THE FACTORS THAT CONTRIBUTE TO

PARENTAL RESPONSIVENESS IN ADOPTIVE FAMILIES

by

SUNG HEE NAM

Submitted in partial fulfillment of the requirements

For the degree of Doctor of Philosophy

Dissertation Advisor: Dr. Gerald J. Mahoney

Mandel School of Applied Social Sciences

CASE WESTERN RESERVE UNIVERSITY

May, 2011

CASE WESTERN RESERVE UNIVERSITY

SCHOOL OF GRADUATE STUDIES

We hereby approve the thesis/dissertation of

Sung Hee Nam ______

Doctor of Philosophy candidate for the ______degree *.

Gerald J. Mahoney, Ph.D. (signed)______(chair of the committee)

Wallace J. Gingerich, Ph.D ______

Michelle R. Munson, Ph.D ______

Anastasia Dimitropoulos, Ph.D ______

______

______

December 1 , 2010 (date) ______

*We also certify that written approval has been obtained for any proprietary material contained therein. i

ACKNOWLEDGEMENTS

For the last six years in doctoral program, countless people gave me laugh, hugs,

and touching memories which inspired me and helped me sustain this long journey. I

hope I can remember all of these moments in my heart.

First of all, I would like to express my appreciation with all the possible existing

words to Dr. Gerald Mahoney. From the very beginning of my doctoral program Dr.

Mahoney has guided me here and let me step to the finishing line. He is an academic

advisor who always makes himself available to listen to me and encourage me when I

need his advice and support. He gave me a great opportunity to work directly with

children and families as well as conduct the research with them at the Center on

Intervention for Children and Families. These experiences are strong foundation for my academic/practice career. He is also a great dissertation chair. Not only did he help me complete research theoretically and practically, but also he helped me writing procedure enjoyable.

I wish to acknowledge my committee members. I thank Dr. Wallace Gingerich, for his willingness to share his insights into my dissertation regardless of his retirement. I want to thank Dr. Michelle Munson for her ongoing support and mentoring for teaching as well as her social work insights into my dissertation. I thank Anastasia Dimitropoulos for her contribution of the psychological discipline into my dissertation.

I want to show my deep appreciation for Dr. Perales for being wonderful company at our office while I was writing my dissertation. She gave me practical advice for working with children and families as my boss as well as she gave me crucial advice for my personal life as my friend. I also want to thank Dr. Corrigan for her enormous

ii generosity. She showed me not only how to be a good writer, but also proved how to live everyday life happily while helping others all the time. I would love to show my thanks to Dr. Sevenson who shares her important moments with me and keeps motivating me to finish my Ph.D program.

I am a person who likes to be surrounded by people. I would like to appreciate all my friends who help with me not being lonely: My exemplar cohort 2005; my Korean fellows who share and help me with my life in the U.S.; friends who hear my research and give me ideas; and friends who call me from Korea to let me know I am still loved while I cannot physically be with them in Korea. I would like to delineate each of my friends’ names but I am afraid to omit someone accidently. Dear my friends, I really appreciate each of you. I would like to extent my special thanks to HeaJung Kim, the friend who is always in my side even when I am wrong.

Most importantly, everything is possible for me thanks to my family, my mom,

Nansuk Ko, my dad, JumSul Nam, and my brother, SungWoo Nam. Right now, the moment I am writing this acknowledgment, writing my family members’ names makes me cry because I love and miss them so much. I am so lucky to have my family members.

I love you from my bottom heart.

iii

TABLE OF CONTENTS

CHAPTER 1

INTRODUCTION ...... 1 Purpose of Study ...... 1 Problem Statement ...... 3 Unique Features of Adopted Children ...... 3 Unique Features of Adoptive Parents ...... 9

CHAPTER 2

CONCEPTUAL FRAMEWORK AND LITERATURE REVIEW ...... 12 Definition of Parental Responsiveness ...... 13 Measures of Parental Responsiveness ...... 15 Conceptual Model ...... 18 Transactional Model of Development ...... 18 Belsky’s Model of Parenting ...... 19

LITERATURE REVIEW ...... 23 Parental Responsiveness and Child Development…...... 23 Cognitive Development ...... 24 Communication Development ...... 30 Social Emotional Development ...... 36 Parental Responsiveness and Adopted Child Development…...... 41 Cognitive Development of Adopted Children ...... 41 Communication Development of Adopted Children ...... 43 Social Emotional Development of Adopted Children ...... 43 Determinants of Parental Responsiveness …...... 46

iv

Parental Contribution...... 47 Children’s Contribution ...... 52 Social Context ...... 60 Multivariate Analyses ...... 63 Adoption Characteristics ...... 66 Independent Variables ...... 68 Control Variables ...... 68

Limitations of Previous Studies ...... 69 Research Questions and Hypotheses ...... 70

CHAPTER 3

METHODOLOGY ...... 73 Subjects ...... 73 Study Design and Procedure ...... 76 Variables ...... 76 Measures ...... 78 Dependent Variable ...... 78 Independent Variables ...... 79 Statistical Analysis ...... 86 Protection of Human Subjects ...... 86

CHAPTER 4

RESULTS ...... 87 Descriptive Study ...... 87 Children’s Development and Functioning ...... 87 Parental Psychological Well-Being ...... 88 Parental Responsiveness ...... 89 Preliminary Screening Procedure ...... 90 Missing Data ...... 90 v

Bivariate Correlations ...... 91

Research Questions and hypotheses ...... 94 Research Question 1...... 96 Research Question 2...... 99 Research Question 3...... 110

CHAPTER 5

DISCUSSION ...... 115 Review of Findings ...... 115 Correspondence of Findings with Existing Literature ...... 117 Characteristics of Parents ...... 118 Characteristics of Children ...... 120 Characteristics of Social Context ...... 125 Practical Implication ...... 127 Strengths and Limitations of Study ...... 131 Future Research ...... 133 Conclusion ...... 138

Appendix A ...... 139 Appendix B ...... 149 Appendix C ...... 152 Appendix D ...... 154

REFERENCES ...... 157

vi

LIST OF TABLES

Table 1: Demographics of Parents ...... 75

Table 2: Demographics of Children ...... 75

Table 3: Study Variables ...... 77 Table 4: Children’s Social Emotional and Development Characteristics ...... 88

Table 5: Parental Psychological Well-Being and Responsiveness ...... 89

Table 6: Correlation Coefficients for the Demographic Characteristics and the Dependent Variables ...... 93

Table 7: Correlation Coefficients for Children’s Developmental Characteristics and Parents’ Psychological Well-Being with Dependent Variables ...... 94

Table 8: The Influence of Parental Psychological Well-Being on Responsivity ...... 97

Table 9: The Influence of Parental Psychological Well-Being on Affect ...... 98

Table 10: The Influence of Children’s Social Emotional Functioning on Responsivity ...... 100

Table 11: The Influence of Children’s Social Emotional Functioning on Affect ...... 101

Table 12: The Influence of Children’s Developmental Quotient on Responsivity ...... 102

Table 13: The Influence of Children’s Developmental Quotient on Affect ...... 103

Table 14: The Influence of Children’s Age of Adoption on Responsivity ...... 105

vii

Table 15: The Influence of Children’s Age of Adoption on Affect ...... 106

Table 16: The Influence of History of Institution and Foster Care on Responsivity ...... 107

Table 17: The Influence of History of Institution and Foster Care on Affect ...... 108

Table 18: The Influence of Parents Income and Education on Responsivity ...... 111

Table 19: The Influence of Parents Income and Education on Affect ...... 112

Table 20: The Influence of Perceived Levels of Social Support on Responsivity ...... 113

Table 21: The Influence of Perceived Levels of Social Support on Affect ...... 114

viii

LIST OF FIGURES

Figure 1: Determinants of Parental Responsiveness ...... 72

ix

The Factors that

Contribute to Parental Responsiveness in Adoptive Families

by

SUNG HEE NAM

Abstract

The level of responsiveness of parents as they interact with their children is considered to be one of the most significant characteristics for children’s cognitive, language, social and emotional development. To the extent that adopted children are at risk for developmental problems, the manner in which adoptive parents’ style of interaction promote children’s development is critical. In an effort to understand adoptive parents’ style of interacting with their children, the main purpose of this study is to identify factors that contribute to adoptive parents’ levels of responsiveness.

Guided by the Transactional Model of Development and Belsky’s Model of

Parenting, three research questions, the basis of this study, address the associations between characteristics of parents, characteristics of children, and social context characteristics and the level of responsiveness of adoptive parents. This study is a secondary analysis of data from 41 adoptive parents and their young children who participated in the Developmental PARTners (Prevention, Assessment, Referral, and

Training for young adopted children) model demonstration project funded by the United

States Department of Education and conducted between 2005 and 2007 at Case Western

Reserve University in Cleveland, OH.

This study found an association between parental responsiveness (e.g., Affect) x with children’s history of having been placed in orphanages. Other variables investigated in this study were not found to be associated with parental responsiveness. Results also indicated that adoptive parents showed relatively low levels of responsiveness as measured by the Maternal Behavior Rating Scale. There were two practical implications to these findings. First, adoptive parents of post-institutionalized children need to be encouraged to accentuate their expressions of affect as a means of eliciting affect from their children who might otherwise have difficulty expressing affection and building emotive relationships. Second, Relationship Focused Intervention may be an effective program to help adoptive parents learn how to interact more responsively with their children.

1

Chapter 1

Purpose of Study

The purpose of this study is to attempt to identify factors that may contribute to differences in parental responsiveness toward their young adopted children. Parental responsiveness, one of several characteristics of parent’s general style of interacting with their children, is defined as a parent’s ―tendency to provide contingent, appropriate, and consistent responses to an infant’s signals or needs‖ (Lamb & Easterbrook, 1981, p. 127).

Parental responsive interaction is considered to be one of the most important characteristics because of the considerable evidence that it is highly associated with children’s cognitive, language, and social-emotional development.

In many cases, prior to adoption, children are neglected or abused by their birth parents and are placed in foster care or orphanages. This type of pre-adoptive history likely limits children’s opportunity to interact consistently with caregivers who are responsive and supportive.

Some believe that the limited opportunities children have for consistent, nurturing, and sensitive caregiving prior to adoption not only influence children’s development and social emotional functioning, but also their vulnerability to adverse post-adoptive social experiences as well (Brodzinsky, Smith, & Brodzinsky, 1998). Compounding this problem is that many adoptive parents have difficulty interacting with their children particularly related to their ability to engage in highly sensitive and supportive interactions with them. In other words, social interactive experiences children have with their parents after adoption might exaggerate pre-existing problems or even cause new developmental problems. 2

To minimize these risks and enhance child development, it may be critical to encourage parents to engage in highly responsive interactions with their adopted children.

Given the importance of adoptive parents engaging in highly responsive interactions with their children, it is critical to identify factors that contribute to parental responsiveness.

That is, to improve parental responsiveness, it is important to understand more about factors which influence parental responsiveness. Although studies have focused on the influence that parental responsiveness has on adopted children’s development, factors which impact parental responsiveness have been understudied.

To explore these factors, this study will examine 41 adoptive parents who participated in an early intervention program. To minimize the intervention effects which might reduce individual differences in parental responsiveness, this study analyzed assessments that were collected prior to the intervention. This study will evaluate the influence of three types of factors on parents’ responsiveness—characteristics of parents, characteristics of children and social context characteristics—based on a framework which integrates the Transactional Model of Development and Belsky’s Model of the

Determinants of Parenting.

There are three aims for this study:

Aim 1: To examine the characteristics of parents that may be associated with their

level of responsiveness with their children.

Aim 2: To examine the characteristics of children that may contribute to parental

responsiveness.

Aim 3: To examine the characteristics of social context that influence parental

responsiveness. 3

Results from this study could be used to :1) help social work professionals target factors that could increase the effectiveness of interventions designed to enhance parent- child interaction; 2) help parents understand the possible determinants of their interactive behaviors with their adopted children; and 3) help to enhance adopted children’s development through enhanced responsive interactive behaviors.

Problem Statement

Since 1987, the number of children adopted each year has remained fairly consistent, ranging from 118,000 to 127,000 (U.S Department of Health and Human

Services, 2004). Approximately 1.7 million children live with adopted parents, and about

4 % of American families live with one or more adopted children (United States Census

Bureau, 2003). Given these large numbers of adopted children, researchers and practitioners from various disciplines have investigated the influence of adoption on children and their families. Because there are a large number of adopted children and adolescents in outpatient and inpatient mental health facilities, adjustment problems of adopted children have been a primary focus of research.

Unique Features of Adopted Children

It has long been believed that adopted children are more likely to experience

developmental delays or mental health problems than non-adopted children. This belief

has been supported by results reported from a national representative survey, The

National Survey of Children’s Health. Findings from this survey indicated that adopted

children not only have poorer health than their non-adopted peers by 6%, but that they

also have 25% more emotional, developmental and behavioral problems than non-

adopted children (Bramlett, Radel, & Blumberg, 2007). 4

There is also an increasing body of research which indicates that adopted children have more psychological problems than non-adopted children. Wierzbicki (1993) conducted a meta-analysis of sixty-six published studies related to the psychological adjustment of adoptive children. Overall, adopted children showed higher levels of psychological maladjustment than non-adopted children with an effect size (d) of .72.

Adopted children were more likely to be represented in clinic samples (d =1.38), to have externalizing disorders (d =.22) (e.g., hyperactive, aggressive, delinquent, conduct disorder, conflicts with peers, running away) and academic problems (d =.13) (e.g., academic performance/ achievement, learning disabilities, intelligence, assignment to special-education classes). Recently, Juffer, and Van IJzendoorn (2005) also conducted a meta-analysis to explore adopted children’s behavioral problems. Studies included in this analysis had samples of adoptees ranging from early childhood to adulthood. Findings indicated that adoptees displayed more behavioral problems (d = .18), including both externalizing (d = .24) (e.g. aggressive, delinquency, hyperactivity) and internalizing problems (d =.16) (e.g., withdrawn, anxious, depressed) than non-adopted children.

According to Cohen’s criteria (1988), an effect size less than .20 is considered to be small, an effect size between .20 and .80 is medium, and an effect size more than. 80 is large. Based upon these criteria, many of effect sizes discussed above are small. However,

Wierzbicki’s study reported an overrepresentation of adopted children in clinical settings

(d =1.38). Although the group comparison effect sizes between adopted children and non- adopted children with a certain diagnosis were small (between .10 and .23), the effect size increased to d =1.38 when the percentages of adopted children in a clinical sample were considered. 5

One of the issues addressed in the literature is whether children’s age of adoption has a significant influence on their likelihood of having social emotional problems later in life. Stem, Juffer, Rispens, and Hoksbergen (2000) studied the developmental outcomes of a sample of children who were adopted before 6 months of age. Stem et al. found that at seven years of age about 30% early adopted children were classified as clinical on the CBCL total problems scale compared to only 10% of children living with their birth parents. They concluded that even when children were adopted at an early age, the likelihood of children developing social emotional problems was still very high.

Consistent with the findings reported by Stems et al. (2000), Juffer and IJzendoorn (2005) conducted a meta-analysis of studies examining the social emotional outcomes of adopted children based upon their age of placement. They found that there were no differences between children adopted as infants (0-12 months) compared with children adopted after their first birthday in total behavioral problems (Q1 = 2.27; P = .13), externalizing problems (Q1 = 3.44; P = .06), or internalizing problems (Q1 = 0.23; P

= .63).

In addition, there has been debate about what overrepresentation of adoptees actually means. Jerome (1994) hypothesized that it stems from adoptive parents having a lower threshold for referring their children. Adoptive parents are likely to have a high

Social Economic Status (SES) (Palacios & Scanchez-Sandoval, 2006), which might enable them to utilize social services more easily. In addition, adoptive parents may be more anxious about their children’s health and well-being and may have become familiar with clinical settings while going through the adoption process (Ingersoll, 1997). In contrast, others have argued that adopted children actually have a higher rate of 6 externalizing problems than non-adopted children (Hauggard, 1998; Stams, Juffer,

Rispens, & Hoksbergen, 2000). That is, regardless of whether the percentage of adoptees in mental health facilities are affected by referral bias, adopted children may still be at greater risk for developmental functioning, mental/physical health, and behavioral problems than non-adopted children (Brodzinsky, Smith, & Brodzinsky, 1998).

What factors contribute to the psychological and behavioral problems of adopted children? Are these problems simply a result of the adverse experiences these children had prior to adoption; or are they related to the psycho-social experiences they have with their adoptive families? If these problems are influenced more by the kinds of experiences children have with their adoptive families, it may be possible to prevent or reduce the amount and severity of problems that adopted children experience.

Wierzbicki (1993) proposed that both genetic and environmental factors contribute to the psychological and behavioral risks of adopted children. Research has shown that birth parents of adopted children have a high rate of psychological disorders such as schizophrenia, bipolar disorder, alcohol abuse, depression and antisocial personality (Brodzinsky & Schechter, 1990). In so far as genetic factors might cause these conditions, adopted children may have a high rate of genetic risks for psychological or mental health disorders.

One of the most important environmental risk factors for adopted children is the quality of care they receive in institutions prior to their placement (Wierzbicki, 1993).

Often, institutional care consists of a low staff to child ratio, as well as multiple and inconsistent caregivers on a daily or weekly basis (Roberson, 2006). These factors result in children having limited environmental stimulation and few opportunities for reciprocal 7 interaction with adults. The poor quality of care children receive in institutions could be a major determinant of the social and health outcomes they experience later in their lives

(Roberson, 2006).

Another environmental risk is the experience of separation and adjustment to new environments. Adoption is thought to be a stressful event for children because it involves the loss of their biological parents and familiar environments (Brodzinsky &

Schechter, 1990). The stress children experience resulting from their feeling of loss may lead to psychological and learning problems (Brodzinsky, 1990). Brodzinsky and

Schechter (1990) have used psychodynamic theories related to rejection, loss and separation to explain the high rate of mental health problems of adopted children. In addition, several studies explained environmental risks based on the attachment theory

(Bowlby, 1988). According to Juffer, Bakermans-Kranenburg, and Van IJzendoorn (2005), adopted children may have unmet attachment needs or suffer from a severe lack of response from others which results in attachment problems. Attachment problems are highly predictive of future child psychopathology (Green & Goldwyn, 2002). Carlson,

Sampson, and Sroufe (2003) postulate that the attachment relationship may serve as a foundation for children learning to regulate their emotions. Calkins, Smith, Gill, and

Johnson (1998) assert that children’s failure to develop emotional regulation contributes to their engaging in both aggressive and withdrawn behaviors.

In addition to pre- adoption adversity, aspects of environments provided by adoptive parents may also contribute to children’s behavioral and mental problems

(Miller, 2005). Jerome (1994) hypothesized that the disparity between adoptive parents’ high expectation and their children’s relatively low-ability may also make children feel 8 frustrated or rejected from their new families. In addition, children who experience ―loss‖ have unresolved issues and may have difficulty adjusting to new environments and accommodating to the caregiving style of their new adoptive parents (Roberson, 2006).

Generally, newborn adoption occurs through private agencies. Because of this the developmental problems among this population of children are not well documented.

Nonetheless, newborn adopted children may be at high risk for later developmental and social emotional problems due to the fact that their parents may have greater difficulty adapting to these children than birth parents have with their children. This may be caused by a variety of factors including adoptive mothers’ lack of experiencing pregnancy, delivery and the biological changes associated with child birth, the inability of adoptive mothers to breast feed their children, and adoptive parent not fully believing that their adoptive child truly belongs to them. In addition even though children are adopted as newborns, they still experience the ―loss‖ of their biological parents which may lead to their resenting their adoptive parent as they grow older. Therefore, newborn adoption is associated with a number of psychosocial risk factors that increase their likelihood for developmental problems, even though the number and severity of risks may be less than those affecting older adopted children.

Adoption cannot change the genetic factors that place children at risk for developmental problems, nor can it erase the early negative events that children have experienced. Nonetheless the supportive environments that adoptive parents provide may buffer the risks and/or promote child development. For example, Rushton, Dance, and

Quinton (2000) reported a study of the first year of placement of 61 adopted children and their parents. Results indicated that the quality of interaction including parents’ warmth 9 and sensitivity and children’s willingness to build relationships with their new parents predicted placement stability. Moreover, Schweiger and O’Brien (2005) reported a study which indicated that adoption can exaggerate children’s risk if new adoptive parents have difficulties responding sensitively to their children. That is, the role of adoptive parents is critical to reducing risks and promoting child development.

Unique Features of Adoptive Parents

Research on Disadvantages for Adoptive Parents. It is not only children who have difficulty adjusting to their new environment and recovering from negative pre- adoption history; parents also experience challenges as well (Brodzinsky & Schechter,

1990). Many assume that adoptive parents may have unique issues and experiences that make it difficult for them to engage in a style of caregiving that is well suited to maximizing their children’s development. First, infertility is the major reason for adoption; therefore, those who are seeking to adopt might already be experiencing depression, anxiety, low self-esteem, and marital difficulties because of this problem

(Edelmann & Connolly, 1986). These psychosocial stressors might not only impact the couple’s relationship, but also their interaction with children. This is especially true if parents have not resolved these emotional issues before they adopt their children. Second, the transition to parenthood tends to be dramatic, so that parents can be emotionally and physically overwhelmed by the abrupt changes (Schechter, as cited in Levy-Shiff,

Goldshmidt, & Har-Even, 1991). Levy-Shiff and colleagues (1991) described the disadvantages of adopted parents regarding the parent-infant relationship due to the fact that adoptive parents do not have the nine months of pregnancy to bond with their children. Finally, Levy-Shiff et al. (1991) conjectured that friends and relatives may 10 contribute to adoptive parents’ feelings of inadequacy by treating them with pity and consolation because of their failure to give birth to their own child. In other words, families with adopted children may be devalued because adopted children may be regarded as ―not quite as good as having your own child‖ (Fisher, 2003. p. 352).

Research on Advantages for Adoptive Parents. There are some who assert that adoptive parents may have advantages that many birth parents do not have. First, the transition to parenthood has a dramatic impact on the psychological well-being of all parents. As a result, becoming a parent is stressful for all parents, not just adopted parents

(Ceballo, Lansford, Abbey, & Stewart, 2004). However, the transition to parenthood is deliberate for adoptive parents and often takes place at a more secure life and career stage

(Hamilton, Cheng, & Powell, 2007). Adoptive parents tend to be older than biological parents and less likely to have financial problems (Brodzinsky & Huffman, 1988). In addition, Levy-Shiff, Goldshmidt and Har-Even (1991) argue that because ―adoptive parents have long been deprived of the parenting experience; they will likely be more intense as parents and will underrate the difficulties related to parenting‖ (p. 132).

Second, adoptive parents derive great satisfaction from their adoption. For example, Ceballo et al.’s study of 204 parents found that adoptive parents reported greater satisfaction with their family and higher family cohesion than did parents who had biological children or stepchildren. Ceballo et al. interpreted their results as indicating that adoptive parents may experience and deal with their distress, unmet expectations, and potential conflicts before the adoption. These experiences may help adoptive parents handle their stress and have stronger coping skills. To support this notion, Abby, Andrews, and Halman (1994) conducted a longitudinal study of 174 11 infertile couples. Results indicated that the transition to parenthood was positively associated with global life quality and increased personal control among infertile women who adopted. In conclusion, adoptive parents have both advantages and disadvantages that might negatively or positively impact their relationships with their children.

Given the disadvantages adopted children experience before adoption, the challenges they face after adoption, and the unique circumstance of adoptive parents, it is natural that research has been focused on the quality of the relationship between adopted children and their parents. This is especially the case due to the fact that building positive relationships is critical, not only for the developmental, social and emotional well-being of the adopted children, but also for the stability of the adoption and the satisfaction of the adoptive parents (Roberson, 2006). Thus, after adoption, most parents focus on developing relationships with their adopted children (Fontenot, 2007). An important aspect of this relationship is that parents learn to become highly sensitive and responsive to their children. Recognizing the importance of parental responsiveness, this study proposes to identify the factors which are associated with parental responsiveness.

12

Chapter 2

Conceptual Framework and Literature Review

For many years, child development researchers have been interested in determining how parents influence the cognitive, language, social and emotional development of young children. Two major findings have emerged from this research.

First, children’s development is likely to be delayed if they do not receive threshold levels of one-to-one social interaction with their parents or other primary caregivers. This situation occurs most often in multi-risk and extremely low SES families, particularly when parents have limited education and significant mental health problems (Hart &

Risley, 1995). Second, given that children are receiving threshold levels of stimulation, the degree to which parents engage in responsive interactions with their children contributes to the variability in children’s rate of development.

Since adopted children are usually placed with parents from middle to higher levels of socio-economic status who do not have mental health conditions, it is likely that they receive at least threshold levels of one-to-one stimulations from their parents. Thus, the influence that adoptive parents have on their children’s development is most likely related to their style of interacting with their children, particularly the degree to which they engage in responsive interaction.

To provide a background for this study, this chapter will; 1) define responsiveness;

2) describe measures which assess parents’ style of interaction; 3) describe the conceptual model for this study; 4) review studies which describe how parental responsiveness is related to concurrent or long term measures of children’s development; and 5) review research related to factors that may contribute to parental responsiveness with their 13 children.

Definition of Parental Responsiveness

Parental responsiveness is defined in a variety of ways ranging from broad to narrow definitions. That is, there is no universal definition of responsiveness.

First, parental responsiveness can be defined narrowly by focusing on one specific interpersonal behavior. For example, response contingency is defined as ―the parent changes her [his] behavior in response to the infant’s focus of attention‖ (Cielinski,

Vaughn, Seifer, & Contraras, 1995, p. 166). In addition, the promptness or frequency of responses to the infant’s signals is an essential feature of contingency. Parental contingent behaviors must be associated with children’s previous behaviors and communications

(Mahoney & MacDonald, 2007).

Second, Ainsworth, Bell, and Stayton (1971) defined responsiveness more globally. According to these researchers, parental responsiveness is the ability to perceive and interpret the signals and communications implicit in infant’s behavior, and to respond to them appropriately, promptly and contingently in a manner that is matched to the child’s developmental level. In other words, Ainsworth et al. (1971) not only considered

―contingency‖ to be an essential element of responsiveness, but also felt ―appropriateness‖ was important as well. Appropriateness can be defined as responsive behaviors that support and encourage the child’s actions, efforts, and intentions. In addition, appropriate behaviors may be determined by the correspondence between parents’ responsive behavior with children’s current level of functioning, interests, and behavioral style

(Mahoney & MacDonald, 2007).

