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.

Author contributions

WP: Conceptualization, Methodology, Writing – original draft, Writing – review & editing. CS: Formal analysis, Writing – original draft, Writing – review & editing. YH: Formal analysis, Funding acquisition, Project administration, Resources, Writing – review & editing. KT: Formal analysis, Writing – original draft, Writing – review & editing. NA: Formal analysis, Project administration, Visualization, Writing – review & editing. EH: Writing – review & editing. FH: Writing – review & editing. I: Conceptualization, Formal analysis, Methodology, Supervision, Writing – original draft, Writing – review & editing.

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Funding was received from the Tanoto Foundation based on the agreement numbers TF.JKT/ECED/SPK/2021/XI/446 and 3022/II/R-KJS.10.02/11/2021.

Acknowledgments

The author(s) thank all participants for their generous support in this research. The author(s) also would like to thank the Tanoto Foundation for granting this research. The authors are also grateful to the full team of this project's researchers: Nicolas Indra Nurpatria, M.Si, Psikolog, Dr. Retha Arjadi, M.Psi., Psikolog, and Dr. Angela Oktavia Suryani, M.Sc., from the Atma Jaya Catholic University of Indonesia; Dr. Octaviani Indrasari Ranakusuma, M.Si, Psi, Dr. Sunu Bagaskara, M.Si, Fitri Arlinkasari, PhD, and Dr. Melok Roro Kinanthi, M.Psi, from the YARSI University; and Binti Khofifah, S.K.M, M.Epid, from the ARTI Foundation.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Keywords: community-based parenting learning, mode of learning, early childhood, adult learner, web-based LMS

Citation: Pandia WSS, Suwartono C, Hestyanti YR, Tanuwijaya KA, Abraham NS, Henry E, Herarti F and Irwanto (2024) Finding alternative community-based learning delivery for parenting skills during COVID-19 for mothers with children aged 0–3 Years. Front. Educ. 9:1386679. doi: 10.3389/feduc.2024.1386679

Received: 15 February 2024; Accepted: 05 July 2024; Published: 06 August 2024.

Reviewed by:

Copyright © 2024 Pandia, Suwartono, Hestyanti, Tanuwijaya, Abraham, Henry, Herarti and Irwanto. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Yohana Ratrin Hestyanti, yohana.hestyanti@atmajaya.ac.id

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Pregnant or parenting: Title IX protects you from discrimination at school

Title IX of the Education Amendments of 1972 ("Title IX11), 20 U.S.C. §1681 et seq., is a Federal civil rights law that prohibits discrimination on the basis of sex-including pregnancy and parental status-in educational programs and activities. All public and private schools, school districts, colleges, and universities receiving any Federal funds ("schools11 must comply with Title IX.

Here are some things you should know about your rights.

Classes and school activities

Your school must do the following:

• Allow you to continue participating in classes and extracurricular activities even though you are pregnant. This means that you can still participate in advanced placement and honors classes, school clubs, sports, honor societies, student leadership opportunities, and other activities, like after-school programs operated at the school.
• Allow you to choose whether you want to participate in special instructional programs or classes for pregnant students. You can participate if you want to, but your school cannot pressure you to do so. The alternative program must provide the same types of academic, extracurricular and enrichment opportunities as your school's regular program.
• Allow you to participate in classes and extracurricular activities even though you are pregnant and not require you to submit a doctor's note unless your school requires a doctor's note from all students who have a physical or emotional condition requiring treatment by a doctor. Your school also must not require a doctor's note from you after you have been hospitalized for childbirth unless it requires a doctor's note from all students who have been hospitalized for other conditions.
• Provide you with reasonable adjustments, like a larger desk, elevator access, or allowing you to make frequent trips to the restroom, when necessary because of your pregnancy.

Excused absences and medical leave

Your school must do the following: 

• Excuse absences due to pregnancy or childbirth for as long as your doctor says it is necessary.
• Allow you to return to the same academic and extracurricular status as before your medical leave began, which should include giving you the opportunity to make up any work missed while you were out.
• Ensure that teachers understand the Title IX requirements related to excused absences/medical leave. Your teacher may not refuse to allow you to submit work after a deadline you missed because of pregnancy or childbirth. If your teacher's grading is based in part on class participation or attendance and you missed class because of pregnancy or childbirth, you should be allowed to make up the participation or attendance credits you didn't have the chance to earn.
• Provide pregnant students with the same special services it provides to students with temporary medical conditions. This includes homebound instruction/at-home tutoring/independent study.

A school that is controlled by a religious organization is exempt from Title IX when the law's requirements would conflict with the organization's religious tenets.

• Protect you from harassment based on sex, including harassment because of pregnancy or related conditions. Comments that could constitute prohibited harassment include making sexual comments or jokes about your pregnancy, calling you sexually charged names, spreading rumors about your sexual activity, and making sexual propositions or gestures, if the comments are sufficiently serious that it interferes with your ability to benefit from or participate in your school's program.

Policies and procedures

• Have and distribute a policy against sex discrimination. It is recommended that the policy make clear that prohibited sex discrimination covers discrimination against pregnant and parenting students.
• Adopt and publish grievance procedures for students to file complaints of sex discrimination, including discrimination related to pregnancy or parental status.
• Identify at least one employee in the school or school district to carry out its responsibilities under Title IX (sometimes called a "Title IX Coordinator") and notify all students and employees of the name, title, and contact information of its Title IX Coordinator. These responsibilities include overseeing complaints of discrimination against pregnant and parenting students.

Helpful tips for pregnant and parenting students

• Ask your school for help-meet with your school's Title IX Coordinator or counselor regarding what your school can do to support you in continuing your education.
• Keep notes about your pregnancy-related absences, any instances of harassment and your interactions with school officials about your pregnancy, and immediately report problems to your school's Title IX Coordinator, counselor, or other staff.
• Using your school's internal Title IX grievance procedures.
• With the U.S. Department of Education, Office for Civil Rights (OCR), even if you have not filed a complaint with your school. If you file with OCR, make sure you do so within 180 days of when the discrimination took place.
• In court, even if you have not filed a complaint with your school or with OCR.
• Contact OCR if you have any questions. We are here to help make sure all students, including pregnant and parenting students, have equal educational opportunities!

If you want to learn more about your rights, or if you believe that a school district, college, or university is violating Federal law, you may contact the U.S. Department of Education, Office for Civil Rights, at (800) 421-3481 or [email protected] . If you wish to fill out a complaint form online, you may do so online via the Office for Civil Rights .

Adopted from U.S. Department of Education, Office for Civil Rights