Department of Psychology of Human Development, Vanderbilt University.
Department of Pediatrics, Washington University School of Medicine.
J Pediatr Psychol. 2019 Nov 1;44(10):1234-1243. doi: 10.1093/jpepsy/jsz065.
Children with sickle cell disease (SCD) are at increased risk for cognitive impairment as a result in part from biological characteristics of the disease; however, limited research has explored possible social and contextual factors associated with risk for cognitive problems. The primary aim of the present study was to examine the relation between children's cognitive functioning and responsive parenting, a potentially important contextual factor in children with SCD, accounting for family socioeconomic disadvantage, child disease severity, and caregivers' perceived stress.
Forty-eight children completed standardized cognitive assessments and caregivers provided self-reports of general and disease-related stress. Parent-child dyads completed a video recorded puzzle-solving task and observed parenting was quantified using two coding systems. Bivariate Pearson correlations were used to assess preliminary hypotheses, and linear multiple regression analyses were used to assess the primary hypothesis.
Results suggested that increased levels of parental stress were related to fewer observations of responsive parenting and provided evidence of an association between children's cognitive function and responsive parenting. Specifically, increased disease-related parent stress and reduced parental use of expansive language were associated with significantly lower cognitive functioning in children with SCD.
Findings suggest that social environmental factors along with disease characteristics are sources of risk for cognitive problems with children with SCD. Further, these findings highlight the need to develop targeted interventions for parents of children with SCD to decrease levels of stress and enhance parenting skills, with the aim improving cognitive functioning in youth.
镰状细胞病 (SCD) 患儿认知障碍的风险增加，部分原因是疾病的生物学特征；然而，有限的研究探索了与认知问题风险相关的可能的社会和环境因素。本研究的主要目的是检验儿童认知功能与反应性养育之间的关系，这是 SCD 患儿一个潜在的重要环境因素，同时考虑了家庭社会经济劣势、儿童疾病严重程度和照顾者感知到的压力。
48 名儿童完成了标准化认知评估，照顾者报告了一般和与疾病相关的压力。亲子二人组完成了一个录像拼图任务，观察到的养育行为使用两种编码系统进行量化。使用双变量 Pearson 相关来评估初步假设，使用线性多元回归分析来评估主要假设。
结果表明，父母压力水平的增加与反应性养育行为的观察次数减少有关，这为儿童认知功能与反应性养育之间的关联提供了证据。具体来说，与疾病相关的父母压力增加和父母使用扩展性语言减少与 SCD 儿童的认知功能显著降低有关。
研究结果表明，社会环境因素与疾病特征是 SCD 儿童认知问题风险的来源。此外，这些发现强调了需要为 SCD 儿童的父母制定有针对性的干预措施，以降低压力水平并增强养育技能，旨在提高青少年的认知功能。