Third, De Wolff and van IJzendoorn (1997) added to additional elements 14

Ainsworth et al.’s definition of responsiveness. They defined parental responsiveness as a behavioral style that encompasses sensitivity to the child signals, prompt and appropriate response, cooperation with and respect for the child’s autonomy, emotional support, warmth and acceptance, and emotional availability. This definition introduces emotion related elements to the notion of responsiveness.

Fourth, Bradley (1989) defined parental responsiveness in the Home Observation for Measurement of the Environment (HOME) Inventory without identifying specific behavior elements such as contingency, appropriateness, etc. He defines responsiveness in terms of how much ―parent[s] responds to child’s vocalization with a verbal response‖

(p. 65) and whether ―parent[s] caresses or kisses child at least once during visit‖ (p. 65).

Regardless of how researchers define and operationalize responsiveness, research tends to produce similar outcomes. That is, research using measures of responsiveness derived from the four definitions described above have shown similar relationships between parental responsiveness and a broad array of child development outcomes. For example, assessing responsiveness by the HOME inventory, Bradley (1989) reported moderate correlations between parental responsiveness and children’s IQ at age three.

Similarly, research conducted with measures of responsiveness that are based upon broader definitions (e.g. Ainsworth et al. 1971 or De Wolff & van IJzendoorn, 1997) show that parental responsiveness is moderately correlated with children’s cognitive development (e.g., Trivette, 2003). One possible explanation for this is that the various parent behaviors used to define and assess responsiveness are highly correlated with each other. Thus, any element of responsiveness that is assessed provides an estimation of the other elements of responsiveness that are not assessed. Therefore, theorists and 15 researchers propose the assumption of a unitary organization—integration of addressed aspects—rather than viewing these characteristics as discrete. They believe that the various components of parental responsiveness are intertwined with each other

(Kochanska, 1998).

Measures of Parental Responsiveness

As researchers and practitioners have become aware of the importance of parental responsiveness, it has become increasingly important to develop measures to assess the quality of parent-child interaction; as such, these measures have been a key element for research (Kelly & Barnard, 2000).

The assessment of responsiveness is partly dependent on how parental responsiveness is defined. Corresponding to the definitions in the previous sections, parental responsiveness can be operationalized and measured in different ways. For example, the HOME Inventory measures parental responsiveness based solely on whether mothers respond to their children’s language during a home visit. In other cases, researchers who define and operationalize parental responsiveness in terms of contingency use microanalytic methods. They code the number of parental actions which are directly related to preceding child behaviors. On the other hand, Ainsworth et al.

(1971) and De Wolff and van IJzendoorn (1997), who define parental responsiveness more globally, measure parental responsiveness with global ratings of general amount and quality of responsiveness and supportiveness of the parent to the child. In addition, they rate the global affective quality of the parent’s relationship with their children.

Among the different methods used for assessing parental responsiveness, the two most commonly used are event recording and global rating. Event recording analyzes 16 each of the discrete behaviors produced by the child or parent and assigns them to predetermined categories. This method is mostly used when parental responsiveness is defined in terms of specific behaviors, such as response contingency. To measure response contingency, an interactive sequence may be observed in which a child looks, smiles, and then vocalizes, followed by the parent vocalizing back to the child; the behaviors of both parent and child are recorded and classified into predetermined codes.

Observed behavior can be recoded based on the frequency of contingent responses to the child’s behavior.

Global ratings are based on diverse child development theories and the complex nature of responsiveness. This method assesses a variety of behaviors and characteristics of parents. Instead of coding the frequency of discrete behaviors, global ratings assess the general quality of parent-child interaction as observed in free or structured play in natural or clinical settings. Free play includes engagement in an activity of parents’ or children’s choice (with toys or without toys); while structured play includes tasks such as teaching, cleaning toys, or opening a gift together (Kochanska, 1998). Based on an entire observation, ratings (e.g. Likert Scale) are assigned to the various characteristics of parental responsive behavior that Ainsworth et al. and De Wolff and van IJzendoorn have identified.

The following global assessment scales have been validated, published, and used widely: the Nursing Child Assessment Feeding Scale (NCAFS, Barnard et al. 1989), the

Maternal Behavior Rating Scale (MBRS; Mahoney, 1992; Mahoney, Powell, & Finger,

1986), the Parent-Child Observation Guide (PCOG; Bernstein, Percansky, & Hans, 1987), the Mother-Child Rating Scale (MCRS; Crawley & Spiker, 1982), and the Parent-Child 17

Early Rational Assessment (ERA , Clark, 1985). These scales share core elements with regard to parental characteristics: responsiveness, sensitivity, stimulation, and affect.

Variability in parental responsiveness generally predicts concurrent or future child development. However, the magnitude of correlations between parental responsiveness and child development are inconsistent and at times contradictory (Bakeman & Brown,

1980). Some studies report strong associations between parental responsiveness and children’s development (Landry, Smith, Swank, Assel, & Vellet, 2001; Mahoney &

Perales, 2005; Bradley, 1989). Other studies have reported little to no association between parental responsiveness and children’s development (Bakeman & Brown, 1980;

Ruble, McDuffie, King, & Lorenz, 2008). Bakeman and Brown (1980) state that these different outcomes may result from the different measures that have been used. That is, they hypothesize that the low or no predictability reported in some studies may occur because of inappropriate measures of parental responsiveness:

It may be more fruitful to think of characteristics of early interaction, like responsiveness, not as frequencies of particular acts but rather as a disposition which permeates all of the mother’s interactive behavior, …, And in that case, global rating scales, and not sequential recording of minute particular behaviors followed by various microanalyses, might be the method of choice (p. 445).

Measures of discrete behaviors of parents often do not generalize across contexts and time, so that they have low predictive validity. However, global ratings also have limitations. Global assessment of parental responsiveness are generally less reliable than micro level assessments because global assessments require subjective judgment.

However, since the goal of assessing parental responsiveness is to understand how parenting predicts child development, most researchers tend to assess parental responsiveness globally rather than in terms of distinct incidences of responsive 18 behaviors (Kassow & Dunst, 2005).

Conceptual Model

The theoretical framework for this investigation is derived from the Transactional

Model of Development (Sameroff & Chandler, 1975) and from Belsky’s Model of

Parenting (Belsky, 1984).

Transactional Model of Development. The Transactional Model of

Development posits that children’s development is influenced by the quality and frequency of interactions that take place between parents and children. The term transactional implies that interacting between parents and children are not influenced only by parents’ style and frequency of interacting with their children but also by the characteristics and behaviors of children as well (Sameroff, 1993). For example, a child’s difficult temperament may influence parents to reduce the time spent with their child

(frequency) or affect the types of interactions parents have with their children

(qualitatively) due to their decreased pleasure from interacting with them. This could result in the child not receiving enough stimulation from his/her parents to meet the norm for development (Sameroff & Fiese, 1990) That is, both the parent and the child can mutually alter and shape their relationship with each other (Belsky, 1984).

The Transactional Model of Development has two main premises. First, children’s development is influenced both by their own inherent characteristics as well as by their experiences with their interactive partners (Sameroff & MacKenzie, 2003). Collins,

Maccoby, Steinberg, Hetherington, and Bornstein (2000) emphasized that although specific factors explain large portions of children’s development, elements of the child’s environment, such as parent-child interaction, also exert significant influences. Collins 19 and colleagues postulated that positive parenting may moderate those aspects of children’s disposition that put them at risk developmentally.

Second, children’s behaviors or characteristics may affect parents’ interaction style (Sameroff & Fiese, 1990). Thus, compared to other child development models, the

Transactional Model of Development emphasizes the important effects that children have on parent-child interaction. That is, both parents and children learn ways to interact with each other, mutually shaping the parent-child relationship over time and becoming competent in reacting to each other (Kaye, 1976).

For example, children with ―easy‖ temperament are likely to evoke different reactions from caregivers than children with ―difficult‖ temperament or intense negative affect (Kochanska, Friesenborg, Lange, & Martel, 2004). Children’s developmental status may also influence parent-child interaction. According to Keogh, Garnier, Bernheimer, and Gallimore (2000), families make adaptations that are calibrated to their children’s developmental level, including time spent together and the complexity of activities they do together.

The Transactional Model of Development also emphasizes the impact that social contextual factors can have on the frequency and quality of parents’ interaction with their children (Sameroff & Mackenzie, 2003). For example, negative economic factors and lack of social support and other stressors may exhaust the physical and psychological resources parents have to interact with their children. Under stress, the possibility of abusive or neglectful parenting may increase placing children at greater risks for developmental delays (Sameroff & Chandler, 1975).

Belsky’s Model of Parenting. Belsky (1984)’s Model of Parenting, which was 20 derived from the Ecological model (Bronfenbrenner, 1979), postulates that ―parenting is directly influenced by forces emanating from within the individual parent (personality), within the individual child (child characteristics of individuality), and from the broader social context in which the parent-child relationship is embedded‖ (p. 84). These factors do not independently influence parenting as separate determinants, but, rather, as a

―coherent whole‖ that is more than the sum of individual factors (Belsky, 1984). Belsky also states that although parenting should be understood as entailing three factors, these factors are not equally influential. Parenting styles may differ, depending on the broader context in which parents and children exist as well as on the individual characteristics of parents and children (Belsky & Jaffee, 2006). There have been many efforts to support and refine Belsky’s Model of Parenting through experimental and conceptual studies. In the remainder of this section, the components of each factor will be discussed briefly. In the next section of this chapter, experimental studies that explored these factors will be described.

First, parents’ contribution to their interaction style is summarized as parental personality and psychological well-being (Belsky, 1984). Bornstein, Hendricks, Haynes, and Painter (2007) reported that different personality traits in mothers may facilitate or undermine maternal sensitivity. For example, Belsky, Crinic, and Woodworth (1995) found that mothers who are extraverted tend to be more sensitive toward their children. In addition, maternal psychological functioning, including parental depression and stress, has been reported to be associated with higher likelihood of maternal disruption, hostility, and rejection of nurturing responsibilities (Belsky, 1984). For example, parenting stress influences the caregiver’s ability to respond sensitively and appropriately to the child 21

(Ostberg, 1998; Calkins, Hungerford, & Dedmon, 2004). Moreover, highly stressed parents are often more irritable, critical and severe in their interactions with their children

(Webster-Stratton, 1990). In addition, many of the characteristics associated with maternal depression, including diminished emotional involvement, impaired communication, disaffection, and increased hostility and resentment, can impede mothers from interacting responsively with their children and/or yield higher rates of negative interaction (Lovejoy, Graczyk, O’Hare, & Neuman, 2000).

Second, children’s temperament has been a major focus of studies of child characteristics that affect parenting. Belsky postulates that parents who perceive their children as having a difficult temperament, are less likely to be responsive to their children’s cries, and more likely to respond harshly to their children’s negative emotions.

Bornstein et al. (2007) reported a study that underscored the impact that child characteristics might have on their language competency. They reported that ―children who exhibit more advanced representation and language abilities might be more responsive themselves and promote higher levels of maternal sensitivity‖ (p. 197).

However, Belsky (1984) posits that parents’ and children’s contribution do not impact parent-child interactions independently, but, rather, the ―goodness-of-fit‖ between parent and child is crucial to determining parent-child interaction style.

Third, the social context includes factors such as the marital relationship, social network, and parents’ work (Belsky, 1984). These components can directly impact parenting (e.g. lack of available time for children due to the work schedule). However, marital relationship and social networks may also impact parenting indirectly as sources of support or causes of stress. For example, Belsky and Jaffee (2006) claim that marital 22 relationships are the ―first order support system‖ for parents. Social support impacts parenting by lessening or promoting parents’ psychological well-being. In addition, these sources of support tend to increase parental satisfaction which facilitates parent-child interaction (Kindle & Erich, 2005).

Parental responsiveness has been reported to be an interactive quality that influences children’s developmental growth and social emotional well being. According to both the Transactional Model of Development and Belsky’s Model of Parenting, the ability of parents to engage in responsive interactions with their children is affected by a host of factors including characteristics of children, the psychological well being of parents as well as family’s psycho-social support. In this study, the Transactional Model of Development and Belsky’s model, both of which consider these interactions and combinations for parental responsiveness, will serve as the overarching framework.

23

Literature Review

Based on these two models, a literature review was conducted. First, the

Transactional Model of Development presumes that children’s development is influenced by experiences with their parents. Therefore, the first section, ―Parental Responsiveness and Child Development‖ supports this premise. The other premise of the Transactional

Model of Development is that not only parents but children also effect parental responsiveness, which is one of the styles of parent-child interaction. In the second section, ―Determinants of Parental Responsiveness,‖ studies exploring the influence of children’s characteristics on parental responsiveness are reviewed. In addition, studies on parents’ own characteristics and their social contextual factors, as well as on children’s characteristics (as based upon Belsky’s model of the determinants of parenting) will also be reviewed in this section.

Parental Responsiveness and Child Development

During the past 30 years, a large number of empirical and theoretical papers have supported the positive influence of parental responsiveness on various domains of child development. There is a growing body of research studies which indicate that parental responsiveness is a quality or dimension of parenting that either predicts or is associated with children’s cognitive, communication, and social emotional functioning (Kochanska

& Aksan, 2004; Landry, Smith, & Swank, 2006).

This section reviews a number of these studies to illustrate the association between parental responsiveness and child development that have been reported.

Although many of these studies examine the effects of responsiveness across multiple developmental domains, research findings will be reviewed separately for each of three 24 major developmental domains: cognition, communication, and social emotional functioning.

This review includes studies that have examined the developmental effects of parental responsiveness on a broad range of children including typically developing children, children with biological and social environmental risks such as prematurity and low family income, and children with developmental delays. At the end of the review, studies are also described that include adopted children and their parents.

The criteria for including studies in this review are as follows: 1) studies in which parents’ style of interaction with their children (ages one to five years old) is the primary focus, 2) studies in which child development measurements serve as dependent variables and parental responsiveness is the independent variable, and 3) studies reported in the last

10 years (e.g., 1997 2008).

Cognitive Development. At least 10 studies have investigated the relationship between parental responsiveness and children’s cognitive development. In each study, researchers have observed and videotaped parent-child interaction from 5 to 45 minutes in free-play or semi-structured situations to assess parental responsiveness. Nine studies used standardized measures to assess children’s cognitive functioning. Every study except one conducted regression analyses to examine relationships between parental responsiveness and children’s cognitive development.

Bornstein and Tamis-LeMonda (1997) investigated the relationship between maternal responsiveness and children’s cognitive development as assessed by attention span and symbolic play. The sample included 36 parent-child dyads. Children’s cognitive functioning and mothers’ responsiveness were assessed when children were 5 and 13 25 months old. Maternal responsiveness was assessed from 45 minute observations of every day routines in the home. The frequency of maternal prompts, contingent responses and appropriate responses to infant’s nondistress activities (e.g., exploration or vocalization) were coded in 30 seconds intervals. Results indicated significant correlations between the frequency of maternal responses when children were five months old with children’s attention span and symbolic play at the age of 13 months (r = . 43 and r= .44, respectively). Regression analyses indicated that maternal responsiveness at 5 months accounted for 15% of the variance in children’s attention span and symbolic play at 13 months.

McGrath, Sullivan, and Seifer (1998) studied the relationship between maternal interactive style and the cognitive development of children with a range of medical conditions. The sample included 184 preschool children (39 full term, 32 healthy preterm,

28 small for gestational age, 53 sick preterm, and 32 neurologic preterm) and their parents. Children’s cognitive functioning was assessed by the McCarthy Scales (GCI).

Maternal interaction was assessed with measures of responsiveness, involvement, and control style that were derived from the Home Observation for Measurement of the

Environment Preschool Version (HOME), the Parent/Caregiver Involvement Scale (PCIS) and the Problem-Solving Scale (Sullivan, 1994). Results indicated that mothers’ style of interaction explained 33% of the variance in children’s cognitive functioning. Partial correlations were used to examine the unique contribution of the three interactive qualities to children’s development. Only responsiveness was significantly associated with children’s GCI scores (r = . 28, p < .00).

Moore, Saylor, and Boyce (1998) investigated the relationship between parents’ 26 style of interaction with the cognitive development of a group of 88 preterm children who had intraventricular hemorrhage. Parent-child interaction was assessed from 10 minute free-play observations when children were 2 years old. Parents’ style of interaction was coded with the Maternal Behavior Rating Scale (MBRS). Children’s cognitive development was assessed with the Stanford- Binet Scale of Intelligence at 5 1/2 years of age. Results from a stepwise multiple regression indicated that responsiveness was a significant predictor of children’s cognitive development (β= .22, p=.01). While the unique contribution of responsiveness was not reported, the full model, which included maternal education, children’s medical and developmental status, as well as parental responsiveness, accounted for 41% of the variance in children’s Stanford-Binet

Intelligence Quotients.

Milgrom, Westley, and Gemmill (2004)’ examined the relationship between the responsiveness of depressed mothers and children’s development. The sample included

40 clinically depressed and 48 non-depressed mothers and their children. Maternal responsiveness was assessed when children were 6 months old from five, three-minute video taped observations. Mothers’ interactions were rated for frequency of responding to their infant’s cues. Children’s cognitive development was assessed when they were 48 months old with the Wechsler Preschool Scale of Intelligence (WPPSI-R). Results indicated that maternal responsiveness had a significant association with children’s

WPPSI-R IQs (unstandardised regression coefficients = 16.8).

Kim and Mahoney (2004) studied the relationship between maternal responsiveness and development of children with various disabilities. The sample included 50 parent-child dyads. Parent-child interaction and children’s cognitive 27 development were assessed when children were between 8 and 54 months of age (Mean age: 26.34 months). Children’s development was assessed by Transdisciplinary Play

Based Assessment (TPBA) which evaluated the child’s cognitive and communication development. Parents’ interaction styles were videotaped for 5 to 10 minutes while playing with their children. Observations were coded using the MBRS. Regression analyses were conducted to examine the relationships between the mothers’ style of interaction to children’s rate of development. Results indicated that maternal responsiveness was a significant predictor of children’s cognitive development (β = .38, p

< .001), accounting for 14% of the variance of the TPBA scores.

Landry, Smith, Swank, Assel, and Vellet (2001) conducted a longitudinal investigation of the effects of early and late maternal responsiveness on children’s cognitive development. There were 360 parent-child dyads in the sample including 103 full-term, 102 medically low-risk and 77 high-risk preterm children. Observations of parent-child interaction were collected when children were 6, 12, 24, 42, and 52 months old. At each observation, maternal responsiveness was examined during 70 minute home observations of daily activities and play. Observations were coded using two 5-point rating scales: warm acceptance and flexibility/ responsiveness. Warm acceptance was described as physical affection, close contact, appropriate pacing and positive voice tone.

Flexibility/responsiveness was defined as the characteristics of prompt, appropriate response, sensitivity, and contingency. Early maternal responsiveness was the average of scores from the observations that were conducted when children were 6, 12, and 24 months old. Later maternal responsiveness consisted of ratings obtained from the 42 and

54 month observation. Four clusters of dyads were created based on the levels of 28 maternal responsiveness observed in early and late time periods: high-high, high-low, low-moderate, and low-low. In addition, in order to assess children’s cognitive development, two different measures were used: the Battelle developmental Inventory

(BDI) when children were 6, 12, and 24 months old and the Standford-Binet Intelligence

Test when children were 42, and 56 months old.

Growth curve analysis was used to examine the relationships between maternal responsiveness and children’s cognitive development over time. This procedure yielded three findings. First, when children were 30 months old, there was approximately a 3- month developmental age difference between children of mothers in the high-high cluster and children of mothers in the low-low clusters across all categories of child’s risk.

Second, the relationship between maternal responsiveness and changes in children’s development varied according to the interaction between cluster and children’s risk category. That is, both low risk and high risk children whose parents were in the high- high responsiveness clusters had 24% higher cognitive growth rates than similar children whose parents were in the low-low responsiveness clusters. Third, across all risk categories children of mothers who were in the high-high clusters had higher levels of cognitive development over time than children of mothers.

Studies have also investigated how mothers’ style of interaction affects children’s cognitive development while they are participating in early intervention. Wheeden (1996) investigated a subsample of 298 low birthweight children who participated in the Infant

Health and Development Program (REFS). This large-scale, multisite intervention research project randomly assigned dyads into treatment and control conditions before children were discharged from the newborn nursery. Children in the treatment group 29 received an extensive array of developmental intervention services including home visiting during their first 12 months of life and a 25 hour per week high-quality preschool experience when they were between 12 to 36 months of age. Children in the control group received medical follow-up services through the entire 36 month period.

Observations of mothers’ interacting with their children were assessed with the MBRS when children’s corrected age was 30 months. Children’s cognitive functioning was assessed with the Bayley Scales of Infant Development (BSID) when children were 24 months old and with the Stanford-Binet when children were 36 months old. Results indicated a significant relationship between maternal responsiveness and children’s cognitive development. Maternal responsiveness accounted for 13% of the variance in

BSID scores and 25% of the variance in Stanford-Binet scores.

Fewell and Wheeden (1998) investigated the role of parent-child interaction in an early intervention program for teen mothers called PALS. This program was designed to enhance the developmental functioning of infants and toddlers by teaching mothers how to interact more responsively with their children. A pre-post design was used to assess the effects of this intervention by comparing Treatment to No-Treatment Control Dyads. The sample included 42 adolescent mothers and their children (mean age 11.5 months).

Children’s cognitive functioning was assessed with the Developmental Activities

Screening Inventory-II. Maternal interaction was assessed from 5 minute free-play observations and coded with the MBRS. Results indicated that the intervention was effective at both increasing mothers’ responsiveness and enhancing children's rate of developmental functioning over a three-month intervention. Stepwise multiple regressions indicated that maternal responsiveness accounted for 10% of the variance in 30 children's rate of development at the end of intervention.

In general, results from these studies indicate there are significant relationships between parental responsiveness and the rate of cognitive development attained by healthy children, preterm children, children with developmental delays, as well as children of depressed mothers. Furthermore, research indicates that this relationship continues to exist even when children are participating in developmental intervention programs.

Overall, the effect sizes of the studies reviewed above are in the weak to moderate range. Nonetheless, these results are highly noteworthy primarily because of the consistency with which maternal responsiveness is reported to be associated with children’s cognitive development, even though the children and parents who participated in these studies have been quite diverse.

Communication Development. Many researchers have proposed that parental responsiveness including maternal communicative behaviors that are contingently related to previous attempts by children to communicate as well as parents’ modifying the structure and length of their utterances to match children’s current level of language functioning may play a critical role in promoting children’s language development. The following reviews several studies that have examined the relationship between parental communicative responsiveness and children’s rate of language and communication development.

McGrath, Sullivan and Seifer (1998) examined how mothers’ patterns of interacting with their children were related to their children’s language development. As described in the previous section, these authors assessed mothers’ interaction patterns 31 with three measures including responsiveness, involvement, and control style. Children’s language functioning was assessed with the Peabody Picture Vocabulary Test- Revised

(PPVT-R; Dunn & Dunn, 1981). Results indicated that mothers’ style of interaction explained 29% of the variance of children’s language functioning. Partial correlation coefficients indicated that of three interactive qualities, only responsiveness was significantly associated with children’s PPVT-R scores (r =. 36, p < .00).

Bornstein and his colleagues reported several studies investigating the relationship between mothers’ style of interaction and children’s language development.

In one study, Bornstein and Tamis-LeMonda (1997) examined the relationship between maternal responsiveness and children’s language comprehension as measured by the

Early Language Interview (ELI; Bates et al., 1988). Maternal responsiveness was assessed when children were 5 months old and children’s language comprehension was assessed at 13 months. Results indicated that maternal responsiveness when children were 5 months old did not significantly predict children’s language comprehension at 13 months. However, Bornstein and Tamis-LeMonda argued that these results occurred because at 5 months of age children are not neurologically mature enough to recognize their mothers’ communication intentions.

In another study, Baumwell, Tamis-LeMonda and Bornstein (1997) observed parental responsiveness in a sample consisting of 40 parents and their healthy children twice when children were 9 and 13 months old. Maternal verbal responsiveness was observed from 10 minute mother-child play situations with a standard set of toys and was coded by the frequency of maternal responses. Maternal responses were defined as changes in verbal behaviors that were contingent related to previous child vocalization 32

(e.g., responsiveness), verbal elaborations of children’s activities or toys on which they were attending (joint topic focus), and verbal attempts to encourage children to focus on toys (focus). In addition, the frequency that mothers failed to respond verbally to a child’s activity within 5 seconds or before the child moved to different activity was also coded.

Children’s language comprehension was assessed by the Language and Gesture

Inventory (Bates, Bretherton, & Snyder, 1988) and the MacArthur Communicative

Developmental Inventories (Fenson et al., 1991). Two significant findings were reported from this study. First, multiple regressions indicated that mothers’ verbal responsiveness at 9 and 13 months explained 15% and 2% of the variance respectively in children’s language comprehension after controlling for children’s early language comprehension.

Second, children’s language comprehension at 9 months moderated the relationship between maternal verbal responsiveness at 9 months on children’s language comprehension at 13 months. In other words, the effects of maternal responsiveness on children’s language comprehension differed based upon children’s level of language comprehension at 9 months (slope = .34 in lowest; slope = .23 in medium; slope = .12 in highest language groups).

In another study, Bornstein and his colleagues (Tamis-LeMonda, Bornstein, &

Baumwell, 2001) reported a longitudinal analysis of the relationship between mothers’ responsiveness and children’s achievement of language milestones using the same data as reported by Baumwell et al (1997). Maternal responsiveness included six categories of communicative behavior: affirmation of a child’s action; imitation of a child’s vocalization; description of an object, event, or activity; question about an object, event, or activity; play prompt or demonstration; and exploratory prompt. Children’s 33 communication skills were assessed by the Early Language Inventory (ELI: Bates,

Bretherton, & Snyder, 1988) and the MacArthur Communicative Developmental

Inventories (MCDI). Children’s communication skills were coded in terms of the age that they acquired five language milestones: first imitations, first words, 50 words, first combinational speech, and first use of language to talk about the past.

