Observing sensitivity in slums in Yemen: the veiled challenge

Evaluating caregiver-child interactions in low- and middle-income countries: a systematic review of tools and methods

AIMS/BACKGROUND

The United Nations Sustainable Development Goals (SDGs) has placed emphasis on improving early child development globally. This is supported through the Nurturing Care Framework which includes responsive caregiving. To evaluate responsive caregiving, tools to assess quality of caregiver-child interactions are used, however there is little information on how they are currently employed and/or adapted particularly in low- and middle-income countries (LMICs) where children have a greater risk of adverse outcomes. The aim of this review is to provide a comprehensive guide on methodologies used to evaluate caregiver-child interaction - including their feasibility and cultural adaptation.

DESIGN/METHODS

We conducted a systematic review of studies over 20years in LMICs which assessed caregiver-child interactions. Characteristics of each tool, their validity (assessed with COSMIN Risk of Bias checklist), and the quality of the study (Mixed Methods Appraisal Tool) are reported.

RESULTS

We identified 59 studies using 34 tools across 20 different LMICs. Most tools (86.5%) employed video-recorded observations of caregiver-child interactions at home (e.g. Ainsworth's Sensitivity Scale, OMI) or in the laboratory (e.g. PICCOLO) with a few conducting direct observations in the field (e.g. OMCI, HOME); 13.5% were self-reported. Tools varied in methodology with limited or no mention of validity and reliability. Most tools are developed in Western countries and have not been culturally validated for use in LMIC settings.

CONCLUSION

There are limited caregiver-child interaction measures used in LMIC settings, with only some locally validated locally. Future studies should aim to ensure better validity, applicability and feasibility of caregiver-child interaction tools for global settings.

Attachment, Mentalizing and Trauma: Then (1992) and Now (2022)

This article reviews the current status of research on the relationship between attachment and trauma in developmental psychopathology. Beginning with a review of the major issues and the state-of-the-art in relation to current thinking in the field of attachment about the impact of trauma and the inter-generational transmission of trauma, the review then considers recent neurobiological work on mentalizing and trauma and suggests areas of new development and implications for clinical practice.

Maternal Harsh Physical Parenting and Behavioral Problems in Children in Religious Families in Yemen

The present study examined maternal religiosity as an underlying cultural factor in the effect of harsh physical parenting on child behavioral problems. Data was collected via a discipline observational task, religiosity-based vignettes, and a questionnaire in a group of 62 mothers and their children in slum areas in Yemen. Moderation and mediation models were tested, where the role of maternal religiosity as a predictor and a moderator in the association between harsh physical parenting and child behavioral problems was explored. Findings showed no direct association between harsh physical parenting, maternal religiosity, and child behavioral problems. However, maternal religiosity was found to significantly moderate the relationship between harsh physical parenting and child behavioral problems such that the positive association between harsh physical parenting and child behavior problems was stronger when parents were more religious. Implications of the moderating role of maternal religiosity on the association between harsh physical parenting and child behavioral problems are discussed.