A nested hierarchical χ² was used to examine maternal contributions to children’s language development. The reduction of χ² goodness-of- fit value by the addition of maternal responsiveness measures to the model indicated that maternal responsiveness improved the model fit. Measures of maternal responsiveness were significantly associated with the age at which children acquired the five language milestones. An

Event-History Analysis was used to compare the onset of the five language milestones by children whose mothers were in the highest 10th percentile of responsiveness to children whose mothers were in the lowest 10th percentile. Results indicated the following findings. (1) At 13months, 100% of the children of high responsive mothers vocalized their first imitation, compared to only 50-60 % of the children of low responsive mothers.

(2) 100% of the children of high responsive mothers spoke their first words at 12 months of age, while this did not happen until 21 months of age for children of low responsive mothers. (3) One half of the children of high responsive mothers achieved 50 words by

15 months of age, while one half of the children of low responsiveness mothers did not achieve this milestone until 21 months of age. (4) At the age that 100 % of the children of high responsive mothers reached the milestones of first combinational speech and first use of language to talk about the past, only 30-40% of children of low responsive mothers had reached these same milestones. 34

Landry, Smith, and Swank (2006) studied the relationship between maternal responsiveness and children’s language development as assessed by their use of words.

The sample included 264 mothers and their young children (age range: 6-10 months) from two different biological characteristics: very low birth weight infants and full term infants. These dyads participated in a brief weekly home visiting program (10 sessions)

(Play and Learning Strategies, PALS) which was designed to promote maternal responsiveness. Mothers’ responsiveness and children’s use of words were observed before intervention, in the middle of intervention and after intervention. Maternal responsiveness and children’s use of words were evaluated from observations of daily activity and toy play. Maternal responsiveness was coded with both frequency and global ratings.

Growth curve analysis was used to examine differences in responsiveness between mothers who participated in the PALS intervention and mothers who participated in a minimal treatment Control Group. Results indicated that mothers in the

PALS group became more responsive with their children than mothers in the control group. In addition, children of mothers in the PALS group showed greater increases in their use of words than children in the Control Group (effect size d= .75).

Paavola, Kunnari, and Moilanen (2005) studied the relationship between maternal responsiveness and communication development with 27 healthy infants from Finland and their mothers. Mother-child interaction was observed for 20 minutes in a semi- structured free-play situation when children were 10 months old. Maternal responsiveness was rated with two variables: number of responses and proportion of responses to infants’ communicative acts. Children’s language development was assessed 35 at 12 months with the Finnish version of the MacArthur Communicative Development

Inventory (MCDI) and the Communication and Symbolic Behavior Scales (CSBS;

Wetherby & Prizant, 1993).

Multiple regression was used to examine the relationship of maternal responsiveness to children’s rate of language development. Results indicated that maternal responsiveness predicted children’s ―phrases understood‖ and ―vocabulary comprehension‖ (β = .433, p < .05 and β = .470, p < .05, respectively), but did not predict children’s ―vocabulary production‖ and ―gestures.‖ In addition, maternal responsiveness was not associated with the total score of the CSBS.

Yoder and Warren (1999) explored whether maternal responsiveness mediated the relationship between infant intentional communication and children’s language development. The sample included 58 children (median age: 22 months) with developmental disabilities and their mothers. Maternal responsiveness and children’s intentional communication were observed twice (time 1 and time 2) 6 months apart, for

15 minutes in structured and free-played situations. Children’s language development was examined after 6 months in a second observation (time 3) by the Reynell

Developmental Language Scale. Results indicated that children’s intentional communication at Time 1 was associated with their level of language functioning at Time

3. However, results from regression analyses indicated that that when maternal responsiveness was statistically controlled, the relationship between intentional communication (Time 1) and language outcomes (Time 3) was nonsignificant. These findings suggest that the relationship between intentional communication and later language functioning may be related to the fact that maternal responsiveness plays a 36 critical role in the development of both of these communication skills.

In general, the role of maternal responsiveness for children’s language development has been reviewed in this section. Results from these studies indicate that parental responsiveness is associated with the language development of typically developing children as well as children with developmental risks and disabilities.

Social Emotional Development. Over the past 10 years, at least seven studies have investigated the relationship between parental responsiveness and children’s social emotional functioning. Social emotional functioning is a broad-based construct which captures various characteristics of children. Therefore, in these studies, children’s social emotional functioning has been operationalized in a variety ways. Generally, literature suggests that parental responsiveness promotes infants’ attachment to caregivers, helps toddlers regulate their behaviors and emotions, and encourages preschoolers to learn social skills with social partners (Harrist & Waugh, 2002).

In this review, studies on children’s attachment to caregivers, children’s self- regulation, children’s internal and external behaviors, children’s social competence such as social responsiveness, and social interaction style are included. For example, two studies used children’s responsiveness to their mothers as dependent variables. However, each of these studies added different variables: initiation of social interaction and sustained attention. In Kochanska’s studies, children’s socialization was observed to assess children’s social emotional development. One study focused on children’s behaviors and two studies with adopted children considered children’s attachment as their outcome variable. Each study will be explored in detail.

Landry, Smith, Miller-Loncar, and Swank (1997) studied the relationship between 37 mother’s style of interaction and children’s responsiveness and initiation of social interaction. The sample included 112 full term children (FT), and 73 medically high risk

(HR) and 114 medically low risk (LR) very low birth weight preterm children and their mothers. Mothers’ style of interaction and children’s social responsiveness and initiations were assessed from 60 minute observations of daily activities when children were 6, 12,

24, and 40 months. Mothers’ style of interaction was coded using frequency measures and global ratings of five behaviors: stimulation (making a request, orienting attention, or commenting), warm responsiveness, maintaining, directiveness, and restrictiveness.

Children’s social emotional functioning included ratings of their responsiveness to mothers’ attention- directing behaviors and requests as well as initiation of social interaction.

The relationship between mothers’ interactive style and children’s social competence was examined with hierarchical linear modeling (HLM). Results indicated that children’s social initiation and responsiveness growth rates were positively associated with their mothers’ stimulation (t=3.46, p=.001 and t=3.61, p=.001 respectively). In addition, the growth rate of children’s social initiation was negatively related to mothers’ restrictive behaviors (t= -3.12, p=.002). However, ratings of mothers’ responsiveness and directiveness did not predict children’s social responsiveness and initiation.

Murray, Sinclair, Cooper, Ducournau, and Turner (1999) studied the relationship between the level of responsiveness of 54 depressed and 42 non-depressed mothers and the social emotional development of their 5 year old children. Mother-child interaction was observed for 10 minutes in structured play. Mothers’ style of interaction was coded 38 with three scales: warmth and acceptance, sensitivity to child, and appropriate adjustment to the child’s behaviors. Results from multiple regression indicated that children’s responsiveness and sustained attention were significantly related to mothers’ sensitivity (β=. 70, p <.001) and to their postnatal depression (β= - .16, p <.1). The full model which included maternal responsiveness, postnatal depression, gender, and class explained 59% of children’s social behaviors.

Kochanska, Forman, and Coy (1999) studied the relationships between early mother-child interaction and maternal responsiveness with infants’ socialization in a sample of 112 typically developing infants and their mothers. Maternal responsiveness and style of interaction were observed in structured and free play situations for 60 minutes at home when children were 9 months old, and for 40 minutes in the laboratory when they were 14 months old. Responsiveness was coded with two systems. First, microscopic coding focused on mother’s responsiveness to discrete child behaviors.

Mother’s behaviors were coded in terms of promptness, engagement, sincerity, sensitivity, acceptance, cooperation, availability, following the child’s lead and attention, and adjusting the level of stimulation to children. Second, macroscopic coding was based on the scale developed by Ainsworth et al., (1971). In addition, mother-child interactive positivity, which included mother-child shared positive affect and mother-child harmonious exchange, was observed. Observations were coded by using discrete codes for mother-child shared positive affect and microscopic coding for mother-child harmonious exchange scores. Children’s socialization was observed in three situations at

22 months and coded by frequencies of specific behaviors. Children’s socialization yielded three variables: empathy to maternal distress, child-motivated imitation, and 39 distress to standard violations.

Results indicated that children’s empathy to maternal distress at 22 months was predicted by maternal responsiveness when children were 9 months old (β=. 34, p <.025).

Maternal responsiveness and mother-child interactive positivity explained 9% of the variance of children’s empathy to maternal distress. In addition, mother-child interactive positivity at 14 months predicted child-motivated imitation and distress to standard violations at 22 months (β=. 25, p <.05 and β=. 27, p <.05, respectively). Mother-child interactive positivity and maternal responsiveness explained 5% of child motivated imitation and 11% of children’s distress to standard violations.

Kochanska (1997) investigated the relationships between a ―mutually responsive orientation‖ and children’s early socialization as assessed by internalization of prohibition and request and reluctance to violate rules of conduct. The sample included 99 mothers and their typically developing children. Parental responsiveness and children’s early socialization were assessed when children were between 26 to 41 months old (time 1) and

43 to 56 months old (time 2). Maternal responsiveness was assessed from 30 minute structured observations at home and 10 minutes free play observations in the laboratory at time1. At time 2, both structured and free play observations were conducted in the laboratory. These observations were coded with two different measures. The first assessed parents’ response to children’s bid for attention, requests, and needs for help.

The second was Ainsworth et al.’s scale (1971). Child responsiveness was observed at time 1 and time 2 from a toy cleanup observation and from a 45 minute prohibited toys observation at time 2. Child responsiveness was coded by the frequency that it occurred.

Mutually responsive mother-child orientation scores were created by aggregating scores 40 of mother’s and children’s responsiveness. Children’s socialization was observed in contrived situation including a doll sorting task, toy cleanup, and a situation in which children were encouraged to perform an illegal act. These were coded by the frequencies of children’s internalization of prohibition and request, and reluctance to violate rules of conduct.

Results from a multiple regression indicated that mutually responsive mother- child orientation was a significant predictor of children’s early socialization (β=. 29, p

< .001), accounting for 23 % of the variance.

Shaw, Winslow, Owen, Vondra, Cohn, and Bell (1998) explored the relationship between maternal responsiveness and children’s externalizing problems with 130 mother- child dyads from low income families. Maternal interactive behavior was observed in free-play and structured observations (high chair task) when children were 12 and 24 months old . Children’s behaviors were assessed by the Child Behavior Checklist (CBCL;

Achenbash, 1992) when children were 24 and 45 months old. Maternal responsiveness included the frequency of mothers’ contingent responses and responses to children’s attention seeking behaviors. Maternal rejection —which included verbal/physical disapproval, critical statement, hostility, lack of warmth, and punitive behaviors—were coded by the Early Parenting Coding System (EPCS; Winslow, Shaw, Bruns, & Kiebler,

1995).

Results indicated that for boys maternal responsiveness at 12 months was negatively related to children’s externalizing behavior problems at 24 (r= - .32) and 46 months of age (r= -. 23). For girls, maternal responsiveness was unrelated to the externalizing problems at 24 and 42 months. However, for all children, maternal rejection 41 at 24 months correlated with children’s behaviors problems 42 months (r= .38, for boys, r= .25 for girls). In addition, results of multiple regression analyses indicated that at 42 months children’s externalizing behavior problems were predicted by maternal rejection at 24 months (β=. 28, p=.01), explaining 7% of the variance of score of externalizing behavior problems, while maternal responsiveness did not predict significantly.

In summary, although several studies indicate that maternal responsiveness is associated with the social-emotional development, evidence to support this relationship is inconsistent. One explanation for inconsistent findings is that different aspects of social emotional development have been measured across studies. In addition, many of the outcome variables that were used in these studies were not standardized measures, but rather informal observational assessments.

Parental Responsiveness and Adopted Children’s Development

Results of various empirical studies support the positive influence of parental responsiveness on various domains of child development. That is, parental responsiveness appears to be associated with variability in children’s development. The question remains—Does a similar relationship exist between parental responsiveness and the development of young adopted children?

Cognitive Development of Adopted Children. Two studies have examined the relationship between parental responsiveness and adopted children’s cognitive development. In the first study, Van Londen, Juffer, and Van IJzendoorn (2007) investigated a sample of mother-child dyads that included 70 international adopted children who were 14 months old (Mean time at adopted home: 8.7 months). Mothers’ style of interaction was observed in two, 4-6 minute episodes: singing a song together 42 and reading a book. Observations were coded with the rating scale developed by

Ainsworth, Bell, and Stayton (1974) which assesses mothers’ awareness of signals, ability to interpret their children’s intentions, as well as the appropriateness and promptness of their responses. Children’s cognitive development was assessed with the

BSID. Results from a hierarchical multiple regression indicated that maternal responsiveness accounted for 7% of the variance in children’s of BSID scores (β = 26, p< .05).

Stams, Juffer, and van IJzendoorn (2002) studied the effects of the responsiveness of adoptive parents on their children’s cognitive development early and later in their lives.

This study included 146 internationally adopted children and their parents. All children had been adopted before 6 months of age. Early maternal responsiveness was assessed at three different times (12, 18, and 30 months) using Ainsworth et al.’s scale. Later maternal responsiveness was assessed from an observation of mothers and children solving a difficult puzzle and drawing together and was coded with a scale developed by

Erikson (Erikson, Sroufe, & Egeland, 1985). This scale assessed mothers’ emotional support, respect for the child’s autonomy, structure and limit setting, hostility, and quality of instruction. Responsiveness ratings from 12, 18 and 30 months were reduced to a single principle component. Children’s cognitive development was assessed when they were 7 years old using the Revised Amsterdam Child Intelligence Test (RACIT,

Bleichrodt, Drenth, Zaal, & Resing, 1987).

Children’s cognitive development scores were regressed on early maternal responsiveness, attachment security and disorganization, later maternal responsiveness as well as children’s background and temperament. Only children’s temperament (β = -.21, 43 p < .01) and maternal responsiveness (β =. 23, p < .01) were significant predictors of cognitive development. These results suggest that, similar to reports from other populations, the rate of cognitive development attained by adopted children is significantly associated with their adoptive mothers’ level of responsiveness.

Communication Development of Adopted Children. According to Howe

(1996), adopted children and adoptive parents have the same developmental tasks for attaining optimal development as do biological children and their parents. However, internationally adopted children display extra needs, due to their high incidence of speech and language delay, which have been reported to range from 30% to 40% among internationally adopted children (Glennen, 2002). Although family environments have been identified as critical to promoting adopted children’s language development, little research has been done on the influence of adoptive parents’ responsiveness on their children’s language development.

Although this has not been studied in the past 10 years, prior research has shown fairly consistent weak to moderate effects of parental responsiveness on children’s language development across diverse populations and measures.

Social Emotional Development of Adopted Children. While the cognitive and communication functioning of young adopted children is similar to that observed for children who grow up in advantaged, middle class or working class families, adopted children generally have a high incidence of social emotional problems early in their lives, since forming an attachment to their adoptive parents is one of the first hurdles faced by adopted children (Howe, 1996). Therefore, attachment has been a major research focus for this population. 44

Attachment is defined as the special emotional bond that infants develop with their caregivers during the first year of life (Carlson, Sampson, & Sroufe, 2003).

Therefore, adopted children who experience prolonged separation from primary attachment figures, as well as unstable and affectionless care before adoption are more like to have insecure attachment styles or a disorganized attachment. These attachment styles have short and long term effects on children’s social emotional and behavioral development (Kochanska, 2001; Bowlby, 1988). Barth and Berry (1991) reported that the primary reason parents return their adopted children is the inability of their children to develop an attachment to them. As a result, it is critical that adopted children develop an attachment with their caregivers in order to attain normal social-emotional development.

―Adoptive parents have the task of facilitating a successful adoption through utilization of caregiving strategies to promote secure attachment‖ (Roberson, 2006, p. 728). Parental responsiveness is the most robust and consistent predictor of children’s attachment. De

Wolff and Van IJzendoorn (1997) reported a meta-analysis which indicated that parental responsiveness including mutuality (r = .32), synchrony (r=.26), and parental sensitivity

(r =.22) were moderately associated with the quality of children’s attachment. In addition, other behaviors associated with parental responsiveness such as contiguity of response, physical contact, cooperation, support, attitude, and stimulation also contributed to the quality of attachment of infants (from r = .08 to r = .18).

Juffer, Bakermans-Kranenburg, and van IJzendoorn (2005) studied the relationship between parental responsiveness and disorganized infant attachment. The sample included 130 mothers and their adopted children who had been placed in their adoptive home before the age of 6 months. These dyads participated in two different brief 45 intervention programs (4 home visits), which were designed to promote maternal responsiveness. Maternal responsiveness was observed at pre-intervention when children were 6 months old and post-intervention when children were 12 months old in a 8 minute semi-structured free-play situations. Observation were coded with Ainsworth et al.’s scale.

Infant-mother attachment disorganization was observed at 12 in the Strange Situation

Procedure (SSP; Ainsworth et al., 1978) and rated by Main and Solomon’s (1990) assessment of attachment disorganization. Results from hierarchical multiple regression indicated that maternal responsiveness was a significant predictor of attachment disorganization (ß = -.23, p < .05), accounting for 5% of the variance after controlling for children’s age at adoption and intervention.

Stams, Juffer, and van IJzendoorn (2002) examined the relationship between parental responsiveness and adopted children’s disorganized attachment as assessed by the Strange Situation Procedure at 12 months of age. This observation was rated by a

Main and Solomon’s scale. Results indicated that maternal responsiveness was significantly correlated with children’s attachment disorganization (r = -.28, p < .01).

Stams et al. also investigated the relationships between parental responsiveness and adopted children’s social development. Nine variables which were derived from the

California Child Q set (CCQ, Block & Block, 1980), Child Behavioral Checklist (CBCL,

Achenbach, 1991), and School Behavior Assessment List (SCHOAL, Bleichrodt, Resing,

& Zaal, 1993) were used to assess children’s social- emotional development. Results indicated that mothers’ responsiveness when children were 3 and 7 years old was significantly correlated with adopted children’s social development at 7 years of age (r

=.22, p < .01, r = .23, p < .01, respectively). Hierarchical multiple regressions indicated 46 that maternal responsiveness when children were 7 years old predicted 5 % of the variance in children’s social development (β= .23, p < 0.01); however, early maternal responsiveness did not significantly predict children’s social development.

Results from two these empirical studies indicated that parental responsiveness was associated with attachment. That is, adopted children are more likely to display disorganized attachment with less responsive parents.

In conclusion, based on the replicated and consistent evidence of the direct and indirect contribution of parental responsiveness to children’s cognitive, communication, and social emotional functioning, it appears that parental responsiveness is moderately associated with the development of all children whether they are biological or adopted.

The association of parental responsiveness with children’s development, especially adopted children, supports the major vital underlying assumption of this study.

Determinants of Parental Responsiveness

In this section, studies which explored the relationships between child, parent and social context factors with parental responsiveness will be reviewed. Research which has applied the Transactional Model of Development and Belsky’s Model of Parenting has faced difficulties in conducting studies due to logistic barriers such as developing appropriate longitudinal studies, and methodological obstacles such as clarifying complex reciprocal pathways (Sameroff & MacKenzie, 2003). For these reasons, many studies fail to evaluate all the factors from a holistic approach to identify possible interdependence of multiple determinants of parenting (Bornstein, Hendricks, Haynes, & Painter, 2007).

Accordingly, in this section, the contribution of each factor (parent, child, and social context) will be examined separately followed by a review that attempted to examine the 47 combined influence of all three factors.

Adoptive parents are also influenced by the three determinants of parenting.

However, the unique experience of adoption may affect parents interactions and responses to their children in a manner that my not be experienced by biological parents.

Therefore, at the end of this literature review, studies of adoptive parents and their children will be reviewed.

The criteria for including studies in this review are as follows: 1) studies in which determinants of parents’ style of interaction is the primary focus, 2) parents’ style of interaction with their young children (ages one to five years old) serve as dependent variables and one of the potential contributors—parent, child, and social context—is the independent variable, 3) studies published in the past 10 years (e.g., 1997-2008).

Parental Contribution. Belsky (1984) summarized parents’ contribution as parental personality and psychological well-being (discussed in the conceptual model section). As a result, studies focusing on parental personality and psychological well- being will be discussed.

Personality. Many theorists believe parental responsiveness may be associated with their personality traits or predispositions (Lamb & Easterbrooks, 1981). This is due to the fact that these theorists believe that personality influences behavior in ―relatively stable, predictable, and meaningful ways‖ (Kochanska, Friesenborg, Lange, & Martel,

2004, p. 744). At least two studies have investigated the relationship between parents’ personality and their style of interaction.

Clark, Kochanska, and Ready (2000) investigated 112 mothers and infants to explore the relationship between personality and parental responsiveness. Parental 48 personality was assessed by a self-report survey, the NEO five-factor inventory (Costa &

McCrae, 1992), when children were nine months old. The five traits assessed by this inventory included neuroticism (proneness to negative affect), extraversion (tendency to be sociable, assertive, active), conscientiousness (tendency to be planful, organized, purposeful), agreeableness (tendency to be prosocial, altruistic, kind), and openness

(tendency to demonstrate intellectual curiosity, active imagination, aesthetic sensitivity).

Parental responsiveness was observed from a ―40 minute natural typical routine‖ (play, cleaning toys and opening a gift together) in a laboratory when children were 14 months old. Observations were coded with micro and macroscopic systems. Microscoptic categories were used to code parents’ responsiveness to children’s behaviors that were intended to get parents’ attention. Parental behaviors were rated in terms of promptness, engagement, sincerity, sensitivity, acceptance, cooperation, availability, following children’s lead and focus of attention, and adjusting the complexity of actions or requests to children’s developmental level. Macroscoptic coding was based upon Ainsworth’s scales (Ainsworth, 1971).

Analyses indicated that three out of five personality dimensions were correlated with parental responsiveness. Neuroticism was negatively correlated with parental responsiveness (r = -.22), while agreeableness and conscientiousness were positively correlated (r = .27 and r =. 32 respectively). Mothers who were high in conscientiousness and agreeableness, and low in neuroticism were more responsive to their children.

Multiple regression indicated that the full model, which included 5 maternal personality traits as well as children’s negative emotionality, accounted for 21% variance of parental responsiveness, although only conscientiousness was a significant predictor of 49 responsiveness (β=.28, p <.05).

Kochanska, Friesenborg, Lange, and Martel (2004) argued that parental empathy should be considered as a personality trait that may contribute to parental responsiveness.

Empathy is important because it involves parents’ recognizing their infant’s cues and signals and responding contingently to them. Therefore, Kochanska and colleagues studied the relationship between the five personality traits and empathy with parental responsiveness in a sample of 102 mothers and infants.

Parental responsiveness and personality were assessed when children were seven months old. The NEO Five Factor Inventory (Costa & McCrae, 1992) was used to assess parents’ personality and the Perspective Taking Scale from the Interpersonal Reactivity

Index (Davis, 1983) was used to assess parents’ empathy. Parental responsiveness was observed at home during typical daily activities, chores, and play routines. It was coded using the microscoptic coding scheme reported by Clark, Kochanska, and Ready (2000).

Multiple regression indicated that mothers’ empathy was significantly associated with their responsiveness (β=.23, p < .05), while other personality traits were not. The six parental personality traits accounted for 14% of the variance of parental responsiveness.

In summary, results from these two studies indicate that certain parental personality traits, such as empathy and conscientiousness, are related parental responsiveness.

Psychological well-being. Parents’ psychological well-being (e.g. stress, depression) is thought to influence the ability of caregivers to respond sensitively and appropriately to their children. It is because highly stressed parents may be more irritable, critical and severe in their interactions with their children (Webster-Stratton, 1990). In 50 addition, symptoms of depression including loss of interest, fatigue, anxiety, rumination, and irritability may be associated parenting difficulties (Lovejoy, Graczyk, O’Hare, &

Neuman, 2000). The following review includes several studies which examined the relationship between parental psychological well-being and parents’ style of interaction with their children.

Ostberg (1998) studied the relationship between maternal stress and parental responsiveness with 104 Swedish parents and their young children (mean: 14.5 months old). These families were referred to a Child Health Center not only because of child behavior problems (including sleeping, feeding, crying, and behavioral problems), but also because of parent issues (lack of support, parenting difficulties, and health issues).

Parental stress was assessed by the Swedish Parental Stress Index. Parental responsiveness was assessed with a global assessment developed for this study by nurses and psychologists. It measured parents’ difficulties in noticing and responding to their children’s needs, signals, and demands. This assessment was based upon observations either in homes or a clinical setting of everyday interactions—such as diaper changing, comforting, talking to the child, feeding, dressing, and playing with child. Pearson correlations indicated that both maternal and paternal stress were associated with their level of responsiveness with their children (r=.49, p <.0001 for mothers; r=.36, p < .01 for fathers).

Lovejoy, Graczyk, O’Hare, and Neuman (2000) reported a meta analysis of studies that examined the relationship between parental depression and maternal parenting behaviors. This analysis included 46 studies which assessed maternal depression and mother-child interaction. Maternal interactive behaviors included 51 hostile/coercive behavior, low levels of engagement, and low levels of positive social interaction. In 50% of the studies, maternal depression was assessed by self-report measures such as the Beck Depression Inventory (BDI), while the remaining studies assessed maternal depression by interview assessments such as the Schedule for Affective

Disorders (SADS; Spitzer & Endicott, 1978). Maternal behaviors were categorized into three categories. First, maternal behaviors were coded as ―positive‖ in terms of a pleasant and enthusiastic interaction with their children such as praise, affectionate contact.

Second, if mothers interacted with their children in a hostile or coercive manner such as threatening gestures, negative facial expression, or intrusive behaviors, they were coded as ―negative.‖ Third, maternal behaviors were coded as ―disengaged,‖ if mothers were not involved with their children or showed neutral affect such as ignoring, withdrawal, and silence during gaze aversion.

The meta analysis yielded effect sizes for each category of maternal behavior.

Depressed mothers showed higher levels of disengaged and negative behaviors compared to non-depressed mothers. The effect size for maternal disengaged and negative behaviors were moderate in magnitude (d =.29, p < .01 and d = .40, p < .01 , respectively).

Depressed mothers also exhibited lower levels of positive interaction with the effect size of d = .16 (p < .01).

Field (2002) explored the influence of maternal depression on their interactions with a sample of 22 mothers (12 depressed, 12 non-depressed) and their children.

Mothers, who received scores of 12 or above on the Beck Depressed Inventory (BDI;

Beck, Ward, Mendelson, Mock, & English, 1969) were classified as depressed. Non- depressed mothers who matched the depressed mothers on demographics were selected 52 randomly. Mother’s responsiveness was observed in three 3 minute episodes. First, they were asked to play as they usually did at home; second, they were asked to pretend to

―looked depressed‖; and third, they were asked to behave normally. Mothers’ interactions were coded in terms of vocalizations, positive or negative facial expressions, looking at infant, and tactile/kinesthetic stimulation. Results indicated that non-depressed mothers showed more frequent positive facial expressions, less frequent negative facial expressions, more frequent vocalizations, and greater amount of time looking at the infant and providing tactile/kinesthetic stimulation. In the ―looked depressed‖ episode, non- depressed mothers were less responsive than they were in the two typical play episodes.

This pattern of results was different for depressed mothers whose behavior did not change across the three episodes. That is, depressed mothers, regardless of what they were asked to do, were relatively unresponsive to their children.

Over all, the studies reviewed above indicate that the way mothers respond to their children depends in part on their own personality and psychological well-being.

Children’s Contribution. In this section, children’s contribution to parents’ style of interaction will be discussed.

Social emotional characteristics. Among various child characteristics, social emotional characteristics have been studied most frequently, because it is believed that social emotional characteristics such as temperament regulate parent-child interaction

(Belsky & Jaffee, 2006).

As described previously, there is no consensus about what social emotional functioning actually refers to for children. Some researchers limit social emotional functioning to emotionality; others include diverse dimensions such as motor activity 53 level, behaviors and threshold of responsiveness, persistence and distractibility. However, general negative emotionality, behavior problems, distress-proneness, low sociability, and irritability are considered to be social-emotional problems in early childhood and predictors of parental responsiveness (e.g., Clark, Kochanska, & Ready, 2000;

Crockenberg, 1986). Windle and Lerner (1986) proposed that ―some particular temperament attributes are difficult…they are not desired by a child’s significant others and that, therefore, when they are in fact possessed by a child, they promote negative interactions between the child and his or her parents‖ (p. 113).

Kochanska, Forman, and Coy (1999) examined the relationship between infant temperament and parental responsiveness. Infant temperament was assessed from observation of various standard short emotion-eliciting episodes, designed to assess infants’ joy, anger, fear, and focused attention (e.g. peek-a-boo game, arm restraint, approaches of unfamiliar toy, and given four colorful soft blocks to explore) when children were seven months old. Results from hierarchical multiple regression indicated that children’s joy predicted mother’s responsiveness (β = .25, p < .01), accounting for

12 % of the variance after controlling for children’s age and mother’ personality. Other temperament traits such as anger, fear, and focused attention did not predict parental responsiveness.

Clark, Kochanska, and Ready (2000) examined the relationship between infants’ negative emotionality and parental responsiveness. Infants’ negative emotionality was observed from 15 minute structured episodes which were designed to elicit various emotions when they were nine months old. Negative emotionality included sadness, fear, anger, fussiness, and distress. Each emotion was coded dichotomously (occur or did not 54 occur). While the authors hypothesized that infants’ negative emotionality would moderate the relation between maternal personality and parental responsiveness, results from hierarchical multiple regressions found that negative emotionality only moderated the relationship between conscientiousness and maternal responsiveness (β = .18, p < .10).

Rubin, Nelson, Hasting, and Asendorpf (1999) studied the relationship between children’s shyness and parents’ style of interaction. The sample included 60 children and their mothers and fathers. Children’s shyness was measured when they were two and four years old. Parent’s style of interaction was assessed by selected items from the Child-

Rearing Practice Report (CRPR: Block, 1981). Individual items from the CRPR were summed to form ―Encouragement of Independence.‖ Children’s shyness was assessed by a subscale of the Toddler Behavior Assessment Questionnaire (TBAQ; Goldsmith, 1988) at age two and by the Colorado Child Temperament Inventory (CCTI; Buss & Plomin,

1984) at age four. Results of a path analyses showed that shyness at age two was negatively associated with parent’s encouragement of independence when children were four years old (mothers, β= -.37, p < .001; father, β= -. 33, p < .05). That is, when children had high levels of shyness, parents tended to be more directive and less responsive with their children.

In general, children’s social emotional characteristics have not been reported to be strong predictor of parental responsiveness. However, these studies have shown consistent weak and moderate effects.

Children’s communication. While the way that parents respond to their children is thought to influence children’s communication development, it also possible that children affect parents’ responsiveness by the way they communicate with them. At least 55 two studies have been reported that support this notion.

Steelman, Assel, Swank, Smith, and Landry (2002) examined the relationship between child language and maternal responsiveness with 252 mothers and their healthy or high-risk children. Each dyad was assessed when the children were at 12, 24, 40, and

54 months of age. At each age point, maternal responsiveness was rated from a 60 minute observation of daily activity and a 10 minute toy play period. Maternal responsiveness was rated by two scales: warm acceptance and flexibility/responsiveness. Warm acceptance was described as praise and encouragement, physical affection, attention to child, and enthusiasm during interactions with the child. Flexibility and responsiveness was defined as the ability of mothers to respond promptly and sensitively to their children’s needs and to the appropriateness of their interactive pace. Children’s language skills were assessed twice. The Sequenced Inventory of Communication Development

(SCID: Hedrick, Prather, & Tobin, 1975) was used at 24 months and the Clinical

Evaluation of Language Fundamentals-Preschool Version (CELF-Pre; Wiig, Secord, &

Semel, 1992) was used at 40 months. Results from structural equation modeling indicated that children’s language at 40 months was significantly related to mothers’ warmth at 54 months (β = .01, p<.05).

Bornstein, Hendricks, Haynes and Painter (2007) reported a study which indicated that children’s language as assessed by the Codes for the Human Analysis of Transcripts

(CHAT, MacWhinney, 2000) explained the largest amount of the variance of parental responsiveness to their children (β = .21), while controlling for parental personality and social context factors. This study will be discussed in greater detail later.

Overall, these studies suggest that there is a reciprocal or transactional influence 56 that mothers and children’s communication have on each. These authors interpreted their results as indicating that children’s enhanced language engaged their parents more and promoted joint attention and active interactions which in turn enhanced mothers’ responsiveness to their children.

Demographic characteristics. Several studies have examined the association between various demographic characteristics of children with parental responsiveness

(Belsky & Jaffee, 2006). Leaper (2002) theorized that there might be gender-related differences in parent-child interaction, which might result from children’s gender differences or from parent’s stereotypes regarding gender.

Weinberg, Tronick, Cohn and Olson (1999) evaluated the effects of gender on mothers’ responsiveness with 81 six month old infants and their mothers. Responsiveness was observed using the Tronick method (Tronick, Als, Adamson, Wise, & Brazelton,

1978) which included (a) a 2 minute natural face-to-face play, (b) 2 minute still face interaction in which the parent did not show any response or reaction to the child’s behavior, and (c) a second 2 minute natural face-to-face play. These observations were coded with the Maternal Regulatory Scoring System (MRSS; Tronick & Weinberg, 1990) which rates maternal Proximity, Caregiving, Gaze, Vocalization, Touch, and Elicits and includes the Overall Mood Rating Scale from the Hedonic Tone Scale (Easterbrooks &

Emde, 1983). Infants’ behavior was assessed with the Infant Regulatory Scoring System

(IRSS; Tronick & Weinberg, 1990) which coded the infant’s direction of gaze, vocalizations, pick-me-up gestures, other gestures, self-comforting, and autonomic stress indicator (e.g. hiccupping). Their facial expressions were scored using the AFFEX (affect expression; Izard & Malatesta, 1987) which rated infants’ joy, interest, sadness, anger, 57 surprise, contempt, fear, shame-shyness-guild, distress, and disgust.

Results indicated that boys showed more negative behaviors (anger, fussiness, pick-me-up gesture, arching their back) than girls. Boys also displayed more positive affect (expression of joy, look at and vocalize) with their mothers. These findings were stable across the three observation episodes. Mother-son dyads also had higher levels of social matching (shared joint state such as looking at one another; t (1, 78) = -1.99, p< .05) than mother-daughter dyads; while mother-daughter dyads higher levels of object matching (shared attention to object; t (1, 75) = 1.84, p < .07) than mother-son dyads.

Mother-son dyads took more time to change from their social and object un-matching states to matching states. In addition, mother-son dyads had significantly higher synchrony scores than mother-daughter dyads during the first two minute of natural play.

That is, mother-son dyad tracked each other’s behavior and facial expressions more carefully than mother - daughter dyads (t (1, 74) = 2.04, p < .05).

Lovas (2005) explored how children’s gender affect parental sensitivity. The sample included 113 19 month old children (50 girls and 63 boys) and their parents.

Observations were also conducted when children were 24 months old with 57 children

(29 girls and 28 boys) and their parents. Both parents’ and children’s sensitivity/responsiveness and involvement were observed during free play and clean-up.

These observations were coded with the Emotional Availability Scale (EAS; Biringen,

Robinson, & Emde, 1998).

Effect size analyses indicated that parents displayed more sensitivity toward daughters than sons when children were 19 (d = 0.39, p < .001) and 24 months old (d =

0.47, p < .001). Dyadic t-test indicated that mother-daughter dyads displayed the highest 58 maternal sensitivity followed by mother-son dyads when children were19 month and 24 months old. Children’s responsiveness and involvement did not differ by gender at either

19 or 24 months of age.

In conclusion, these two studies reported conflicting results. Results from one study indicated that mothers were more responsive to their sons while the other indicated they were more responsive to their daughters. However, results from both studies suggest that gender is a moderator which influences the effects of children’s temperament and sociability on parental responsiveness (Leaper, 2002). In addition, gender influences on parental responsiveness may depend on children’s age. As children grow, parenting might differ based on gender- related expectations and beliefs (i.e., Weinberg and colleagues included 6 month old and Lovas study included 19 month old children).

A handful of studies have been reported which indicate that parental responsiveness is associated with children’s age. For example, Biringen, Emde, Brwon,

Lowe, Myers, and Nelson (1999) showed that mothers’ emotional availability increased when children were 9, 12, and 14 months old. The sample included 46 families (25 mother-daughter and 21 mother-son). Parent-child dyads were observed in one hour naturalistic sessions at three different times. Parent-child interaction was assessed by the

Emotional Availability Scale (EA: Biringen et al., 1993). Parental emotional availability was coded in terms of sensitivity—refering to the mother’s prompt responsiveness to infant communications, appropriate affectivity, and flexibility about negotiation of difficult or conflictual moments—and intrusiveness—the mother’s tendency to structure, direct, or stimulate in the context of interaction. Children’s emotional availability was rated in terms of their overall responsiveness to their mothers (e.g. visual, vocal, gestural, 59 and emotional receptivity and willingness to include mother in interaction).

Results of a multivariate analysis showed a main effect of age (F = 6.20, p < .001).

Parents and their children became more emotionally available to one another as children grew older. Univariate tests found that maternal sensitivity (F = 7.83, p < .001) and child involvement with mother (F=17.41, p < .001) increased over time. Based upon these findings, Biringen and colleagues concluded that children’s developmental transitions and mother-child interaction are associated.

Kochanska and Aksan (2004) also explored the relationships between children’s age and parental responsiveness. The sample included 102 parents and their normally developing children when they were seven months. When children were 15 months, 101 families returned for follow-up observations. Parent-children interaction was assessed from 45 minute home observations when children were 7 months, and from 45 minutes laboratory observations when children were 15 months old.

Observations included typical daily activities such as free time, preparing and having a snack, playing with toys, bathing and dressing, opening a gift together as well as other routine parent-child leisure, chore-oriented, and caregiving activities. Observations were coded based on Ainsworth’s global coding of maternal responsiveness. In addition, the study used microscopic coding of discrete child behaviors and maternal responses.

Every 60 seconds mothers’ responses were rated in terms of promptness, engagement, sincerity, sensitivity, acceptance, cooperation, availability, following the child’s lead and attention, and adjusting to the situation. Children’s responsiveness to parents was also rated with both global and microscopic coding. In the global assessment, children’s responsiveness was rated as poor, fair, good, and exceptional in terms of their promptness, 60 sincerity, eagerness, wholeheartedness of response, and effort to please the parent. The microscopic assessment rated whether children responded to their parents’ social interactive bids, influence attempts, and mood regulation attempts.

Results from the global assessment indicated that children were more responsive to their parents when they were 15 months old than 7 months old (F (1, 100) = 4.56, p

<.05), while maternal or paternal responsiveness did not differ between 7 and 15 months.

However, in the microscopic assessment, parents had a lower number of bids toward their children (F (1, 100) = 65.84, p < .001) and used different types of bids as children aged (F

(2, 200) = 1264.54, p < .001). For example, parents decreased their social-interactive bids

(e.g. verbal or nonverbal attempts to engage child) and mood regulation attempts, while they increased their influence attempts bids (e.g. asking child to start or stop an activity, to cooperate with caregiving) over time.

In general, these two studies suggest that children’s age is associated with parents’ responsiveness. The influence of age is strongly related to children’s developmental changes which are associated with parental responsiveness, especially social emotional functioning. Overall, children’s social emotional behavior, communication, and demographic characteristics (e.g. gender and age) appear to have a significant effect on parental responsiveness.

Social Context. In addition to parent and child characteristics, social and environmental factors may also impact parental responsiveness (Belsky, 1984). Among these, social support and socio-economic status (SES) appear to be key influences on parental responsiveness (Belsky, 1984). Therefore, in this section, studies regarding social support and family SES are reviewed. 61

Social support. Social support includes informal support from intimate relationships such as spouse or parent as well as formal support from professionals. Some research suggests that positive supportive relationships are linked to more positive parental functioning as indicated by mothers’ interactive behavior, parenting satisfaction, and life satisfaction (Crnic & Stormshak, 1997).

For example, Feldman, Varghese, Ramsay and Rajska (2002) explored the relationship between social support and mother-child interaction with 18 mothers with intellectual disabilities who had children under six years of age. Social support was measured by the Talleen Parenting Social Support Index (Talleen 1985) and by the

Interpersonal Support Evaluation List (ISEL; Cohen & Hoberman, 1983). Parent- child interaction was observed from 10 minutes of free play. The observational checklist by

Feldman and associates (1986) was used to code the quality of parents’ interaction in terms of praise, initiating/expanding child vocalizations, talking to child, looking at child, and giving physical affection. Results showed that parents’ support satisfaction scores were moderately correlated with positive maternal behaviors (r = .53, p < .05).

In many studies, social support has been reported to have a moderating or mediating role rather than a direct influence on parent responsiveness (Armstrong,

Birnie-Lefcovitch, & Ungar, 2005; Belsky & Jaffee, 2006). For example, Miller-Loncar,

Landry, Smith, and Swank (1997) studied the relationship between social support and parental responsiveness. The sample included 323 infants who were both pre-term and full-term and their mothers. Social support was assessed twice when children were six and 12 months old by the Personal Relationship Inventory (PRI) developed by authors.

Maternal responsiveness was observed from a 60 minute naturalistic observation at home 62 when children were 24 months old.

Results from structural equation modeling indicated that the effects of social support on parental responsiveness were mediated by mothers’ child-centered perspectives and parental self-esteem. Specifically, social support had a relation both directly (β=.32, p< .05) and indirectly through self-esteem (β=.33, p< .05) with mothers’ child-centered perspectives with their children.

Although there is a lack of empirical studies explicitly addressing the direct or indirect relationship between social support and parental responsiveness, several studies have shown that social support is associated with parenting stress (Smith, Oliver, &

Innocenti, 2001; Visconti, Saudino, Rappaport, Newburger, & Bellinger, 2002; Waisbren,

Rones, Read, Marsden, & Levy, 2004). Insofar as parenting stress affects parental responsiveness, these findings suggest that parents who experience a high level of social support are more likely to be responsive to their children.

Socioeconomic Status. Socioeconomic status (SES) –which reflects education, occupation, and income— has long been considered an important social influence on parenting (Raviv, Kessenich, & Morrison, 2004). Most studies of SES have not been hypothesis-driven but have simply analyzed how SES might be associated with maternal responsiveness. For example, Raviv, Kessenich, and Morrison (2004) did not directly study the relationship between SES and parental responsiveness. However, they explored the potential pathways by which SES might affect language development with a sample of 1,016 families from the National Institute of Child Health and Human Development

(NICHD) study of Early Child Care and Youth Development. Results indicated that maternal responsiveness mediated the relationship between SES and children’s language 63 development.

These researchers coded maternal education as a continuous variable (M=14.5,

S.D. = 2.4) and income-to-needs ratio was calculated by dividing the total yearly family income by the 1992 poverty threshold for each families. Mothers’ interactions were observed from structured and a semi-structured mother-child play sessions and coded in terms of hostility, supportive presence of the mother, and respect for child’s autonomy.

Results of a path analyses indicated that maternal education influenced maternal responsiveness (β = .35, P < .01) and income-to-needs ratio influenced maternal responsiveness (β = .17, P < .01) when children were 36 months old. The combined model—which explored both the direct impact of SES on children’s communication development and indirect impact of SES on communication development through a mediator (maternal responsiveness)—showed that family SES influenced parental responsiveness more than it impacted children’s language skills.

The studies reviewed in this section suggest that characteristics of social context are associated with parental responsiveness. In particular, results suggest that both social support and social economic status may affect parental responsiveness.

Multivariate Analyses. Although most of the research on the determinants of parental responsiveness (or parenting itself) has focused on a single source of influence, there has been some effort to include multiple determinants. For example, a study reported by Bornstein, Hendricks, Haynes and Painter (2007) was conducted within a multivariate framework based on the integration of ideas from Belskey’s and

Bronfenbrenner’s model of development. Bornstein and colleagues identified unique and simultaneous associations of context, maternal, and child factors with parental 64 responsiveness, while controlling for other factors. The sample included 254 European

American mothers and their 20 month old children. Maternal responsiveness was observed from a 10 minute mother-child free-play observations and was coded with the

Emotional Availability Scales (EAS; Biringen, Robinson, & Emde, 1998). The EAS assesses affectivity, acceptance, flexibility, clarity of perception, and affect-regulation with a nine point and global rating scale.

First, the social contextual factors that were assessed included socioeconomic status, employment, and reported spouse’s parenting style. Spouse’s parenting style was assessed by the Parental Style Questionnaire (PSQ; Bornstein, Haynes, O’Reilly, &

Painter, 1996). It was hypothesized that the less dissonance between mothers’ perceptions of ideal and actual spouses’ parenting would be regarded as spousal support and would help mothers engage in more sensitive interactions with their infants. Second, maternal characteristics were explored in terms of 1) maternal personality as assessed by the

Jackson Personality Inventory (JPI; Jackson, 1976); 2) parenting knowledge as measured with the Knowledge of Infant Developmental Inventory (KIDI: MacPhee, 1981); 3) maternal competence, satisfaction, investment, and role balance in parenting as assessed by the Self- Perception of Parenting (SPPR; MacPhee, Benson, & Bullock, 1986); 4) maternal parenting behavior as assessed by the Parental Style Questionnaire (PSQ;

Bornstein, et al., 1996); and 5) maternal internal attribution (maternal ability, effort, and mood) as assessed by the Parent Attributions Questionnaire (PAQ; MacPhee, Seybold, &

Fritz, n.d; Sirignano & Lachman, 1985). Third, children’s characteristics included representational capacity, language competence, and sociability. Children’s representational capacity was observed from 10 minutes of solitary play and was coded 65 with four levels of nonsymbolic play and four levels of symbolic play. Children’s language competence was assessed by the Reynell Developmental Language Scales

(RDLS; Reynell & Gruber, 1990) and the Codes for the Human Analysis of Transcripts

(CHAT; MacWhinney, 2000). Children’s sociability was assessed from observations of their playing alone and coded in terms of frequency of vocalizations directed to observer, frequency of vocalizations with no specific object, and amount of time the child spent within two feet of the observer.

Results from zero-order correlations (critical level; p <.10) showed that among social contextual factors, maternal employment and spouse’s didactic exchange dissonance correlated with parental responsiveness. Six maternal characteristics correlated with parental responsiveness: open personality, knowledge of infant development, parent’s competence, parent’s satisfaction, parent’s didactic exchange for stimulating their children and providing learning experience, and parents’ limit setting.

Children’s language competence was also correlated with parental responsiveness.

Factors that correlated to responsiveness were included in a hierarchical regression analysis of maternal responsiveness. Results showed that mothers who worked fewer hours (β = -. 11, p < . 10), who had children with more vocabulary (β =.21, p < .01) , who reported less limit setting (β = -.13, p < .05), and who attributed their parenting failures to internal causes (β = .18, p < .01) were more responsive with their children.

In summary, research has investigated the influence of diverse contributors to parental responsiveness because of the crucial impact of parental responsiveness on the child’s development. Within the Transactional Model of Development and Belsky’s

Model of Parenting, research indicates not only that individual parent, child, and social 66 contextual factors are related to parental responsiveness, but also that the combination of these factors are also associated with parental responsiveness.

Adoption Characteristics. Many of the challenges and joys experienced by adoptive families are similar to those experienced by non-adoptive families (Brodzinsky

& Pinderhughes, 2002). Therefore, under these frameworks (the Transactional Model of

Development and Belsky’s Model of Parenting) determinants of adoptive parents’ responsiveness may be understood as extensions of those of non-adoptive parents. That is, common factors—parent, child, and social context—may contribute to parental responsiveness in adoptive families as they do in non-adoptive families. However, researchers have also suggested that specific adoption characteristics may also influence parents’ style of interaction with their adopted children. Since few empirical studies have been reported to support this idea, it is necessary to explore these characteristics and implications.

For example, the age of the child at the time of adoption is an important consideration, since it influences a child’s adoptability and attachment. For successful adoption, which is primarily dependent upon a positive parent-child relationship, children need to accept their previous separations as losses and their adoptive family as permanent.

They need to be willing to build a new relationship with their adoptive parents (Roberson,

2006). When children are younger, they are more rapidly integrated into their new environments (Pomerleau, et al., 2006). As reported by Lydens and Snarey (1989),

Korean adoptees who were adopted at one year of age or earlier showed significantly higher self-concept and less difficulty in family relationships. In addition, parents who adopted younger children also showed higher satisfaction. Although the fact that parents 67 are more satisfied does not necessarily mean that those parents are more responsive, the two factors could be related. Age of adoption may also reflect a negative pre adoption history, since children who are older at adoption are more likely to have experienced cumulative deprivation prior to adoption (Krakow, Tao, & Roberts, 2005).

Adversity of pre-adoption history, including the experience of institutional care and multiple caregivers, is another factor to consider. As discussed in the Problem

Statement section, institutional care dramatically increases the risk of social and behavioral problems (Johnson, 2002). Internationally adopted children have a high likelihood of being raised in institutions which provide only minimum routine care before adoption. Thus, parents of internationally adopted children might face different challenges than other parents. For example, children who have spent more than 8 months in Romanian orphanages tended to fail to make their needs known, and often avoided or withdrew from peers (Johnson, 2002). Such difficulties in interpersonal functioning might affect the readability of the child’s signals, and/or the reactions these children elicit which might in turn might hinder their adoptive parents’ responsiveness with them (Juffer,

Hoksbergen, Riksen-Walraven, & Kohnstamm, 1997).

Children who spend their early years in orphanages without appropriate language simulation may also experience significantly delayed language development (Roberson,

2006). As a result, parents of internationally adopted children whose native language is different from their adoptive parents may face unique challenges. Given that children’s language influences parental responsiveness, adoptive children’s delayed language development may negatively influence parental responsiveness. On the other hand, adoptive parents might be more responsive to their adopted children in efforts to 68 stimulate and help them to acquire new language.

In conclusion, in addition to the common factors impacting all parents, children’s age at adoption, pre-adoption history--especially institutional experience—and whether the adoption is international or domestic, all need to be examined as potential influences on the responsiveness of adoptive parents.

Independent Variables. After having conducted a literature review, the following independent variables were chosen for the present study. First, with regard to parent factors, parental psychological well-being including parenting stress and depression, have been selected as the independent variables. Second, with regard to child factors, based upon reviewed study findings, children’s social emotional functioning, children’s gender and ages, and their adoption history (age of adoption, months in adoptive homes, experience of institutional care, or foster care) will also be included in this study as independent variables.

The Transactional Model of Development presumes reciprocal relationships between parental responsiveness and children’s development. There are a number of studies exploring the influence of parental responsiveness on children’s cognitive development. However, the current study hypothesizes that children’s cognitive development might contribute parental responsiveness. Therefore, this study also includes children’s cognitive development as an independent variable. Lastly, with regard to social contextual factors, perceived social support and parental socio economic status, including parental education and family income, will be included in this present study.

Control Variables. Two control variables were included in this study. The first was children’s age. Previous studies (Biringen, Emde, Brwon, Lowe, Myers, & Nelson, 69

1999; Kochanska & Aksan, 2004) reported that parental responsiveness increases with children’s age. In addition, there is evidence that parents are more attentive and affectionate with infants as opposed to toddlers (Erikson, 1963). Since the sample of subjects that will be used in this study includes children who range in age from 14 to 60 months, it is likely that a significant portion of the variability in the dependent variables,

Affect and Responsivity, will be associated with the age differences of the children participating in this study.

The second control variable will be children’s level of communication functioning. Previous studies found that as children’s level of communication increases, parental responsiveness is also increase. Since this study includes a heterogeneous group of children who were adopted from English speaking countries as well as non-English speaking countries, and since children who have widely varying levels of communication functioning due to the differences in their level of development, it is anticipated that much of the variability in parental interaction, particularly related to responsiveness, will be associated with children’s level of communication functioning,

Limitations of Previous Studies

Based upon aforementioned studies, there are several points which are relevant to the present study. First, parents’ responsiveness appears to be a crucial factor for adoptive children’s optimal cognitive, communication, and social-emotional functioning.

Numerous studies have indicated moderate relationships between parental responsiveness and each of these areas of developmental functioning. Parental responsiveness also appears to be one of the most crucial factors for successful adoption. Although studies emphasize the influence of parental responsiveness on child development, the 70 determinants of parental responsiveness have yet to be delineated. Furthermore, no empirical studies have examined the determinants of responsiveness in adoptive parents.

Therefore, this study focuses on the determinants of parental responsiveness in adoptive parents.

Second, according to the literature reviewed in this chapter, characteristics of parents, children, and social context influence parental responsiveness. While it is hypothesized that the determinants of parental responsiveness reported for biological parents may be similar to these for adoptive parents, several studies also suggest that the unique circumstances and experiences of adoptive parents as well as the distinctive characteristics of adopted children may affect parental responsiveness. These adoption- related characteristics should be considered in addition to factors that influence responsiveness of biological parents. However, no study has yet been reported investigating the association between the unique characteristics of adoption and adoptive parents’ responsiveness. Therefore, the specific ways adoption-related issues impact parental responsiveness will be explored in the present study to fill this gap in the literature.

Research Questions and Hypotheses

This study is designed to identify factors are associated with adoptive parents’ responsiveness with their children. Based upon the Transactional Model of Development and Belsky’s Model of Parenting, this study will attempt to examine how characteristics of parents, children, and social context are associated with the level of responsiveness of adoptive parents. The research questions and hypotheses for this study are derived from this conceptual framework and from the research findings reviewed in this chapter. The 71 research model is shown in Figure 1.

Research question #1:

Q1: What is the influence of the psychological well-being of adoptive parents on parental

responsiveness with their children?

H1: Adoptive parents who have lower levels of parenting stress and depression will show

higher levels of responsiveness with their children.

Research question #2:

Q2. How do the characteristics of adopted children influence parental responsiveness

with their children?

H2. The level of responsiveness of adoptive parents will be associated with children’s

temperament and social emotional functioning.

H3. The level of responsiveness of adoptive parents will be associated with children’s

level of cognitive functioning.

H4. Children’s age of adoption and years in their adoptive homes will be associated with

parental responsiveness with them. `

H5. Children’s history of institutional or foster care will be associated with parental

responsiveness with them.

Research question #3:

Q3: What is the influence of social contextual characteristics on parental responsiveness

with their children?

H6. Parents with higher levels of socio-economic status (consisting of income and

education) will exhibit higher levels of responsiveness with their children.

H7. Parents with higher levels of social support will have higher levels of responsiveness 72

with their children.

Figure 1: Determinants of parental responsiveness

73

Chapter 3

Methodology

This study is a secondary analysis of data from adoptive parents and their children who participated in the Developmental PARTners (Prevention, Assessment, Referral, and

Training for young adopted children) model demonstration project funded by the United

States Department of Education. This project was designed to promote children’s development and well being by enhancing the ability of parents to interact more responsively with their children. It was conducted between 2005 and 2007 at the Center on Intervention for Children and Families, Case Western Reserve University, Cleveland,

OH.

Subjects

This secondary data analysis study examined forty-six parents and their adopted children who volunteered to participate in an intervention program, Project PARTner.

This study recruited parents who had either a domestically or internationally adopted child who was under 5 years of age. For the most part, these parents were referred by their pediatricians or walked in to the CWRU Center on Intervention for Children and

Families after seeing flyers publicizing the study.

Adoptive parents who participated in the study could be either mothers or fathers.

When both parents were involved, only one parent was chosen to be a main participant

(the choice was based on parental preference). The chosen parents filled out surveys and were videotaped for assessment purposes. Among forty-six parents, only data from forty- one families were used (39 mothers and 2 fathers). Of the subjects who were not included in this study, three parents refused to be videotaped, and one parent did not want to 74 provide the required information about family demographics and their psychological well-being. In addition, one parent left the study before completion.

To minimize the intervention effects which might reduce variability in parental responsiveness, this study analyzed observations and assessments that were collected prior to the initiation of intervention.

As shown in Table 1, the parents were between 30 and 51 years old, M=40.37,

SD=4.96. Most were White, n=37, from middle-class socioeconomic backgrounds.

Thirty-four parents were married; two parents lived in stable unmarried relationships; three parents were separated or divorced; two parents were never married. Ninety five percents of the parents had at least an associate degree, while 44 % achieved a master’s degree or higher, and 65.9% had full or part time jobs outside the home.

As shown in Table 2, the children (18 male and 23 female) were between 14 months and 60 months (M=31.7, SD=14.25). The races of children were diverse (13

White, 9 Asian, 9 Hispanic, 6 African American, and 4 Others). Twenty six children were internationally adopted, while 15 children were born in the U.S. Almost half of the children (n=19) had lived in orphanages, 73.8% (n=30) did not have experience with their birth family, and 36.6% (n=15) had lived with a foster family. Most of the children (n=38) were adopted before 2 years of age and 9.8% (n=4) of children were adopted as newborns.

Sixteen children received a medical diagnosis of developmental delay, asthma, attachment disorder, etc.

75

Table 1 Demographics of Parents

Parents (N=41) Parent’s Age (yr) Mean (SD) 40.37 (4.96) Range 30-51

Parent’s Race (% White) 90.2 Marital Status (% Marriage) 82.9

Education level (% Bachelor’s or higher) 73.2

Family Income (% less than $20,000) 4.9

Employed (%) 65.9 Full time (%) 24.4 Part time (%) 41.5

Table 2 Demographics of Children

MALE FEMALE TOTAL (N=18) (N=23) (N=41) Chronological age Mean (SD)(month) 32 (15.63) 31.39 (13.42) 31.66 (14.25) Range (month) 15-58 14-60 14-60

Age of adoption Mean (SD)(month) 12.50 (15.42) 10.17 (6.83) 11.20 (11.31) Range 0-52 1-29 0-52

Child’s race (%) African 11.1 17.4 14.6 American Hispanic 16.7 26.1 22.0 White 38.9 26.1 31.7 Asian 22.2 21.7 22.0 Other 11.1 8.7 9.8

Type of International 55.6 69.6 63.4 adoption (%) Domestic 44.4 30.4 36.6

Pre-adoption Orphanage 44.4 47.8 46.3 history (%) Foster care 38.9 34.8 36.6 None & NA 16.7 17.4 17.1 76

Study Design and Procedure

This study is an exploratory, descriptive study of parent, child and social contextual factors that might be associated with parental responsiveness. Thus, the data used for this study are the baseline data that were collected prior to parents participating in the PARTners Project.

Data were collected over a three week period of time. Data included a standardized assessment of child development, parent-report measures of children’s social emotional functioning, parent report measures of psychological status, family demographics as well as video taped observations of parent-child interaction. Videotaped observations were conducted at the families’ homes with a standard set of developmentally appropriate toys. Parents were not given any specific directions regarding the way they or their children should play with the toys provided for the observational setting. Instead, parents were asked to play with their children as they typically do, while the researcher videotaped for 7 minutes. Each of the assessment is described below.

Variables

As listed in Table 3, the dependent and independent variables examined in this study are the following.

77

Table 3

Study Variables

Variables Assessment Instrument Measures Variable Type Dependent Parental Maternal Behavior Rating Responsivity Ordinal Responsiveness Scale Affect

Independent Parenting Stress Parenting Stress Index- Total Stress Index Interval Short Form Depression Center for Epidemiologic Total CESD Index Interval Studies Depression Scale Child’s Cognitive Bayley Scale of Infant DQ Interval Development Development- 2nd Edition / (Developmental Quotient) Battelle Developmental Inventory -2nd Edition Child’s Social- Child Behavior Checklist Externalizing Interval Emotional Internalizing Functioning T-Score

Child’s Temperament and Atypical Detached Interval Temperament Behavior Scale Hypersensitive/Active Underreactive Dysregulated T-Score

Adoption History Age of adoption Interval history of institution Nominal Social Support Arizona Social Support Need for support Interval Interview Satisfaction with support SES Family income Ordinal parents’ education Control Child’s age Interval Communication Vineland Adaptive Standard score of Interval Behavior Scale communication domain

78

Measures

Dependent Variable.

Parental responsiveness. Parental responsiveness was rated with the Maternal

Behavior Rating Scale (MBRS) developed by Mahoney, Powell, and Finger (1986, revised in 1992). The MBRS was designed as a means to assess parent-child dyadic interaction and has been used to assess the interaction style of mothers of diverse samples of children--normal, at risk, developmentally delayed and low birth weight (Mahoney et al., 1998). Each item of the MBRS is derived from the child development literature which reported the significant influence of the items on child development.

The MBRS consists of global ratings of 12 components of interactive style. These items are clustered into four different factors. These are 1) ―Responsivity‖ measured by three items: sensitivity to child’s interests, responsiveness, effectiveness; 2) ―Affect‖ measured by five items: acceptance, enjoyment, expressiveness, inventiveness, warmth; 3)

―Achievement orientation‖ measured with two items: achievement orientation, praise; 4)

―Directive‖ measured with two items: directiveness, pace. Each item is rated on a 5- point

Likert scale with ratings of 1 reflecting a low incidence of the component and 5 indicating a high incidence. In this study, ―Responsivity‖ and ―Affect‖ factors will be used to assess parental responsiveness. The reason for this is that among the four maternal behavioral factors in the MBRS, ―Responsivity‖ and ―Affect‖ factors are in agreement with the definitions of parental responsiveness.

To minimize subjectivity and rater bias, parents’ interactive style was coded by a rater who received at least 40 hours of training on the MBRS and who had attained at least 80% agreement within 1 point on a 5-point Likert Scale with one of the MBRS 79 developers. Interrater reliability was assessed by having a second rater code a random selection of 30% of all observations. Boyce, Marfo, Mahoney, Spiker, Price, and Taylor

(1996) demonstrated the convergent validity of the MBRS with other measures of maternal interactive characteristics using alternative rating scales.

While there are no norms for parents on this scale, the MBRS was developed so that the most common ratings would cluster near the midpoint of the scale. Indeed, this is what has been reported in many of the samples in which the MBRS has been used. For example, Mahoney, Boyce, Fewell, Spiker, and Wheeden (1998) reported MBRS ratings for 488 mothers before they participated in four early intervention studies that involved both typically developing children as well as children with disabilities. Average ratings for this group of mothers on Responsivity were 3.1, while the average ratings on Affect were 2.7 (Appendix A).

Independent Variables.

Parenting stress. Parenting stress was measured with the Parenting Stress Index-

Short Form (3rd edition; PSI-SF; Abidin, 1995). The PSI-SF measures three components of stress: Parent Distress (PSI-SF/PD), Parent-Child Dysfunctional Interaction (PSI-

SF/PCD), and Difficult Child (PSI-SF/DC). The Parent Distress subscale measures the quantity of distress parents experience directly related to the parenting role, considering other personal stresses. The Difficult Child subscale assesses parenting stress associated with children’s difficult behaviors. The Parent-Child Dysfunctional Interaction subscale assesses the degree to which children meet their parents’ expectations and are emotionally reinforcing their parents.

This parent-report instrument consists of 36 items with a 5-point Likert Scale, 80 incorporating 1 to 5 levels of agreement with the questions. A score of 90 or higher

(range from 36-180) is considered to indicate clinically significant levels of parenting stress. Extensive validity and reliability testing have been conducted on the PSI-Long

Form across a variety of samples (Abidin, 1995). The PSI-SF is derived directly from the

PSI-Long Form; the psychometric properties of the PSI-SF were assessed by Abidin

(1995). Coefficient alphas for total stress, parental distress, parent-child dysfunctional interaction, and difficult children were .91, .87, .80, and .85, respectively, and test-retest correlations were .84, .85, .68, and .78 in the same order indicating moderate to high levels of relabilty. The validity of the PSI-SF was also supported by a study with lower socioeconomic, primarily African American, mothers reported by Reitman, Currier, and

Stickle (2002).

Depression. The presence of depressive symptoms among parents was measured with the Center for Epidemiologic Studies Depression Scale (CES-D) (Radloff, 1977).

This measure taps several major dimensions of depression: depressed mood, feelings of guilt and worthlessness, feelings of helplessness and hopelessness, psychomotor retardation, loss of appetite, and sleep disturbance. The CES-D is a self- administered instrument that has 20-items. Each item is rated on a four-point Likert scale with total scale scores ranging from 0 to 60. A score of 16 or higher is the cut-off point for clinically significant depression (Radloff, 1977) . This measure has been reported to have high internal consistency across studies ranging from Cronbach’s alphas of .85 to .90 (Radloff,

1977). Concurrent validity with clinical and self-report criteria, as well as evidence of construct validity has also been reported (Radloff, 1977).

Children’s social emotional functioning. Children’s social emotional functioning 81 was assessed by the Child Behavior Checklist/1.5-5 (CBCL; Achenbach & Rescorla,

2000). As a standardized clinical measure, the CBCL relies upon parental report. It consists of 99 items that are rated with three point Likert Scale from 0 (not true of child) to 2 (very true of child), and 1 item with an open-ended question in which parents describe additional problems. The CBCL provides two subscale scores (externalizing, internalizing) as well as a total score. The Externalizing subscale consists of Attention and Aggression problems and, while the Internalizing subscale consists of Emotionally

Reactive, Anxious/Depressed, Somatic Complaints, and Withdrawn behaviors.

Item scores for each scale were added together. Higher scores on these scales have been associated with higher levels of behavior problems. In addition, these scores are transformed into T-scores to determine whether children’s social emotional functioning is in the clinically significant range. T-scores above the 93rd percentile indicate that a child is at the borderline or clinical range of social-emotional functioning.

The CBCL/1.5 -5 is a revised version of the CBCL/ 2-3 (1992) which had well- documented reliability and validity. The CBCL/1.5 -5 has also been shown to have excellent test-retest reliability, and the Cronbach alphas are reported to be .95 for the total scale, .89 for the Internalizing scale, and .92 for the Externalizing scale indicating high levels of internal consistency (Achenbach & Rescorla, 2000). Achenbach and Rescorla reported a factor analysis to support the construct validity of the subscales. In addition,

Tan, Dedrick, and Marfo (2007) reported data on the internal consistency and validity of this scale with Chinese adoptees in the United States.

Children’s temperament. Children’s temperament was measured by an assessment instrument called the Temperament and Atypical Behavior Scale (TABS; 82

Bagnato, Neisworth, Salvia, & Hunt, 1999). This 55 item parent-report instrument consists of four subscales. The Detached subscale includes withdrawn, aloof, self- absorbed, difficult to engage, and disconnected from others in daily routines. The Hyper-

Sensitive/Hyper-Active subscale consists of overreactivity to stimulation, impulsivity, high activity, negativity, and defiance. The Underreactive subscale is associated with low awareness, and alertness as well as passivity, and lethargy. The Dysregulated subscale assesses children’s difficulty in controlling or modulating neurophysiological behaviors such as sleeping, self-comporting, and hypersensitivity to physical contact. For each item on the TABS, respondents are required to check yes if it applies to their children. The four subscales are reported as T-sores which have a mean of 50 and a standard deviation of 10. Higher scores indicate that children have more difficult temperaments. Cronbach’s alpha is .83 indicating high internal consistency. The TABS has also been reported to have high test-retest reliability. Although there is limited evidence for the concurrent and predictive validity of the TABS, the four subscales were established through confirmatory factor analyses from large, diverse racial and ethnic samples of typically developing children (n=621) and children who had social-emotional disorders (n=212).

Cognitive functioning. The Bayley Scales of Infant Development- 2nd Edition

(BSID-II; Bayley, 1993) was used to assess the cognitive functioning of children who were developmentally under 3 years old, and the Battelle Dvelopmental Inventory –2nd

Edition (BDI-II; Newborg, 2005) was used for children who were developmentally older than 3 years.

The BSID-II is designed to measure the mental and motor development of infants from one to 42 months of age. The mental and motor development subscales on this test 83 have mean scores of 100 and SD of 15. Children with scores of 70 or under are classified as significantly delayed. Only the mental score (MDI) of the BSID-II was used in this study. The MDI is based upon assessment of recognition memory, problem solving, sensory perception, and number concepts. The BSID-II also provides developmental age scores. In this study, children’s developmental rate was calculated using the following formula: (Developmental age / chronological age x 100). The BSID-II has high levels of content, construct, concurrent, predictive, and discriminant validity (Bayley, 1993). In addition, test-retest reliability of the MDI is r= .87 with 175 children, and the internal consistency of MDI was .88 (Bayley, 1993).

The Battelle Developmental Inventory II (BDI-II; Newborg, 2005) assesses the social, adaptive, motor, communication, and cognitive abilities of children from birth to 8 years. As a norm-referenced instrument, each domain score of the BDI-II is converted to age equivalent scores, percentiles, and scale scores. Only cognitive and communication subscale scores were used for this study. The cognitive sub-domain includes perceptual discrimination/conceptual development, reasoning and academic skills, attention, and memory. The communication subscale assesses expressive and receptive language.

Children’s developmental rate will be calculated according to the procedures outlined for the BSID-II. The validity of the BDI has been reported across diverse populations including typically developing children (Guidubaldi & Perry, 1984), young children with known or suspected disabilities (Boyd, Welge, Sexton, & Miller, 1989), and children with speech and language disorders (Mott, 1987). Cronbach’s alpha for all the sub-scales range from .90 and .96 indicating high levels of internal consistency. The BDI has been reported to have high test-retest and inter-rater reliability (Newborg, 2005). 84

Children’s communication. The Vineland Adaptive Behavior Scale (Vineland;

Sparrow, Balla, & Cicchetti, 1984) was used to assess children’s communication. The

Vineland assesses the personal and social competence of children from three to 18 years of age. It assesses communication, daily living skills, socialization, and motor functioning. The Vineland is individually administered by professionals to parents or caregivers through interview. In this study, only scores from communication sub-domain are used. The communication sub-domain evaluates the receptive, expressive, and written communication skills of the child. The sum of obtained raw scores is converted to standard scores (mean =100 and standard deviation=15) for each age group. This scale was normed with large, diverse racial and ethnic samples of children from birth to 18 years. Higher scores reflect higher levels of communication. For the communication domain, Cronbach’s alpha coefficients range from .73 to 94 across age groups. There is also evidence of high levels of test-retest reliability (Sparrow, Balla, & Cicchetti, 1984).

Construct and criterion-related validity were reported by the Vineland developers with a sample of 3,000 subjects.

Adoption history. Children’s adoption history was obtained using the Adoption

Placement Questionnaire which was developed for the PARTners project. Age of adoption was the age that a child first came to live with his/her adoptive family. This questionnaire also asked parents to record their children’s pre-adoptive placements in institutions, orphanages and foster care. The answers are coded as two dummy variables.

One is the child’s experience of institutional care and the other is the child’s experience of foster care. Institutional care will be coded 1 for children that experienced institution care before adoption and 0 for children who did not experience institutional care. Foster 85 care will be coded 1 for children that experienced foster care before adoption and 0 for children who did not experience foster care (Appendix B).

Social support. Social support was assessed with the Arizona Social Support

Interview Schedule (ASSIS) (Barrera, 1981). This instrument assesses the parents’ social network over the past month. The ASSIS is an interviewer-administered measure that consists of 30 interview items. However, in this study, a modified version of the ASSIS, which is a self-report, paper and pencil measure, consisting of 12 items was used. This version of the ASSIS assesses parents’ perceived need of and satisfaction with the support received within six domains: Intimate interaction, Material aid, Advice, Positive feedback,

Physical assistance, and Social participation. Rating from 1 (a lot more support needed) to 3 (support was just about right) were collected to assess parents’ perceptions of the adequacy of their supports. Cronbach alpha of the ASSIS with a sample of high-risk adolescents admitted consecutively to psychiatric inpatient units was .93 (Chase, 1992).

Rivera, Rose, Futterman, Lovett, and Gallagher-Thompson (1991) also reported high internal consistency (.85) of the ASSIS with a sample of female caregivers (Appendix C).

Family SES and parents’ employment. Family SES was assessed through single item questions that considered family household income and parents’ educational levels.

Family household income was divided into four categories (1 = under $20,000; 2=

$20,000- $39,999; 3=$40,000-$59,999, and 4=$60,000 or over). Parents’ education level was coded with four levels (1=Less than high school, 2=High school/GED, Associates degree/some college/post secondary training, 3= Bachelor’s degree, 4=Master’s degree or higher). Parents’ employment outside the home was assessed with the following four options; full-time, part-time, retired, or not working. These four options were categorized 86 into two groups; work outside the home or not working outside home (Appendix D).

Statistical Analysis

Hierarchical ordinary least squares (OLS) regression analysis was used to answer research questions 1-3. For each research question, separate regression analyses were conducted for each hypothesis to address the relationship between the independent variables (parent, child, and social contextual factors) and the dependent variables

(Responsivity and Affect). Each multiple regression equation included two control variables (age of child, level of communication functioning) and up to two independent variables directly associated with each hypothesis.

Protection of Human Subjects

An exempt review was requested of the Institutional Review Board (IRB) of Case

Western Reserve University. The present study involves existing retrospective de- identified data; thus issues of confidentiality are not relevant. The original data were collected for the Project,―Developmental PARTners: Prevention, Assessment, Referral, and Transition for Young Adopted Children,‖ funded by the U. S. Department of

Education from 2005 through 2007. The data were used only for answering research questions proposed for the present study, with the approval of the Principle Investigator for the original project. The secondary data analysis was approved by Case Western

Reserve University IRB.

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Chapter 4

Results

This chapter is organized as follows. First, descriptive data regarding children’s development and functioning and on parents’ psychological status and responsiveness is reported. Second, the description of preliminary screening procedure— including missing data, normality and data transformation—is presented to examine data sets before running multivariate analyses. Third, the results of bivariate correlations are presented to assess the magnitude and direction of relationship among all of the study variables.

Fourth, a series of multiple regression are reported that are related to each of the research questions.

Descriptive Study

Children’s Development and Functioning. Table 4 shows the means and standard deviations for children’s social emotional and developmental functioning. The means of children’s behavior problems (internalizing behavior problems, M=51.02; externalizing behavior problems, M=51.07) were comparable to the measures reported for the normative sample (M=50, SD=10). 24.4 % of the children had total CBCL scores that fell into the clinical or borderline ranges (cut off score is 60). On the TABS, the children had an overall score that was more than 1SD below the mean of the normative sample. This overall score was the result of their having scores that were nearly 1SD below the mean on Detached, Hypersensitivity and Dysregulated subscales. Although children’s scores on the Bayley were only slightly below the mean, the score on the

Communication domain of the Vinland Adaptive Behavior Scales was almost 11 points lower than the mean of the normative sample. 88

Table 4

Children’s Social Emotional and Development Characteristics

Child Characteristics M SD

CBCL CBCL Total behavior problems1 51.71 10.68 CBCL Internalizing behavioral problems1 51.02 11.84 CBCL Externalizing behavioral 51.07 10.01 problems1

TABS TABS TRI total scores2 82.27 26.50 Detached1 41.29 19.93 Hypersensitivity/Hyperactivity1 40.24 16.08 Underreactive1 48.83 19.49 Dysregulated 1 42.71 14.60

Bayley/Battelle Developmental Quotient2 96.19 17.15

Vineland Adaptive Behavior Scales Communication2 89.15 16.74

1 Norm: M=50; SD=10 2 Norm: M=100; SD=15

Parental Psychological Well-Being. Table 5 presents the means and standard deviations for parenting stress and depression. Scores on the PSI-SF indicated that the parents had higher Parent-Child Dysfunctional Interaction (PSI-SF/PCD) and Difficult

Child (PSI-SF/DC) scores than those of normative sample (t=2.02, p< .05, t=2.06, p< .05, respectively), while Parent Distress (PSI-SF/PD) and Total Parenting Stress (PSI-SF/T) did not differ significantly from the normative sample. In addition, 22 % of the parents had a PSI-SF Total scores that exceeded the clinical cutoff score (e.g. 90), while only 10% in normative sample had scores in this range (Abidin, 1995). However, parents’ CES-D scores were not significantly different from the normative sample. Less than 10% of the 89 sample had CES-D scores above the clinical cutoff score (e.g. >16).

Parental Responsiveness. Two scale scores from the Maternal Behavioral

Rating Scales (MBRS) were used to assess parental responsiveness, Responsivity and

Affect. Responsivity was the average of three MBRS items (sensitivity, responsiveness, effectiveness). Mean score of the Responsivity scale was 2.59 out of 5 (SD=.69). Affect was the average of five MBRS items including acceptance, enjoyment, expressiveness, warmth, inventiveness. The mean score of Affect was 2.45 (SD=.56).

Table 5

Parental Psychological Well-Being and Responsiveness

M (Norm) SD (Norm) Parental Stress Index-Short Form (PSI-SF)

Parental distress (PSI-SF/PD) 25.19 ( 26.4) 7.21 (7.2)

Parent-child dysfunctional interaction 21.53 (18.7) 8.97 (4.8)

(PSI-SF/PCD)

Difficult child (PSI-SF/DC) 29.10 (26.0) 9.66 (6.7)

Total Parenting Stress (PSI-SF/T) 1 75.82 (71.96) 22.48 (15.4)

The Center for Epidemiologic Studies Depression

Scale (CES-D) 2 9.74 7.02

Maternal Behavior Rating Scale

Responsivity (range: 1-5) 2.59 .69

Affect (range: 1-5) 2.45 .56

1clinically significant levels of parenting stress (> 90) 2cut-off point for clinically significant depression (>16)

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Preliminary Screening Procedure

Prior to conducting statistical analysis, all independent and dependent variables were examined. Descriptive analyses were used to assess the distribution of the independent and dependent variables to determine if they have adequate variability, normal distribution, and no extreme outliers.

In addition, all of the variables used to analyze the research hypotheses were examined to determine if they met the major assumptions for OLS regression: normal distribution of residuals, linear relationship, homoscedasticity, and independence of residuals (Cohen, Cohen,West, & Aiken, 2003). First, to examine the normal distribution,

Skewness and Kurtosis scores were checked. As a general rule, Skewness was acceptable within the range of 0 to 2.00; and Kurtosis was acceptable within the range of 0 to 7.00.

The Skewness and Kurtosis scores of every dependent variable except ―income‖ were normally distributed. Income was significantly negatively skewed (-2.89). Inverse transformation of the Income scores were conducted; this transformation successfully corrected the skewness of this variable (-1.72).

Second, a set of plots, including normal p-p plot and scatterplots of the relationship between residuals and predicted values, was created to examine the linear relationship, to examine the normal distribution of residuals, and to examine the homoscedasticity while assuring that the residuals were dispersed randomly throughout the range of the estimated dependent. In addition, measures of multivariate outliers, including, Centered Leverage, and Cook’s Distance was examined to assess the relative influence of individual cases on the regression.

Missing Data. There were missing data for family income, parental age, and 91 selected items of both the PSI-SF and the CED. Because there were less than 5% missing data for each of these variables and items, data substitutions were not required (Duffy,

2000). However, to retain all subjects in the regression analyses, data substitutions were conducted. For the demographic variables of family income (missing N=1) and parental age (missing N=3), missing data were imputed via mean substitution (Allison, 2002). For the PSI-SF and the CESD, missing data did not exceed two cases per item (less than 5%).

Missing data on these scales were replaced using the Ipsative Mean Imputation method, which calculates the mean across each person’s available item responses (Schafer &

Graham, 2002).

Bivariate Correlations

Bivarate correlations analyses of all demographic variables were conducted to evaluate for the presence of significant relationships. Bivariate correlations were also performed to assess multicollinearity among independent variables and to eliminate potentially insignificant variables from regression analyses. Because the sample size is small, only independent variables that are correlated with dependent variables (p < .1) were be retained for regression analyses.

Table 6 presents the correlations of Responsivity and Affect with the demographic characteristics. Overall, Responsivity was marginally correlated with children’s age (r = -.28, p = .08), length of time in adoptive home (r =-.27, p =.09), parents’ education (r =. 29, p = .07) and employment (r =.30, p =.06). Affect was negatively correlated with children’s age (r = -.48, p = .02), length of time in adoptive home (r =-.38, p =.01), and experience of being in an orphanage (r = -. 36, p = .02). Table

7 presents the correlations of Responsivity and Affect with children’s developmental 92 characteristics and parents’ psychological well-being. In general, Responsivity and Affect did not correlate significantly with any of child development or parent psychological well-being (CBCL, TABS, Vineland communication score, developmental quotient, PSI total score, and CES-D).

Table 6

Correlation Coefficients for the Demographic Characteristics and the Dependent Variables

Responsivity Affect 1 2 3 4 5 6 7 8 9 10

1. Children’s age -.28+ -.48** --

2. Age of adoption .02 -.07 .23 ---

3. Length of time in -.27+ -.38* .73** -.50** -- adoptive home

4. Gender -.14 -.15 -.02 -.09 .05 --

5. Born U.S -.19 -.06 -.09 -.38* .19 -.14 --

6. Experience of -.23 -.36* .17 .36* -.09 .03 -.60** --- Orphanage

7. Parent age -.09 -.17 .03 .25 -.15 .35* -.30+ .18 --

8. Parent education .29+ .09 -.02 .45** -.34* .06 -.32 .25 .20 --

9. Income .04 -.00 -.01 .28+ -.21 .06 -.11 .33* .04 .35* ---

10. Employment .30+ .16 .01 .22 -.15 .09 -.20 .15 .09 .32* .35* ---

+ p < .10 ; * p < .05; ** p< .001

93

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Table 7

Correlation Coefficients for Children’s Developmental Characteristics and Parents’

Psychological Well-Being with Dependent Variables

Variables Responsivity Affect 1 2 3 4 5 6

1. CBCL total score -.04 -.18 ----

2. TABS TRI score .02 .11 -.73** ----

3. Bayley/Battelle -.04 -.01 -.20 .18 ---- Development Quotient

4.Vineland -.14 -.21 -.26+ .31+ .73** ---- Communication score

5. PSI total score -.02 -.14 .68** -.76** -.03 -.09 ----

6. CES-D .12 -.07 .42** -.39** -.10 -.15 .65** --

+ p < .10 ; * p < .05; ** p< .001

Research Questions and Hypotheses

All hypotheses were tested by using a hierarchical multiple regression analysis in which the outcome variable was parental responsiveness. Because parental responsiveness was assessed with two different variables, Responsivity and Affect, each of these dependent variables was regressed separately. That is, two different regression models were used to test each hypothesis one for predicting Responsivity and the other for predicting Affect. Control variables, children’s age and communication, were entered in the first block. The unique predictors proposed by each hypothesis were entered in the second block.

Because of the small sample size and lack of power, the alpha level was set at .10.

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Typically an alpha level of .05 is used to determine significance. A higher alpha level enables this investigation to detect marginal relationships that may be significant with studies that have larger samples (Bartlett, Kotrlik, & Higgins, 2001).

In general, there is concern about the reliability and validity of results from multiple regression analyses that are conducted with small sample sizes. However, there is no agreement regarding the fewest subjects to independent variable ratio that is needed for regression analyses. For example, Tabachinick and Fidell (1989) suggest that the absolute minimum number of subjects for each predictor in a regression model be 5 to 1, while other authors recommend 15 subjects per predictor (e.g. Stevens, 2002; Pedhazur,

1997). This study established the subject to independent variable ratio at10 to 1, restricting the number of independent variables to four.

To ensure that the analyses had sufficient power, a priori power analyses were conducted with G*Power 3.1 (Faul, Erdfelder, Buchner, & Lang, 2009). Power was set as .80, which means that there is 80% of probability of avoiding type II error. With the effect size set at .20, alpha at .10, and the sample size of 41, the maximum number of predictors would be four. Thus, this study used the 10 to 1 subject to independent variable ratio, which allowed for four predictor variables.

For each analysis, assumptions including linear relationship, homoscedasticity, normal distribution of residuals, and independence of residuals were diagnosed (Cohen,

Cohen,West, & Aiken, 2003). In addition, Tolerance scores for predictors were checked to examine multicollinearity. Specifically, when independent variables correlated one another higher than .70, they were examined for multicollinearity (Tabachnick & Fidell,

2001). In general, if the Tolerance score was less than .20, multicollinearity was indicated.

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The effect size for the model was also examined using the procedure suggested by Cohen (1992). Effect size of the hierarchical regression was calculated according to

2 the formula (f² =R²YAB - R²YA / 1- R²YAB ). R Y.A stands for Y variance accounted for

2 by variables A, while R Y.AB means Y variance accounted for by variables A and B. Cohen suggests that f² values .02, 0.15, and 0.35 represent small, medium, and large effect sizes.

Research Question 1. What is the influence of the psychological well-being of adoptive parents on parental responsiveness with their children?

Hypothesis 1. Adoptive parents who have lower levels of parenting stress and depression will show higher levels of responsiveness with their children.

Correlations indicated that parenting stress and depression, which were the predictors for this hypothesis, were highly correlated (r =.65, p <.01) although the correlation coefficient was less than .70. However, since the lowest Tolerance value for the predictors was .52, there was no multicollinearity problem (> .20).

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The first hierarchical multiple regression analysis was conducted to determine if parents’ psychological well- being was associated with Responsivity. Control variables— children’s age and communication level—were entered in the first block. In the second block, total parenting stress and CES-D depression scores were entered. Results from this regression model were not significant, F (4, 36) = 1.476, p = .230 (see Table 8).

Table 8

Q1.H1a. The Influence of Parental Psychological Well-Being on Responsivity

Model 1 Model2

Variables Β Std.Error β Β Std.Error β

Age -.014+ .008 -.279 -.018 .009 -.366

Communication level -.006 .006 -.134 -.004 .006 -.098

Parenting stress .000* .007 .009

Depression .022 .020 .225

Constant 3.520 3.289

Δ R² .097 .044

R² .097 .141

F (4, 36) = 1.476, p = .230

+ p < .10 ; * p < .05; ** p< .001

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The second hierarchical regression examined whether parents’ psychological well- being was associated with Affect. The overall model was significant (F= 3.503, p=.016, R²=.280, adj R²=. 200). The control variables explained 27% of the variance in

Affect (R²= .27, p = .003). Parental psychological well–being, which was entered in the second block, did not explain any additional variance (Δ R²= .01, p = .78). Furthermore, while children’s age (the control variable) was significantly associated with Affect (β = -

.021, p =.002), there was no significant relationship between parents’ psychological well- being and Affect (see Table 9).

Table 9

Q1.H1b. The Influence of Parental Psychological Well-Being on Affect

Model 1 Model2

Variables Β Std.Error β Β Std.Error β

Age -.019* .005 -.477 -.021* .006 -.534

Communication level -.007 .005 -.203 -.006 .005 -.188

Parenting stress .002 .005 .080

Depression .004 .015 .047

Constant 3.641 3.482

Δ R² .270* .010

R² .270 .280

F(4, 36) = 3.503, p =.016

+ p < .10 ; * p < .05; ** p< .001

In general, results from these analyses which indicated that parenting stress and parental depression were not associated with Responsivity and Affect provide no support for hypothesis 1.

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Research Question 2. How do the characteristics of adopted children influence parental responsiveness with their children?

Hypothesis 2. The level of responsiveness of adoptive parents will be associated with children’s temperament and social emotional functioning.

This hypothesis was tested by conducting two hierarchical regression analyses in which the dependent variables were Responsivity and Affect. The control variables, children’s age and communication level, were entered in the first block; children’s temperament and behavioral problems were entered in the second block. Collinearity was examined prior to regression. Correlations indicated that children’s temperament and behavioral problems were highly correlated with each other ( r = -.73, p <.01). This indicated a high risk for multicollinearity. However, the Tolerance value of each of these predictors was higher than .20 in the regression models. Thus, there were no problems of multicollinearity.

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The first hierarchical regression model examined whether children’s temperament and behavioral problems predicted Responsivity. The control variables

(children’s age and communication level) were entered in the first block; in the second block, both children’s temperament and behavioral problem scores were entered. Results from this model were not statistically significant, F (4, 36) =.995, p=.423 (see Table 10).

Table 10

Q2.H2a. The Influence of Children’s Social Emotional Functioning on Responsivity

Model 1 Model2

Variables Β Std.Error β Β Std.Error β

Age -.014+ .008 -.279 -.015+ .008 -.299

Communication level -.006 .006 -.134 -.005 .007 -.118

Behavior problems -.002 .015 -.029

Atypical temperaments -.002 .006 -.079

Constant 3.520 3.757

Δ R² .097 .003

R² .097 .100

F (4, 36) =.995, p =.423

+ p < .10 ; * p < .05; ** p< .001

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The second hierarchical regression was conducted to examine whether children’s temperament and behavioral problems were associated with parental Affect. The first block (children’s age and communication level) explained 27% of the variance in Affect

(R²= .27, p = .003). The second block, which contained the children’s temperament and behavioral problems, did not explain any additional variance (ΔR²= .01, p = .73). The overall model was significant (F= 3.55, p =.015, R²=.283, adj R²=. 203). However, as presented in the Table 11, children’s temperament and behavioral problems were not significantly associated with Affect.

Table 11

Q2.H2b. The Influence of Children’s Social Emotional Functioning on Affect

Model 1 Model2

Variables Β Std.Error β Β Std.Error β

Age -.019* .005 -.477 -.018* .006 -.468

Communication level -.007 .005 -.203 -.007 .005 -.208

Behavior problems -.009 .011 -.166

Atypical temperaments -.003 .005 -.124

Constant 3.641 4.306

Δ R² .270* .013

R² .270 .283

F(4,36)= 3.55, p =.015

+ p < .10 ; * p < .05; ** p< .001

In general, Hypothesis 2 was not supported since multiple regression analyses did not find that children’s socio-emotional functioning was associated with Responsivity and Affect.

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Hypothesis 3. The level of responsiveness of adoptive parents will be associated with children’s level of cognitive functioning.

This hypothesis had only one predictor. Correlations (Table 7) showed that children’s communication level (control variable) and developmental quotient were positively correlated (r =.73, p=.00). However, there was no problem of muticollinearity as indicated by these predictors having Tolerance values, less than .2.

The first hierarchical regression examined whether children’s developmental quotient was associated with Responsivity. The control variables (children’s age and communication level) were entered in the first block. Children’s developmental quotient was entered in the second block. Results indicated that the overall model was not statistically significant, F (4, 36) =1.388, p =.262. (see Table 12).

Table 12

Q2.H3a. The Influence of Children’s Developmental Quotient on Responsivity

Model 1 Model2

Variables Β Std.Error β Β Std.Error β

Age -.014+ .008 -.279 -.013+ .008 -.272

Communication level -.006 .006 -.134 -.009 .010 -.208

Children’s DQ .004 .009 .100

Constant 3.520 3.390

Δ R² .097 .005

R² .097 .101

F (3, 37) =1.388, p =.262

+ p < .10 ; * p < .05; ** p< .001

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The second hierarchical regression was conducted to determine if children’s developmental quotient was associated with Affect. The first block (children’s age and communication level) explained 27% of the variance in Affect (R²= .27, p = .003). The second block, which contained the children’s developmental quotient, did not explain any additional variance (ΔR²= .03, p = .26). The overall model was significant (F= 5.17, p=.004, R²=.295, adj R²=. 238). However, children's developmental quotient was not associated with Affect (see Table 13).

Table 13 Q2.H3b. The Influence of Children’s Developmental Quotient on Affect

Model 1 Model2

Variables Β Std.Error β Β Std.Error β

Age -.019* .005 -.477 -.018* .005 -.461

Communication level -.007 .005 -.203 -.012+ .007 -.375

Children’s DQ .008 .003 .235

Constant 3.641 3.399

Δ R² .270* .025

R² .270 .295

F (3, 37) = 5.17, p =.004

+ p < .10 ; * p < .05; ** p< .001

Hypothesis 3 was not supported because results from these analyses indicated that children’s development was not significantly associated with either Responsivity or

Affect.

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Hypothesis 4. Children’s age of adoption and years in their adoptive homes will be associated with parental responsiveness with them.

Collinearity was examined prior to regression analyses. There was only a moderate correlation between children’s age of adoption and years in their adoptive homes (r = -.50, p <.01). However, children’s age and years in their adoptive home were highly correlated with each other (r = -.73, p <.01). The Tolerance value of every predictor except children’s communication level in the following two regression models were less than .20. Thus, multicollinearity problems were indicated. To reduce multicollinearity, the variable of children’s years in their adoptive homes was removed from the analysis, because previous regression analyses (hypothesis 1, 2, 3) showed a significant relationship between children’s age and parental responsiveness. Thus, only children’s age of adoption, was entered in the second block.

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The first regression model examined whether children’s age of adoption is associated with Responsivity. Results indicated that children’s age of adoption did not significantly predict Responsivity, F (3, 37) = 1.323, p = .281 (See Table 14).

Table 14

Q2.H4a. The Influence of Children’s age of adoption on Responsivity + p < .10 ; * p < .05; ** p< .001

Model 1 Model2

Variables Β Std.Error β Β Std.Error β

Age -.014+ .008 -.279 -.014+ .008 -.285

Communication level -.006 .006 -.134 -.005 .008 -.122

Age of adoption .001 .012 .024

Constant 3.520 3.466

Δ R² .097 .000

R² .097 .097

F (3, 37) = 1.323, p = .281

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The second regression model examined the relationship between children’s age of adoption and Affect. Although this regression model was statistically significant (F (3,

37) =4.697, p = .007), only the control variable— children’s age—was significant (see

Table 15).

Table 15

Q2.H4b. The Influence of Children’s age of adoption on Affect

Model 1 Model2

Variables B Std.Error β B Std.Error β

Age -.019* .005 -.477 -.018* .006 -.455

Communication level -.007 .005 -.203 -.008 .006 -.251

Age of adoption -.004 .008 -.091

Constant 3.641 3.807

Δ R² .270* .006

R² .270 .276

F (3, 37) = 4.697, p = .007

+ p < .10 ; * p < .05; ** p< .001

Hypothesis 4 was not supported since multiple regression analyses indicated that children’s age of adoption was not associated with either Responsivity or Affect.

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Hypothesis 5. Children’s history of institutional or foster care will be associated with parental responsiveness with them.

The hypothesis was tested by using two hierarchical regression analyses in which the outcome variables were Responsivity and Affect with each outcome variable regressed separately on the same predictor variables. The control variables, children’s age and communication level, were entered in the first block; children’s history of institutional care and foster care were entered in the second block.

The first hierarchical regression was conducted to examine whether children’s experience of orphanage and foster care are associated with Responsivity. Results indicated that the overall model was not statistically significant, F (4, 36) =1.437, p =.242

(see Table 16).

Table 16 Q2.H5a. The Influence of History of Institution and Foster Care on Responsivity

Model 1 Model2

Variables Β Std.Error β Β Std.Error β

Age -.014+ .008 -.279 -.012 .008 -.244

Communication level -.006 .006 -.134 -.006 .006 -.146

Orphanage (dummy) -.241 .305 -.176

Foster Care (dummy) .058 .314 .070

Constant 3.520 3.600

Δ R² .097 .041

R² .097 .138

F (4, 36) =1.437, p =.242

+ p < .10 ; * p < .05; ** p < .001

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The second hierarchical regression was conducted to examine whether children’s experience of orphanage and foster care were associated with Affect. Results indicated that the first block explained 27% of the variance in Affect (R²= .27, p = .003); and the second block, which contained children’s experience of orphanage and foster care variable, explained marginally significant variance in Affect (R²= .097, p = .076). The full regression equation was significant (F = 5.23, p = .002, R²= .367, adj R²=.297) with a medium effect size (f² = .19).

Of the variables entered in the first block, children’s age was statistically significant (β = -.017, p=.003) and children’s communication level was marginally significant (β = -.008, p =.083). In the second block, the experience of orphanage was statistically significant (β = -.43, p =.046), while foster care was not significant. In other words, parents showed more affect with children who did not experience orphanage care than to those who did by average of .43 (see Table 17).

Table 17 Q2.H5b. The Influence of History of Institution and Foster Care on Affect Model 1 Model2

Variables Β Std.Error β Β Std.Error β Age -.019* .005 -.477 -.017* .005 -.427

Communication level -.007 .005 -.203 -.008+ .004 -.239

Orphanage (dummy) -.433* .209 -.394

Foster Care (dummy) -.144 .215 -.126

Constant 3.641 3.941

Δ R² .270* .097+

R² .270 .367

F (4,36) = 5.23, p = .002 + p < .10 ; * p < .05; ** p< .001

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Hypothesis 5, which proposed children’s pre-adoptive history of institutional or foster care would be associated with parental responsiveness, was partially supported by results from regression analyses. While history of orphanage and foster care was not associated with Responsivity, children’s experience of orphanage was negatively associated with Affect.

Analyses were conducted to explore the association between institutional care and parental Affect. Because the children in this sample only experienced orphanage or foster care, the sample was divided into three groups: parents and children who were placed in orphanages, parents and children who were placed in foster care, and parents and children who did not experience either orphanage or foster care. An ANOVA was conducted to examine differences between these three groups in terms of parental Affect.

Results indicated marginally significant Group differences, [F (2, 38) = 2.855, p<. 07].

Post hoc comparisons were conducted with independent t-test. For these analyses, two groups were combined to compare with the third group. For example, parental Affect of parents of children who did not experience orphanage or foster care was compared with other two groups (children who experienced orphanage or children who experienced foster care). Results indicated that parents of children who experienced orphanage showed less Affect than parents of children who experienced foster care or who did not experience either (t=-.24, p=.021). However, parents of children who did not experience orphanage and foster did not differ from other parents.

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Research Question 3. What is the influence of social contextual characteristics on parental responsiveness with their children?

Hypothesis 6. Parents with higher levels of socio-economic status (consisting of income and education) will exhibit higher levels of responsiveness with their children.

Correlations indicated that family income and parents’ education, which were predictors for this hypothesis, were only moderately correlated (r =.35, p <.05).

Furthermore, the Tolerance value of every predictor in the following two regression models was higher than .20, indicating no problems of multicollinearity.

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The first hierarchical regression model examined whether family income and parents’ education was associated with Responsivity. Control variables (children’s age and communication level) were entered in the first block; family income and parents’ level of education levels were entered in the second block. Results indicated that the overall model was not statistically significant, F (4, 36) =1.853, p =.140 (see Table 18).

Table 18

Q3.H6a. The Influence of Parents Income and Education on Responsivity

Model 1 Model2

Variables Β Std.Error β Β Std.Error β

Age -.014+ .008 -.279 -.014+ .007 -.283

Communication level -.006 .006 -.134 -.001 .007 -.017

Income (transformation) -.362 .519 -.121

Parents’ education .244+ .136 .326

Constant 3.520 2.680

Δ R² .097 .074

R² .097 .171 F (4, 36) =1.853, p =.140

+ p < .10 ; * p < .05; ** p< .001

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The second hierarchical regression examined whether family income and parents’ education were associated with Affect. The first block (children’s age and communication level) explained 27% of the variance in Affect (R²= .27, p = .003). The second block, which contained the family income and parents’ education, did not contribute significantly to Affect (ΔR²= .005, p = .89). While the overall model was significant (F=

3.42, p =.018, R²=.275, adj R²=. 195), family income and parents’ education were not significantly associated with Affect (See Table 19).

Table 19

Q3.H6b. The Influence of Parents Income and Education on Affect

Model 1 Model2

Variables Β Std.Error β Β Std.Error β

Age -.019* .005 -.477 -.019* .006 -.483

Communication level -.007 .005 -.203 -.006 .005 -.179

Income (transformation) -.185 .388 -.077

Parents’ education .035 .102 .058

Constant 3.641 3.736

Δ R² .270* .005

R² .270 .275

F (4, 36) = 3.42, p=.018

+ p < .10 ; * p < .05; ** p< .001

Hypothesis 6 was not supported since results from multiple regression analyses indicated family income and parents’ education were not associated with parental responsiveness.

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Hypothesis 7. Parents with higher levels of social support will have higher levels of responsiveness with their children.

To test the relationship between social support and parental responsiveness, two separate hierarchical regression were performed, one for each dependent variable,

Responsivity and Affect. In both regression models, control variables (children’s age and communication level) were entered in the first block, and social support was entered in the second block. In the resulting regression models, no independent variables had scores less than .2 in the Tolerance values, indicating no problems with multicollinearity.

The first model which examined the association of social support with

Responsivity was not statistically significant, F (3, 37) =1.337, p =.277 (see Table 20).

Table 20

Q3.H7a. The Influence of Perceived Levels of Social Support on Responsivity Model 1 Model2

Variables Β Std.Error β Β Std.Error β

Age -.014+ .008 -.279 -.014+ .008 -.289

Communication level -.006 .006 -.134 -.006 .006 -.136

Perceived social support -.010 .046 -.037

Constant 3.520 3.695

Δ R² .097 .001

R² .097 .098

F (3, 37) =1.337, p =.277

+ p < .10 ; * p < .05; ** p< .001

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The second model which examined the association of social support with Affect was statistically significant (F=4.79, p=.006) and explained 28% of the total variance in

Affect (R²=.28, p < .001). However, social support did not contribute to variability of

Affect (ΔR²= .009, p = .49). Of the control variables, only children’s age was associated with Affect (β = -.018, p =.004); however, social support was not associated with Affect

(see Table 21).

Table 21

Q3.H7b. The Influence of Perceived Levels of Social Support on Affect Model 1 Model2

Variables Β Std.Error β Β Std.Error β

Age -.019* .005 -.477 -.018* .006 -.450

Communication level -.007 .005 -.203 -.007 .005 -.199

Perceived social support .123 .033 .101

Constant 3.641 3.259

Δ R² .270* .009

R² .270 .280

F(3, 37) = 4.79, p=.006

+ p < .10 ; * p < .05; ** p< .001

Hypothesis 7 was not supported since results from multiple regression analyses indicated that social support was not associated with either Responsivity or Affect.

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Chapter 5

Discussion

Parental responsiveness is crucial, not only for successful adoption but also for children’s development. The major aim of this study, therefore, was to explore the factors that contribute to parental responsiveness among adoptive parents. Based upon a conceptual model which combines elements of the Transactional Model of Development

(Sameroff & Chandler, 1975) and Belsky’s Model of Parenting, as well as empirical evidence found in the existing literature, this study examined three questions. The first question was concerned with identifying characteristics of parents that might be associated with parental responsiveness. The second question sought to identify characteristics of children associated with parental responsiveness. The third question investigated how social contextual variables such as socio-economic status and social support were associated with parental responsiveness. These research questions were addressed by analyzing patterns of interaction between adoptive parents and their children. Parental responsiveness was conceptualized and assessed with two different variables, Responsivity and Affect.

The major findings from this study will be presented in this chapter. In addition, this chapter will discuss these findings in relation to the current literature on parental responsiveness. These sections will be followed by a discussion of implications for practice and of the study’s overall strengths and limitations and future directions for research.

Review of Findings

Research Question #1:

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What is the influence of adoptive parents’ psychological well-being on parental responsiveness?

In general, findings were not supportive of the proposed hypothesis; parenting stress and depression were negatively associated with parental responsiveness. In other words, it was expected that parents with higher levels of parenting stress and depression would be less likely to be responsive to their children. However, results from this investigation indicated that neither parenting stress nor depression were associated with parental Responsivity or Affect.

Research Question #2:

How do the characteristics of adopted children influence parental responsiveness?

Four different characteristics of children including social-emotional functioning, development, age of adoption, and pre-adoptive history were investigated through regression analyses. Among these four variables, only one—children’s pre-adoptive experience in orphanages—was significantly associated with parental responsiveness, and then, only with Affect not with Responsivity. In contrast, the other three variables— social emotional functioning, child development, and age of adoption —were not significantly associated with parental responsiveness. Specifically, parents of adopted children who did not experience orphanage placement showed more Affect with their children by .43 points. Considering that the possible range of scores of Affect was between 1 and 5, and the distribution of scores on Affect were concentrated in the mid- range, this half point difference appeared to be a clinically significant finding.

Research Question #3:

What is the influence of social contextual characteristics on parental

117 responsiveness?

The relationship between parental responsiveness and social contextual characteristics, including socio-economic status (e.g., family income, parents’ education) and perceived social support were explored. It was proposed that parents with higher education or income would be more responsive with their adopted children than parents with lower education or income. In addition, parents who perceived that they received adequate social support, such as intimate interaction, material aid, advice, positive feedback, physical assistance, and social participation, were expected to display higher levels of responsiveness. However, results from this study were not supportive of these hypotheses. That is, these social contextual characteristics were not significantly associated with parental responsiveness.

In summary, few of the variables investigated in this study were found to be associated with parental responsiveness. The experience of living in an orphanage was the only statistically significant predictor of Affect.

Correspondence of Findings with Existing Literature

In general, findings regarding the relationship between characteristics of parents, children, and social context with Responsivity and Affect were not consistent with existing research literature. However, one should be cautious in comparing the findings from this study to findings from existing literature, because the research data related to this issue is limited and has been reported primarily with biological families.

It is important to note that while most of the variables examined in this study were not associated with parental responsiveness, children’s age (the control variable) was consistently associated with Affect. In other words, parents of younger children were

118 more likely to express enjoyment and positive attitude/affection with their children regardless of their children’s age at adoption.

Characteristics of Parents. One of the more consistent findings in the literature is the association between parents’ psychological well-being and their level of responsiveness with their children. For example, several studies have reported that parenting stress and depression are associated with caregivers’ ability to respond sensitively and to engage in affective interactions with their children (Ostberg, 1998;

Calkins, Hungerford, & Dedmon, 2004; Belsky & Jaffee, 2006; Goodman & Brumley,

1990). Studies have reported that depressed parents have difficulties being emotive and providing stimulation to their children (Lovejoy, Graczyk, O’Hare & Neuman, 2000;

Field, 2002). In addition, Webster-Stratton (1990) proposed that parents who are highly stressed tend to be more irritable, critical and severe while interacting with their children.

While the failure of this study to find a significant association between parent’s psychological well-being and responsiveness may be a valid finding, it is also possible that there were, at least, two unique characteristics of this study that might account for the failure to find this association in this study.

First, there may have been insufficient variability in parental psychological well- being. Generally, adoptive parents are thought to have a unique and positive perception of their role and competency. As a result, many adoptive parents may downplay the difficulties associated with child rearing, especially after being deprived of the opportunity to parent a child for long periods of time (Levy-Shiff, Goldshrnidt & Har-

Even, 1991; Holditch-Davis, Sandelowski, & Glenn Harris, 1999). Furthermore, although few empirical studies have investigated the level of depression of adoptive parents,

119 several studies have found that adoptive parents generally appear to have healthy psychological well-being (Borders, Black, & Pasley, 1988; Senecky et al., 2009).

Consistent with the studies cited above, fewer than10% the parents in this study were at, or above, the cut off scores for clinical depression on the CES-D. In addition, the average parenting stress levels of the parents in this study did not differ significantly from the average PSI-SF scores reported for biological parents. Therefore, the sample for this study may not have included a sufficiently large group of parents at risk for psychological problems to examine the effects of psychological well-being on parents’ style of interaction with their children.

Second, psychological well-being may affect adoptive parent’s interactive style in two ways, as opposed to the one way commonly described for birth parents. Adoptive parents who are both concerned about and experiencing stress related to their children’s difficulty of attaching to them may engage in highly responsive interactions with their children. According to Foli (2010), for many adoptive parents’ parenting stress and depression may be caused by their unmet expectations to achieve a full and positive parent-child bonding, as opposed to general parental or personal distress. Thus, as a response to this type of stress and depression, these adoptive parents may react to feelings of stress by attempting to increase their responsiveness with their children.

On the other hand, adoptive parents who are overwhelmed, stressed and/or depressed about the demands associated with the daily burden of caring for their children may find it difficult to interact responsively with their children as many studies of birthparents have reported.

To the extent these two different models may have operated in this sample, it

120 would be difficult to identify a linear relationship between parents’ psychological status and their style of interacting with their children.

Characteristics of Children.

General characteristics. Both the Transactional Model of Development and

Belsky’s Model of Parenting emphasize that the way children behave toward their parents influences the way parents interact with their children. That is, parental responsiveness is not solely determined by the characteristics of parents, but may also be influenced by the bi-directional relationships parents have with their children. As cited in the literature review, several studies have reported significant associations between children’s social emotional functioning and development with parents’ level of responsiveness. Given that adopted children tend to have social emotional difficulties and poor developmental functioning, it was assumed that in this sample these child characteristics would be associated with the level of responsiveness of their adoptive parents.

However, there was no evidence from this study that children’s social emotional and general developmental functioning were associated with parental responsiveness.

These findings may have occurred for the following reasons.

First, children’s social-emotional and developmental functioning may not have the same effect on adoptive parents as they have on birth parents. From the time of adoption, adoptive parents may have been informed that their children are likely to have behavior and temperament problems that are caused by negative pre-adoption experiences or the adoption itself. As a result, adoptive parents may believe that their role is to help their children with these difficulties, and that with their efforts their children’s social emotional and developmental difficulties may diminish over time. Thus, adoptive

121 parents may respond to their children’s social emotional and developmental difficulties with a less reactive and more responsive child-oriented style.

On the other hand, other adoptive parents may allow their children’s social- emotional and developmental difficulties to affect their interactions with their children.

Their inability to control their children’s behavior may result in their adopting a highly authoritarian or discipline oriented style of interacting with their children.

To the extent that these two processes might be operating in this population of parents, it would be difficult to detect a linear relationship between children’s social- emotional or developmental functioning with parental responsiveness.

Second, the failure to find an association between children’s social emotional functioning and parental responsiveness may be related to the instruments used to measure these characteristics. Previous studies in which children’s social emotional functioning has been report to affect parental responsiveness have used measures that target negative social emotional behaviors that occur when children are interacting with their parents (Kochanska, Forman, & Coy, 1999; Rubin, Nelson, Hasting, & Asendorpf,

1999).

This study used a parent report measure which assessed children’s social emotional functioning in terms of how mothers generally perceived their children’s behavior across normal daily routines and activities. It was assumed that this measure would provide a reliable indicator of the way that children might behave while interacting with their parents. However, it is possible that parent-report measures may not be valid predictors of children’s behavior during the observations with their mothers. To the extent that parents’ level of responsiveness is influenced by their children’s behavior at the

122 moment (e.g., 7 minute video observation), it is not surprising that mother’s responsiveness during the observation was not associated with maternal ratings of children’s general social-emotional behavior.

Third, the heterogeneous nature of the sample of children who participated in this study may have introduced complex confounds that made it difficult to identify reliable relationships between child development and parental responsiveness. While children who participated in this study were all adopted and less then six years of age, they differed in terms of their country of origin, chronological age, age of adoption and amount of time with their parents.

For example, children who were international adoptees were likely delayed in their language development if they had not lived in the United States with their adoptive families for a sufficient period of time to learn English. Limited knowledge of English would result in low child development scores, even though the child may be developing normally, primarily because child development tests include test items that require an understanding of English. In this situation, it is unclear whether child developmental test scores would accurately reflect those developmental characteristics that are most likely influence parents’ style of interaction.

While statistical procedures were used to control for these confounds (such as children’s language level), this procedure could only be effective if there were a linear relationship between the confounds and parents’ style of interaction. However, the amount of time children had to learn English may have also had a different influence on parents’ interactions based on the age of the child (range from 14 to 60 months). Given the nature of the confounds in this sample, the relationship between the confounding

123 variables and parental responsiveness may have been too complex to be disentangled through statistical controls.

Thus, it is possible that findings in this study are a valid reflection of the relationship between children’s general characteristics and parental responsiveness as measured in this study. However, the complexity of factors that were not adequately controlled in this study may have obscured the true relationship between these constructs.

Adoption-related variables. Research on adoption has placed a great deal of emphasis on understanding how adoption related factors, such as children’s age at adoption and pre-adoption history, contribute to children’s adjustment. Generally, studies have found that if children are adopted at younger ages they are more easily integrated into their adoptive families, they have fewer adjustment problems, and their parents are less stressed (Pomerleau, et al., 2006; Lydens & Snarey, 1989; Brodzinsky & Schechter,

1990). In addition, several studies have published data indicating that early experience of institutional care has short and long-term negative effects on children’s well-being

(Kadlec, & Cermak, 2002; Merz, & McCall, 2010; Murphy, 2009) as well as on parent- child interaction (Marcovitch et al., 1997). Based upon this literature, the present study assumed that adoption-related characteristics of the children who participated in this study would be associated with their parents’ responsiveness.

While children’s age at adoption was not associated with parental responsiveness, children’s experience in orphanages was negatively associated with parental responsiveness, as measured by Affect.

Perhaps, the most likely explanation for the failure to find an association between age of adoption and parental responsiveness is that the experiences that children have

124 before adoption might be more critical influences on parent-child interaction than their age at adoption per se (Bartel, 2005; Juffer & Rosenboom, 1997). Older adopted children are more likely to have accumulated negative experiences including lack of affection and stimulation, which might lead to adjustment problems that affect parent-child interaction

(Juffer & Rosenboom, 1997). However, considering the heterogeneous nature of this study sample—which not only included domestic adoptees but also international adoptees with varied pre-adoption histories— and insufficient information on pre adoption situations, older adopted children may not have accumulated more negative experiences than young adopted children.

The findings that children’s placement in orphanage was negatively associated with parental responsiveness—while children’s social emotional and developmental characteristics were not— was surprising. This study was based upon the assumption that children’s social-emotional and developmental problems would mediate the relationship between placement in orphanages and parental responsiveness. Yet, the lack of association between children’s social emotional functioning and parental responsiveness suggests that institutional care might have other effects on children which influence their interactions with their parents.

Adopted children might have other unique difficulties, in addition to social- emotional and developmental problems. One such difficulty might be the inability to form strong bonds with their adoptive parents; a factor that is likely to be negatively associated with adoptive parents’ responsiveness. Institutionalized children have been reported to be more distant and less affectionate with their adoptive parents, even though they may be very compliant (Verrier, 1993). This might be the result of their missing the

125 early bonding experiences in institutional settings in which caregiving is provided by multiple people (Marcovitch et al.,1997).

Perhaps even more problematic, some adopted children do not allow their parents to be affectionate with them. This lack of emotional bonding (the feeling of belonging together) may cause adoptive parents to feel insecure about their own sense of being the parent or even feel that they are being rejected (Varrier, 1993). Thus, the finding of present study—the association between the experience of institutionalization and

Affect—may reflect that adoptive parents and their post institutionalized children are not comfortable in expressing affection toward each other.

Characteristics of Social Context. A handful of studies have reported that family socio-economic status and social support are important influences on parent-child interaction (Raviv, Kessenich, & Morrison, 2004; Feldman, Varghese, Ramsay& Rajska,

2002). However, results from this study were not supportive of this literature, insofar as the relationships between family SES and social support with parental responsiveness were not statistically significant. Considering the unique social circumstances of adoptive families, these findings may be valid.

First, restricted variability in family SES would reduce the likelihood of association between family SES and parental responsiveness in adoptive families. As discussed previously, most adoptive parents achieve higher levels of education and are less likely to have financial problems than biological parents (Hamilton, Cheng, &

Powell, 2007; Brodzinsky & Huffman, 1988). Indeed, every parent who participated in this study had finished high school and 43% (n=18) held Masters or higher academic degrees. In addition, most of the parents had incomes greater than $60, 000 per year.

126

Given the SES characteristics of the parents who participated in this study, there may not have been sufficient variability of SES to examine its covariance with parental responsiveness. However, although this study did not include lower socio-economic adoptive families, the study sample may indeed be representative to the general population of adoptive parents, since children are often adopted by parents who are above average in SES (Kamphaus, 2005). Thus, findings from this study may not consistent with the previous literature, because this literature has included mostly birth parents with a wide range of SES.

Second, adoptive parents are generally satisfied with their support systems, so that there may have been limited variability in social support. Several studies have reported that adoptive parents perceived themselves to be receiving higher levels of support from spouses, extended family, and friends than do biological parents (Singer,

Brodzinsky, Ramsay, Steir, & Water, 1985; Levy-Shiff, Bar, & Har- Even, 1990). In particular, Holditch-Davis, Sandelowski, and Glenn Harris (1999) reported that adoptive fathers are more involved in parenting and take more active roles than biological fathers.

In addition, the adoption decision-making process and actual adoption procedure requires many support systems—not only informal support from immediate and extended families but also support from professionals. Thus, the range of perceived social support scores of adoptive families tends to be skewed resulting in insufficient variability on this measure.

In summary, the lack of association between social contextual factors and parental responsiveness may reflect the true nature of the relationship between these constructs in adoptive families because these families tend to come from restricted spectrum of socio-economic status and social support.

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Practical Implication of Study

The purpose of this study was to identify factors that contribute to adoptive parents’ style of interacting with their children, particularly as related to their level of responsiveness. While most of the factors examined in this study were not significantly associated with maternal responsiveness, the study produced at least two findings which have practical significance.

A large percentage of the employees in adoption agencies are social workers who are interested in working with children and families. Social workers are ideally suited to help adoptive families, because of their interests in working with parents and families, their academic training in child development and family systems theory, as well as their academic and practical training in mental health services. Most social workers work provide a variety of services to adoptive parents including case management pre-adoption preparation to post-adoption counseling. As a result, social work plays an important role in working with adoptive families. This section discusses two findings that emerged from this study that have practical implications for social work with adoptive families

The first finding was that parents’ level of Affect was associated with children having a history of institutional care. That is, mothers had lower ratings on Affect with adopted children who had previous histories of institutional care compared to adopted children without such histories. One of the questions raised by this finding is in what ways might children's experience of being raised in an institution influence parents’ affect with them. One possible explanation might be that in an institutional setting children have few, if any, opportunities to bond, or attach to a primary caregiver, perhaps due to the fact that they are cared for by multiple adults while living in an institution. The absence of

128 opportunities to form attachment relationships with a caregiver may result in these children developing low levels of depressive mood, or may interfere with these children having opportunities to engage in the kinds of intimate social interactions that are needed to develop their ability to express their emotions (Marcovitch, et al. 1997). Either condition, low-level depression or limited competency with emotional expression, could have a negative transactional effect on parents’ affective expressions toward their children.

While further research is needed to fully understand the factors that may be inhibiting parents’ Affect, the finding that adoptive parents of institutionalized children may have difficulties in expressing Affect toward their children can be a useful piece of information to provide parents, particularly at the time of adoption or even before the adoption.

According to Groza and Ileana (1996), adoptive parents report not having sufficient information about their children’s pre-adoption history, especially in cases of international adoption. Aadoptive parents are also unaware of the range of the problems that can be caused by institutional care. Therefore, social work agencies who work with international adoption need to help parents obtain as much information as possible about children’s pre-adoption history. Social workers need to help adoptive parents become aware of the potential impact that their children could have on their interactions with their children. This type of information may not only help parents identify a factor that could have a negative impact on their attachment with their children, but may also help parents understand that their children's lack of affective expression toward them may be the result of their children’s history of institutional care and, there, is not a reflection of their

129 adequacy as parents.

To the extent that parents are the more potent agents in the establishment of dyadic reciprocity with their children (Kochanska & Akson, 2004), parents need to be encouraged to accentuate their expressions of affect while interacting with their children as a means of eliciting more frequent and intense expressions of affect from their children.

Parents’ success in accomplishing this might be an important strategy for developing a mutually rewarding attachment relationship with their child.

The second finding of practical significance from this study had to do with mothers' level of responsiveness with their children, at least as measured by the Maternal

Behavior Rating Scale. As described in the results section, mothers’ mean rating for

Responsivity was 2.6 and for Affect was 2.5. Both of these ratings were considerably lower than the midpoint rating on this scale which is 3.0. In fact, 61% of the mothers had ratings that were less than 3.0 on Responsivity and 83% had ratings that were less than

3.0 in Affect. Not only were parents’ ratings on these two items well below the mean, but they were also substantially lower than MBRS ratings reported for a sample of 500 mothers who were participating in early intervention research studies and had not received parent-child training (Mahoney, Boyce, Fewell, Spiker, & Wheeden, 1998) .

Mahoney et al., (1998) reported that the mean Responsivity rating for these mothers was

3.1, while the mean Affect rating was 2.7.

To the extent that the level of responsiveness observed in this sample can be generalized to parents of young adopted children, this observation supports an underlying premise of this study. The premise is that parents of young adopted children may have difficulty showing a high level of responsiveness with their children in a way that will be

130 optimally beneficial to enhancing their children’s developmental and social emotional well being. While it is unclear why adoptive parents have such low levels of responsiveness, due to the lack of research, it is speculated that adoptive parents might not have had sufficient time to learn to read their children’s cues related to their needs or that adopted children’s difficulties of bonding with their parents might result in the low levels of parental responsiveness. Regardless, the data reported in this study are important insofar as they point to the possibility that the vulnerabilities these children bring to their newly adopted families due to their pre-adoptive histories, may be aggravated by parents’ apparent inability to engage in highly responsive interactions with them.

As a result, these findings point to the need to provide parents with information and other types of supports that could help to encourage responsiveness with their children. Adoption agencies might not only provide parenting education regarding the basic care of the child, but also intervention services that work directly with parents to help enhance their early interactive relationship with their children. This in addition to coordinating the adoption for families, social workers also need to develop the skills needed to work with families post-adoption to ensure that parents are engaging in the kinds of interactions that will increase the likelihood their children attain optimal developmental and social emotional outcomes.

Relationship focused intervention may provide an effective alternative for addressing these issues. Relationship focused intervention is an approach to encourage parents to engage in highly responsive interactions with their children during daily routine activities (Mahoney & MacDonald, 2007). This approach is based on two basic concepts. First, parents have a significant impact on their children’s development,

131 because parents spend much more time with their young children and have greater opportunities to provide developmental stimulation and other support to their children compared to other professionals and other adults. Second, highly responsive interactions between parents and children promote children’s social emotional and developmental functioning (Mahoney & Perales, 2005). Thus, it helps parents to interact more responsively with their children as well as helps children maximize their developmental potential (Mahoney, 2009).

There is an increasing body of literature which indicates that the methods and strategies associated with this approach can be effective at promoting and sustaining higher levels of parental responsiveness and children’s development (Spiker, Ferguson &

Brooks-Gunn, 1993, Landry, Smith, Swank, & Guttentag, 2008). Therefore, relationship focused intervention may be an effective method for parents of young adopted children as a means of preventing or reducing the negative issues related to developmental and social emotional function that are often reported for these children.

Strengths and limitations of study

There are at least two major strengths of this study. The first has to do with its focus on the interactive behavior of adoptive parents of young children. As described in the introduction, most of the research on parental responsiveness has been conducted with birth parents, and there is insufficient information about the nature of interactions that take place between adoptive parents and their young children. However, given the nature of the vulnerabilities that adoptive children bring to their early relationships with their parents, and given the fact that adopted children are at very great risk for developing mental health problems later in their lives, it is important that studies such as the one

132 conducted for this dissertation be carried out. This is necessary both to gain a greater understanding of how adoptive parents typically interact with their children, and to begin to identify factors that may either positively or negatively influence the patterns of interaction that take place between adoptive parents and their children.

The second strength of this study is associated with the measure of parent-child interaction that was used to assess parents’ responsiveness. As described in the Literature

Review, there are a wide range of measures that have been used to assess and analyze parents’ interactions with young children. The Maternal Behavior Rating Scale which was used to assess mothers’ style of interacting with their children in this study, has been used in several other studies of parent-child interaction. Results from these studies support the validity of this instrument in so far as they indicate that the MBRS measures those qualities of parental responsiveness that are highly associated with children's cognitive, communication, and social emotional functioning. While the MBRS does not have normative data, the ratings of mothers in the sample with this instrument could be compared to the ratings of several other samples of mothers that have been reported in the literature. In the absence of control groups of birth mothers, this provided a way of evaluating the degree to which mothers in the sample were engaging in typical levels of responsive interaction with their children.

Despite these strengths, as pointed out previously, there are several limitations that lead to concerns regarding the reliability of the findings of this study. First, perhaps the major limitation had to do with the heterogeneity of the children in this study with regard to several factors that are likely to have major influences on parents’ interactions with them. Not only did this include the fact that the children were both international and

133 domestic adoptees, but also that they varied considerably in terms of their chronological age, age of adoption and amount of time that they lived with their adoptive parents.

A second major limitation was associated with the procedures that were used to assess children's development and social emotional functioning. As described previously, the validity of the child development measure was compromised by the fact that several of the children who participated in this study had had limited opportunity to learn English.

In addition, while the measures of social emotional functioning were likely valid indicators of mothers’ general perceptions of their children's behavior, there is little reason to believe that these measures provided a reliable indicator of children's social emotional behavior in the observation that was used to assess mother child interaction. As a result, this study may not have had appropriate data for examining the impact that children's social behavior has on parents' level of responsiveness with their children.

The third limitation was related to the observation that the parents in this study did not display the range of variability in either social economic status or psychosocial functioning that may be needed to examine how these constructs influence parents’ style of interacting with their children. Most of the parents came from middle and higher levels of SES. In addition, they reported having adequate levels of social support, and did not appear to have levels of parenting stress or depression that previous studies have indicated to influence parents’ interactions with their children. As a result, the restricted range of these parenting characteristics in the sample may have obscured the actual impact that these constructs have on parents’ responsiveness with their children.

Future Research

How parents interact with young adopted children and the role that parenting

134 plays in the development of these children is a critical issue that clearly needs to be better understood. If adoptive parents engage in relatively ineffective styles of interaction with their children, as results from this study suggest, the two most obvious questions that need to be investigated in future research are related to identifying factors that contribute to these parents’ style of interaction as well as to identify intervention strategies that might be effective in promoting more effective patterns of parent-child interaction.

As discussed previously, it may be that the failure of this study to identify factors associated with parental responsiveness occurred because this study was conceptualized in terms of research findings associated with the parenting characteristics of birth parents.

However, there may be other factors or conditions that are unique to adoptive parents that influence the way these parents interact with their children. Insofar as this is true, future studies on the parenting characteristics of adoptive parents need to be conceptualized more in terms of the child and family factors associated with adoption that are likely influences on these parents’ style of interaction as versus conceptual models that are focused on the factors that influence birth parents. Undoubtedly, this will need to include a focus on the concept of bonding, particularly as associated with changes in children's bonding to their adoptive parents over time. In addition, parents’ motivation for adoption, whether an adoption is open or closed, as well as children’s awareness of adoption are some other relevant factors that need to be included in the conceptual model.

Because the impact of adoption-related factors on parental responsiveness has not been studied previously; there is no empirical basis for deciding which of these factors to include in future studies. As a result, there is a critical need for qualitative studies that provide an in depth understanding of the experiences of adoptive parents in

135 learning how to interact with and care for their children. For example, as discussed previously, the stress experienced by adoptive parents may be qualitatively different from that experienced by biological parents. In this case, through qualitative studies we can gain a better understanding of the nature of the stress experienced by adoptive parents and how this might affect their interactions with their children. In addition, to getting a better understanding of how adoption factors influence parent responsiveness, parent- child interaction needs to be videotaped more intensively. In this study, parent-child interaction was video recorded for 7 minute during one parent-child play observation.

However, to obtain a more complete picture of the way adoptive parents interact with their children, future studies may need to conduct observations over longer periods of time in the context of a range of daily routines and activities that are more representative of the interactive experiences of these parents and children.

One of the findings of this study was that adoptive parents were rated as displaying relatively low level of responsiveness with their children. Yet this study was unable to identify factors that might explain this. To understand the possible reasons for low responsiveness, future studies might consider dividing adoptive parents into two groups: adoptive parents who show relatively high levels of responsiveness and adoptive parents displaying low levels of responsiveness. By accentuating group differences in parental responsiveness, future studies could conduct more in depth analyses of how these families differ, perhaps through the use of focus groups and more extensive observations of parent-child interaction. This might help identify factors which inhibit or facilitate parents’ Responsivity or Affect.

In addition to having a more appropriate conceptual framework, there are a

136 number of other issues that need to be considered in future research. Although many of these issues have been described previously they will be listed again in this section to emphasize importance of these factors to future research.

First, future studies need to be conducted with larger samples of parents and their adoptive children. Larger sample sizes will provide the power that is necessary to analyze the complex set of factors that are likely to moderate and mediate parents’ style of interaction with their children. While this study focused on attempting to identify direct relationships between child development and parent psychosocial factors that are likely to affect parents’ style of interaction, the possibility exists that the factors examined in this study only had an indirect relationship to the parenting style of adoptive parents. Such indirect relationships are best analyzed using Path analyses, and are unlikely to be identified as significant predictors in the types of regression analyses conducted in this study, especially when these analyses are based upon samples as small as used in this study.

Second, future research related to the issues examined in this study needs to be conducted with groups of parents of adoptive children that are much more homogeneous than the sample that was used for this study. At the very least, samples should either include domestic adoptees or international adoptees, but not mix these two groups together. These two groups of adopted children tend to be very different in terms of their pre-adoptive histories as well as their opportunities to learn English. Domestic adoptees, including children who have had one or more foster care placements, seldom experience the types of pre-adoptive caregiving environment that international adoptees are often subjected to in institutional settings. The differences in caregiving experienced by these

137 two groups of children may be so great that they have radically different influences on their adoptive parents’ style of interacting with them. In addition, the amount of opportunities that international adoptees have had to learn English is a highly relevant consideration, not only because a child's English proficiency may be a major influence on their parents’ interactions with them, but also because limited English proficiency can obscure the effects that children's level of development as measured by standardized child development assessments instruments, might also have on their parents.

Other factors that were not controlled in this sample included age of adoption, and amount of time living with their parents. While children’s age was controlled in the analyses, this only alleviated some of the confounding problems, and perhaps did not resolve them. At the very least, studies examining influences on parent style of interaction need to investigate research samples that are stratified according to children’s age, age of adoption, and amount of time living with parents so that there are sufficient numbers of children for each strata that would allow meaningful analyses of the influence these factors have on parents’ style of interacting with their children.

Third, descriptive studies such as the one conducted in this dissertation are useful for identifying factors that are likely influences on parent style of interaction. However, a more appropriate research design for identifying causal influences would be a longitudinal study. With longitudinal data, future studies could identify how the patterns of changes in the pathways between children, parents and social contexts influence parental responsiveness as children grow and develop. In other words, longitudinal studies could be used to determine whether the effects of children's placement in orphanages on parents’ style of interaction are enduring or whether they might change

138 and perhaps even decrease over time.

Conclusion

This study attempted to identify characteristics of children, parents and social contexts that might influence parents’ level of responsiveness with their children. Results indicated that although adoptive parents engaged in relatively low levels of responsiveness with their children, none of the variables investigated in this study, with the exception of children’s experience of living in an institution prior to adoption, was significantly associated with parents’ levels of responsiveness with their children. For the most part, these findings were inconsistent with research investigating the determinants of responsiveness of birth parents. While it is possible that findings reported in this study are reliable indicators of the influence of the constructs investigated in this study on the responsiveness of adoptive parents, several of the unique characteristics of this study may have interfered with its capacity to identify child, parent and social-contextual influences on parental responsiveness. Future research is needed to continue to identify factors that may be influencing parental responsiveness with adopted children, given the importance of this parenting characteristic is likely to have on children’s developmental and social emotional functioning. Several factors were described that need to be considered in future research including conceptual frameworks, sample size and composition, as well as child assessment procedures and instruments.

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Appendix A

Maternal Behavior Rating Scale (Revised - 2008)

Note: The 12 Maternal Behavioral Scale Items assess four Interactive Style Factors (Boyce, Marfo, Mahoney, Spiker, Price & Taylor, 1996). The following organizes this scale according to the interactive factors they contribute to. Factor scores are computed by calculating the average (Mean) Likert ratings of all items on each factor. We recommend that this scale be used to assess the impact of intervention procedures on parent-child interaction (i.e., program evaluation). This scale should not be used in its current form for Evaluation or Family Assessment purposes (Mahoney, Boyce & Spiker, 1996).

RESPONSIVE/CHILD ORIENTED

1. SENSITIVITY TO CHILD'S INTEREST. This item examines the extent to which the parent seems aware of and understands the child's activity or play interests. This item is assessed by the parent's engaging in the child's choice of activity, parent's verbal comments in reference to child's interest and parent's visual monitoring of child's behavior or activity. Parents may be sensitive but not responsive - such as in situations where they describe the child's interests but do not follow or support them.

Rating of [1]: Highly insensitive. Parent appears to ignore child's show of interest. Parent rarely watches or comments on child's behavior and does not engage in child's choice of activity.

Rating of [2]: Low sensitivity. Parent occasionally shows interest in the child's behavior or activity. Parent may suddenly notice where child is looking or what child is touching but does not continue to monitor child's behavior or engage in activity.

Rating of [3]: Moderate sensitivity. Parent seems to be aware of the child's interests; consistently monitors child's behavior but ignores more subtle and hard-to-detect communications from the child.

Rating of [4]: High sensitivity. Parent seems to be aware of the child's interests; consistently monitors the child's behavior but is inconsistent in detecting more subtle and hard-to-detect communications from the child.

Rating of [5]: Very high sensitivity. Parent seems to be aware of the child's interests; The parent positions herself so that she can make face to face contact with the child. The parent consistently monitors the child's behavior and follows interest indicated by subtle and hard-to-detect communications from the child.

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2. RESPONSIVITY. This item rates the frequency, consistency and supportiveness of the parent's responses to the child's behaviors. Responses are supportive when they match the child’s actions, requests and intentions. Responsivity is assessed in relation to child behaviors that both demand a response from adults as well as non-demand behaviors that may not be directed toward the adult. Child behaviors include play and social activity as well as facial expressions, vocalizations, gestures, signs of discomfort, body language, requests and intentions.

Rating of [1]: Highly unresponsive. Parent responds infrequently to the child and usually only to behaviors that demand a response. Less than 10% of the time the parent reacts to the child's play and social activities, facial expressions, vocalizations, gestures, body language, and intentions that do not demand a response.

Rating of [2]: Unresponsive. Parents respond to most of the child’s demand behaviors but to less than one fourth of the child’s non-demand behaviors and intentions. The parents’ responses may be non-supportive in insofar as they stop the child’s activity or redirect the child to do something different than what they were intending to do. They may also be mismatched to the child’s behavior such as when parents label or comment on the child’s activity but do physically react to the what the child is doing

Rating of [3]: Consistently responsive. Parents respond to almost all of the child’s demand behaviors and to at least one fourth of the child’s non-demand behaviors and intentions. Most of the parent’s responses are supportive in insofar as they encourage the child’s activity. At least one half of the parent’s responses match the child’s behavior such that the parent’s responses are directly related to what the child is doing. For example, if the child is playing the parent responds with actions to the child’s activity; if the child is vocalizing or communicating the parent responds by vocalizing or communicating. .

Rating of [4]: Responsive. Parents respond to almost all of the child’s demand behaviors and to about one half of the child’s non-demand behaviors and intentions. Most of the parent’s responses are supportive in insofar as they encourage the child’s activity. Most of the parent’s responses match the child’s behavior such that the parent’s responses are directly related to what the child is doing. For example, if the child is playing the parent responds with actions to the child’s activity; if the child is vocalizing or communicating the parent responds by vocalizing or communicating. .

Rating of [5]: Highly responsive. Parents respond to almost all of the child’s demand behaviors and to most of the child’s non-demand behaviors and intentions including subtle and hard to detect gestures, vocalizations and other behaviors. The parent’s responses are almost always supportive in insofar as they encourage the child’s activity. The majority of the parent’s responses match the child’s behavior such that the parent’s responses are directly related to what the child is doing. For example, if the child is playing the parent responds with actions to the child’s activity; if the child is vocalizing or communicating the parent responds by vocalizing or communicating. .

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3. EFFECTIVENESS (RECIPROCITY). This item refers to the parent's ability to engage the child in the play interaction. It determines the extent to which the parent is able to gain the child's attention, cooperation and participation in a reciprocal exchange characterized by balanced turntaking in play or conversation.

Rating of [1]: Very ineffective. Parent is seldom engaged in any kind of joint or cooperative activity or communication with the child. The child may be actively engaged and may even be in close proximity to the parent, but the parent is usually not joining in what the child is doing. The parent my attempt to elicit the child's cooperation, but the child either does not respond, or responds briefly and quickly disengages. Parent may give the appearance of helplessness where the child is concerned.

Rating of [2]: Ineffective. Parent is mostly ineffective in keeping the child engaged in joint or cooperative activity or communication. The child may be actively engaged and may even be in close proximity to the parent, but the parent is only occasionally successful at cooperating or participating with what the child is doing. In the few instances when the parent gains the child’s cooperation, the interaction tends to last little more than two or three turns before the child disengages. In such instances, the child may continue the activity without noticing or responding to the parent

Rating of [3]: Moderately effective. At least one third of the time parent is successful in engaging the child in a joint activity or communication. Interactive sequences seldom last more than 3 to 5 turns before the child disengages, but such interactive sequences occur frequently during the observation. Interactive sequences may be dominated by either the parent or the child and are generally not characterized by a balanced reciprocal exchange of turns.

Rating of [4]: Highly effective. More than one half of the time parent is successful in engaging the child in a joint activity or communication. Interactive sequences generally last ten or more turns at a time. With little prompting the parent is successful at encouraging the child to transition into this pattern of interaction. The majority of interactive sequences are characterized by a balanced, reciprocal exchange of interactive turns.

Rating of [5]: Extremely effective. Parent is able to keep the child willingly engaged in joint activity or communication throughout the majority of the interaction. Interactive sequences generally last a few minutes at a time before the parent or child disengages. Interactive sequences are almost always characterized by a balanced, reciprocal exchange of turns.

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AFFECT/ANIMATION

1. ACCEPTANCE This item assesses the extent to which the parent’s behaviors and communications accept or affirm the child and what the child is doing. Acceptance can range from rejection, to no or few signs of approval, to a more active affirmation as reflected in interactions that indicate that the child’s behaviors and communications are legitimate, good or worthy. Acceptance is measured primarily in terms of how parent’s nonverbal and verbal behavior accept and affirm the child for who he or she is or what he or she is currently doing rather than for meeting the parent’s requests or expectations.

Rating of [1]: Rejecting. Parent primarily interacts with the child by trying to get the child say or do things that the child does not appear capable of doing at the moment. Parent may express dissatisfaction with what the child is doing, and almost never takes delight in or encourages the child to communicate or play the way the child is able to do.

Rating of [2]: Low acceptance. Parent puts little pressure on the child to say or do things he is not yet able to do. However, parent shows little positive affect toward the child. Parent mostly remains neutral and almost never takes delight in or encourages the child to communicate or play the way the child is able to do.

Rating of [3]: Accepting. Parent expresses a general positive affect toward the child and occasionally expresses delight in child’s actions or communications. While the parent affirms the child by frequently responding in a way that supports the child’s actions or intentions, the parent also requests or prompts the child to do or say things that the child is unable to do.

Rating of [4]: Very accepting. Parent expresses enthusiasm and delight for the child’s actions and communications. More than one half of the time, the parent’s interacts in a way that affirms the child’s actions and communications as legitimate and worthwhile. The parent may make a few suggestions or requests, but these are generally made to help the child communicate or do what they want more effectively.

Rating of [5]: High acceptance. Parent is effusive with delight and admiration of the child. Parent expresses intense positive affect in response to the child’s actions and communications in a way that continually affirms the child as legitimate and worthwhile. The parent’s suggestions or requests almost always support the child’s actions and communications.

2. ENJOYMENT. This item assesses the parent's enjoyment of interacting with the child. Enjoyment is experienced and expressed in response to the child himself -- his spontaneous expressions or reactions, or his behavior when interacting with his parent. There is enjoyment in child's being himself rather than the activity the child is pursuing.

Rating of [1]: Enjoyment is absent. Parent may appear rejecting of the child as a person.

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Rating of [2]: Enjoyment is seldom manifested. Parent may be characterized by a certain woodenness. Parent does not seem to enjoy the child per se.

Rating of [3]: Pervasive enjoyment but low-intensity. Occasionally manifests delight in child being himself.

Rating of [4]: Enjoyment is the highlight of the interaction. Enjoyment occurs in the context of a warm relaxed atmosphere. Parent manifests delight fairly frequently.

Rating of [5]: High enjoyment. Parent is noted for the buoyancy and display of joy, pleasure, delighted surprise at the child's unexpected mastery.

3. EXPRESSIVENESS. This item measures the tendency of the caregiver to communicate and react emotionally toward the child. It assesses both the frequency of the parent’s verbal and nonverbal communications as well as well as the intensity and animation of these communications.

Rating of [1]: Highly inexpressive. Parent may be characterized as quiet and uncommunicative during the interaction. When the parent speaks, affect is flat; voice quality is dull and facial expressions vary little.

Rating of [2]: Low overt expressiveness. Parent communicates occasionally during the interaction. Parent’s body language, affect, voice quality and facial expression may be characterized as dull to neutral

Rating of [3]: Moderate overt expressiveness. Parent communicates consistently during the interaction. Parent’s body language, affect, voice quality and facial expression may be characterized as ranging from neutral to mildly positive.

Rating of [4]: Overtly expressive. Parent communicates consistently during the interaction. Parent uses body language, voice quality and facial expression in an animated manner to express emotion toward the child. Parent is generally enthusiastic but not extreme in expressiveness.

Rating of [5]: Highly expressive. Parent communicates consistently during the interaction. Parent is extreme in expression of all emotions using body language, facial expression and voice quality. Appears very animated, these parents are "gushers."

4. INVENTIVENESS. This item assesses the range of stimulation parents provide their child; the number of different approaches and types of interactions and the ability to find different things to interest the child, different ways of using toys, combining the toys and inventing games with or without toys. Inventiveness is both directed toward and effective in maintaining the child's involvement in the situation. Inventiveness does not refer merely to a number of different, random behaviors, but rather to a variety of behaviors which are

144 grouped together and directed towards the child.

Rating of [1]: Very small repertoire. Parent is unable to do almost anything with the child, parent seems at a loss for ideas, stumbles around, is unsure of what to do. Parent's actions are simple, stereotyped and repetitive.

Rating of [2]: Small repertoire. Parent does find a few ways to engage the child in the course of the situation, but these are of limited number and tend to be repeated frequently, possibly with long periods of inactivity. Parent uses the toys in some of the standard ways, but does not seem to use other possibilities with toys or free play.

Rating of [3]: Medium repertoire. Parent performs the normal playing behaviors of parenthood, shows ability to use the standard means of playing with toys, and the usual means of free play. Parent shows some innovativeness in play and use of toys.

Rating of [4]: Large repertoire. Parent shows ability to use all the usual playing behaviors of parenthood, but in addition is able to find uses which are especially appropriate to the situation and the child's momentary needs.

Rating of [5]: Very large repertoire. Parent consistently finds new ways to use toys and/or actions to play with the child. Parent shows both standard uses of toys as well as many unusual but appropriate uses, and is continually able to change his/her behavior in response to the child's needs and state.

5. WARMTH. This item rates the demonstration of warmth to a child which is positive attitude revealed to the child through pats, lap-holding, caresses, kisses, hugs, tone of voice, and verbal endearments. Both the overt behavior of the parent and the quality of fondness conveyed are included in this rating. It examines positive affective expression; the frequency and quality of expression of positive feelings by the parent and the parent's show of affection.

Rating of [1]: Very low. Positive affect is lacking. Parent appears cold and reserved, rarely expresses affection through touch, voice.

Rating of [2]: Low. Parent occasionally expresses warmth through brief touches and vocal tone suggests low intensity of positive affect.

Rating of [3]: Moderate. Pervasive low-intensity positive affect is demonstrated throughout the interaction. Fondness is conveyed through touch and vocal tones.

Rating of [4]: High. Affection is expressed frequently through touch and vocal tone. Parent may verbalize terms of endearment.

Rating of [5]: Very high. Parent openly expresses love for the child continually and effusively through touch, vocal tone and verbal endearments.

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ACHIEVEMENT ORIENTATION

1. ACHIEVEMENT. This item is concerned with the parent's encouragement of sensorimotor and cognitive achievement. This item assesses the amount of stimulation by the parent, which is overtly oriented toward promoting the child's developmental progress. This item assesses the extent to which the parent fosters sensorimotor and cognitive development whether through play, instruction, training, or sensory stimulation and includes the energy which the parent exerts in striving to encourage the child's development.

Rating of [1]: Very little encouragement. Parent makes no attempt or effort to get child to learn.

Rating of [2]: Little encouragement. Parent makes a few mild attempts at fostering sensorimotor development in the child but the interaction is more oriented to play for the sake of playing rather than teaching.

Rating of [3]: Moderate encouragement. Parent continually encourages sensorimotor development of the child either through play or training but does not pressure the child to achieve.

Rating of [4]: Considerable encouragement. Parent exerts some pressure on the child toward sensorimotor achievement, whether as unilateral pressure or in a pleasurable interactional way and whether wittingly or unwittingly.

Rating of [5]: Very high encouragement. Parent exerts much pressure on the child to achieve. Parent constantly stimulates him toward sensorimotor development, whether through play or obvious training. It is obvious to the observer that it is very important to the parent that the child achieve certain skills.

2. PRAISE (VERBAL) This scale assesses how much verbal praise is given to the child. Examples of verbal praise are "good boy," "that’s a girl," "good job." Praise in the form of smiles, claps or other expressions of approval are not included unless accompanied by a verbal praise. Praise may be given for compliance, achievement or for the child being himself.

Rating of [1]: Very low praise. Verbal praise is not used by the parents in the interaction even in situations which would normally elicit praise from the parent.

Rating of [2]: Low praise. Parent uses verbal praise infrequently throughout the interaction.

Rating of [3]: Moderate praise. Parent uses an average amount of verbal praise during the interaction. Parent praises in most situations which would normally elicit praise.

Rating of [4]: Praises frequently. Parent verbally praises the child frequently for behavior which would not normally elicit praise.

Rating of [5]: Very high praise. Very high frequency of verbal praise from the

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parent even for behavior which would not normally elicit praise.

DIRECTIVE

1. DIRECTIVENESS This item measures the frequency and intensity in which the parent requests, commands, hints or attempts in other manners to direct the child's immediate behavior.

Rating of [1]: Very low directive. Parent allows child to initiate or continue activities of his own choosing without interfering. Parent consistently avoids volunteering suggestions and tends to withhold them when they are requested or when they are the obvious reaction to the immediate situation. Parent's attitude may be "do it your own way."

Rating of 2: Low directive. Parent occasionally makes suggestions. This parent rarely tells the child what to do. He/she may respond with advice and criticism when help is requested but in general refrains from initiating such interaction. On the whole, this parent is cooperative and non-interfering.

Rating of [3]: Moderately directive. The parent's tendency to make suggestions and direct the child is about equal to the tendency to allow the child self-direction. The parent may try to influence the child's choice of activity but allow him independence in the execution of his play, or he may let the child make his own choice but be ready with suggestions for effective implementation.

Rating of [4]: Very directive. Parent occasionally withholds suggestions nut more often indicates what to do next or how to do it. Parent produces a steady stream of suggestive remarks and may initiate a new activity when there has been no previous sign of inertia and/or resistance shown by the child.

Rating of [5]: Extremely directive. Parent continually attempts to direct the minute details of the child's "free" play. This parent is conspicuous for the extreme frequency of interruption of the child's activity-in-progress, so that the parent seems "at" the child most of the time -- instructing, training, eliciting, directing, controlling.

2. PACE. This item examines the parent's rate of behavior. The parent's pace is assessed apart from the child's; it is not rated by assessing the extent to which it matches the child's pace but as it appears separately from the child.

Rating of [1]: Very slow. Parent is almost inactive. Pace is very slow with long periods of inactivity.

Rating of [2]: Slow. Parent's overall tempo is slower than average. There may be inconsistency in the parents’ tempo in which periods of inactivity are followed by occasions of active participation.

Rating of [3]: Average pace. This parent is neither strikingly slow nor fast. Tempo appears average compared to other parents.

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Rating of [4]: Fast. Parent's overall tempo is faster than average. There may be few brief periods of inactivity, that re followed by quick paced activity.

Rating of [5]: Very fast. Parent’s interactive tempo could be characterized as rapid fire behavior. The pace of the parent’s interactive tempo may not allow the child time to react.

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MATERNAL BEHAVIOR RATING SCALE (MBRS)

SCORING SHEET Observation 1 Observation 2 Observation 3 Observation 4 MBRS ITEM Date ______Date ______Date ______Date ______

RESPONSIVE/CHILD ORIENTED

1. Sensitivity

2. Responsivity

3. Effectiveness

Scale Score (Sen + Res + Eff)/3

AFFECT/ANIMATION

1. Acceptance

2. Enjoyment

3. Expressiveness

4. Inventiveness

5. Warmth

Scale Score (Acc + Enj + Exp + Inv + War)5 ACHIEVEMENT ORIENTATION

1. Achievement

2. Praise

Scale Score (Ach + Pra)/2 DIRECTIVE

1. Directiveness

2. Pace

Scale Score (Dir + Pac)/2 COMMENTS

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Appendix B

Adoption Placement Questionnaire

Please answer the following questions to the best of your knowledge. For questions 5-11, follow the Instructions in order to determine which questions apply to your child.

1. Today's Date:

2. Your relationship to the child: (check one) (Adoptive) Mother .. 0 (Adoptive) Father ... 0 (Adoptive) 0 (Adoptive) 0 Step-Mother ...... Step-Father ......

3. Date child first came to LIVE with your family:

I I

4. Date child was LEGALLY ADOPTED:

5. Number of OTHER children (I.e., adopted, foster, biological, step) who CURRENTLY live in your home: "0 go to #6; if 1 or 0 more, go to #58

Sa. !E other children are in your family NOW, how many are: Adopted...... 0 Foster ...... 0 Biological...... 0 Step ...... 0

6. Number of children in your family BEFORE adoption of this child: "090 to #7; If1 or 0 more, go to #68

6a. !E there were children in your family BEFORE adoption, how many were: Adopted ...... D Foster ...... D Biological ...... D Step ...... D

7. How many children joined your family AFTER adoption of this child: "090 to #8; if 1 or 0 more. go to #78

7a. IF children joined family AFTER adoption of this child, how many were: Adopted...... 0 Foster ...... 0 Biological ...... D Step ...... 0 150

S. Was this child BORN outside of the United States? No . Yes .. · OGoto ···· o;;to #8a

Sa.!E child was BORN outside of the United States, where was child born?

I

9. Was child in an institution or orphanage before adoptive placement? No ...... 0 ;;oto Yes ...... 0 ;;ato Don't Know ... 0 ;~oto

IF chifd was in an institution or orphanage before adoptive placement:

9a. How many months was child in this placement?

9b. To the best of your knowledge or observation, how would you evaluate the overall quality of this placement? Excel/ent .. Fair ·· 0 Don't Know ...... 0 Good... Poor .. .. ·· ..·....·0

9c. What was the staff-to-child ratio at this facility?

Number of staff...... 0 To: Number of children. .. 0

Don't Know ...... 0

10. Was child with his or her birth family (I.e., parent or grandparent) before adoptive placement? No ...... D#G0 to Yes .... ·...... ·0 Go to Don't Know .. 0 Go to 11 #10a #11

IF chifd was with his or her birth famify before adoptive placement:

10a. How many months was child in this placement?

I I

1Db. To the best of your knowledge or observation, how would you rate the overall quality of this placement? Excel/ent ...... 0 Fair ...... 0 Don't Know ...... 0 Good ...... 0 Poor ··· .. ··· 0 151

11. Was child with a foster family before adoptive placement? No ...... 0 ~f2to Yes ...... 0 ~fl~ Don't Know .. 0 ~f2to

IF child was with a foster family before adoptive placement:

11 a. How many months was child in this placement?

I I

11 b. To the best of your knowledge or observation, how would you evaluate the overall quality of this placement?

Excellent ...... 0 Fair ...... 0 Don't Know .0 Good. ... 0 Poor ...... 0

12. To the best of your knowledge or observation, before adoption: Sometimes Very Often Never True Rarely True True Often True True Don't Know My child did not have enough to eat. 0 0 0 0 0 0 My child had to wear dirty clothes. 0 0 0 0 0 0 My child felt loved. 0 0 0 0 0 0 Someone took my child to the doctor if slhe needed it. 0 0 0 0 0 0 I believe my child was sexually abused. 0 0 0 0 0 0 I believe my child was physically abused. 0 0 0 0 0 0 I believe my child was neglected. 0 0 0 0 0 0

13. Where was child living during the following time periods: (check l!.!! boxes that apply for each time period) Birth Family (parent or Maternity Foster grandparant) Hospital Orphanage Hospital Institution Family Adopted Don't Know 0-1 Month 0 0 0 0 0 0 0 0 1-6 Months 0 0 0 0 0 0 0 0 6-12 Months 0 0 0 0 0 0 0 0 12-24 Months 0 0 0 0 0 0 0 0 24-36 Months 0 0 0 0 0 0 0 0 36+ Months 0 0 0 0 0 0 0 0

14. Overall, the impact of this child's placement on your family has been: Very Positive ...... 0 ~~~tde~~~~iti~e~a.n~.~e.g~tiv~S .... 0 Mostly Negative ...... 0 Mostly Positive ...... 0 Very Negative...... 0

THANK YOU! 152

Appendix C

Arizona social support Adequacy of support Items # 1,3,5,7,9,11 ( higher scores = adequate) Need for support Items # 2,4,6,8,10,12 reverse code ( higher scores=greater need)

1. During the past month, would you have liked: 1 = a lot more opportunities to talk to people about your personal and private feelings? 2 = a few more opportunities to talk to people about your personal and private feelings? 3 = or was this about right?

2. During the past month, how much so you think you needed to talk to people about things that were very personal and private? 1 = quite a bit 2 = a little bit 3 = not at all

3. During the past month, would you have liked people to have loaned you or have given you: 1 = a lot more? 2 = a little bit? 3 = or was it about right?

4. During the past month, how much do you think you needed people who would give or lend you things that you needed? 1 = quite a bit 2 = a little bit 3 = not at all

5. During the past month, would you have liked 1 = a lot more advice? 2 = a little more advice? 3 = or was it about right?

6. During the past month, how much do you think you needed to get advice? 1 = quite a bit 2 = a little bit 3 = not at all

7. During the past month, would you have liked people to tell you that they liked your ideas or things that you did? 1 = a lot more often 2 = a little more 3 = it was about right

153

8. During the past month, how much do you think you needed to have people let you know when they liked your ideas or things that you did? 1 = quite a bit 2 = a little bit 3 = not at all

9. During the past month, would you have liked: 1 = a lot more help with things that you needed to do? 2 = a little more help with things that you needed to do? 3 = or was it about right?

10. During the past month, how much do you feel you needed people who would pitch in to help you do things? 1 = quite a bit 2 = a little bit 3 = not at all

11. During the past month, would you have liked: 1 = a lot more opportunities to get together with people for fun and relaxation? 2 = a few more opportunities to get together with people for fun and relaxation? 3 = or was it about right?

12. During the past month, how much do you think you needed to get together with other people for fun and relaxation? 1 = quite a bit 2 = a little bit 3 = not at all

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Appendix D

Family Information

Please answer the following questions to the best of your knowledge.

Today's date:

Child's name:

Your relationship to this child: (check one) Biological Mother..... 0 Adoptive Stepmother 0 Biological Father ...... 0 Adoptive Stepfather .. 0 Adoptive Mother ...... 0 Foster Mother...... 0 Adoptive Father.. .. 0 Foster Father ...... 0 Stepmother ...... 0 Grandmother ...... 0 Stepfather ...... 0 Other...... 0 Specify Below

Child's date of birth:

Was child born premature? No ...... 0 yes...... ·· .. ..· ...... ·O Not certain ...... 0

Child's sex: Male ...... ··· .. 0 Female ...... 0

Child's race: (check one) African American/Black ..... 0 Hispanic.. .. ····0 Other .. White, Non-Hispanic ...... 0 Asian ... . ·········0

Area child lives Is: Urban ...... 0 Suburban. ·····0 Rural ...... ·······0

Has child received a medical diagnosis? NO· .. ·· .. ·· ...... ··· .. ·· .. ·.. O yes.. ·· .. ·...... ···· .. ····O Specify ,------, diagnosis, date of diagnosis, and type of professional who made diagnosis 155

Has the child EVER received any early intervention services (e.g., physical therapy, speech therapy)? No .... ········0 yes··· ·· .. ········· .. ··O

andSpecify dates type of services '1------"1

Is child CURRENTLY on medication? No··························· D yes...... 0 Specify type Ir------­ and date of medication

Your marital status: (check one) Married, first marriage...... 0 Separated/Divorced ...... 0 Single, never married ...... 0 INidowed ...... 0 ~:~~:~~~~~o.n~ .o rlast...... 0 ~~;!~ithPa.~~~r.. ~~tle.~all~.. 0

Parents' race: (I.e., the parents child lives with) Mother Father African American/Black o o White, Non-Hispanic o o Hispanic o o Asian o o Other o o N/A o o

Parents' highest level of education: (I.e., the parents child lives with) Mother Father Less than High School o o High School/GED o o Associate Degree/some college/post­ secondary training o o Bachelor's Degree o o Master's Degree or higher o o N/A o o

Mother's birth date:

Father'S birthdate: 156

Total household income: Under $20,000 ...... 0 $20,000-$39,999 ..... 0 $40,000-$59,999 ...... 0 $60,000 or over.. . 0

Does mother work outside the home? Yes, full-time ...... 0 Yes, part-time ...... 0 No .. ·· .. .. ·.. ·· .. ·· .. ········ D Retired

Describe mother's occupation (If any):

Does father work outside the home? Yes, full-time ...... 0 Yes, part-time ...... 0 No ·· .. ..· · ...... ·.. D Retired ········..·0

Describe father's occupation (if any):

Does either PARENT take medication? Mother Father No o o YeS o o

Describe I

Number of OTHER children CURRENTLY living In the same home: D

Is there anything else we should know about your family?

THANK YOU! 157

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