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226 FROM NEURONS TO NEIGHBORHOODS INTRODUCTION Starting with the motherâs reproductive health and behavior, the childâs primary caregiversâbe they parents or grandparents or foster parentsâ structure the experiences and shape the environments within which early development unfolds. A vast store of research, summarized in this chapter, has confirmed that what young children learn, how they react to the events and people around them, and what they expect from themselves and others are deeply affected by their relationships with parents, the behavior of parents, and the environment of the homes in which they live (Bradley et al., 1988; Collins and Laursen, 1999; Dunn, J., 1993; Hartup and Rubin, 1986; Maccoby and Martin, 1983). Even when young children spend most of their waking hours in child care, parents remain the most influential adults in their lives. We shall also see, however, that efforts to change the course of development by strengthening parenting have met with mixed success. Shifting parental behavior in ways that shift the odds of favorable outcomes for children is often remarkably difficult. This perplexing mis- match between the power of parenting and the difficulty of altering it in ways that are sufficient to affect development is one of the major dilemmas confronting developmental scientists and interventionists alike. It is important to clarify that we use the term âparentingâ to capture the focused and differentiated relationship that the young child has with the adult (or adults) who is (are) most emotionally invested in and consistently available to him or her. Usually this is a birth or adoptive parent (thus the use of the term âparentingâ), but sometimes it is a grandparent, a foster parent, or another primary caregiver. Who fills this role is far less impor- tant than the quality of the relationship she or he establishes with the child. The hallmark of this important relationship is the readily observable fact that this special adult is not interchangeable with others. A child may not care who cuts his hair or takes his money at the toy store, but he cares a great deal about who is holding her when she is unsure, comforts her when she is hurt, and shares special moments in her life. Understanding Parenting Parenting has been a centerpiece of developmental inquiry from the beginning of the field, reflecting the firm belief that childrearing makes the child. Only in the 1990s has this belief come under intense scrutiny, in debates over the influence of parenting relative to that of genetics and peers (Borkowski et al., in press; Harris, 1995, 1998; Rowe, 1994). While these debates have focused on children of school age and older (few dispute the significant role of parents during the earliest years of life), they have impli- cations for the understanding of the more enduring influences of parenting
NURTURING RELATIONSHIPS 227 in adolescence and adulthood. The controversy, moreover, highlights im- portant shifts in studying and understanding the role of parents in early development. The classic, early studies of childrearing sought to identify styles of parenting that promoted competent behavior in preschoolers (i.e., a child who is happy, self-reliant, self-controlled, friendly, and cooperative as dis- tinct from withdrawn or immature) (see Baldwin et al., 1945; Baumrind, 1967, 1971, 1973; Emmerich, 1977). The answers yielded by this research highlighted the combined influence of clear standards of conduct, firm control, and ample warmth. The heritage of this research is an abiding interest in both the management or control function and the emotional quality of parent-child relationships. In the ensuing 25 years, however, static characteristics of parents as restrictive or warm have been challenged by substantial evidence that parenting changes over time, varies from one child to another, and is not just received, but is also shaped, by the childâs own behavior (Grusec and Goodnow, 1994; Holden and Miller, 1999). The result is a concept of parenting and parental influence that is more complex and conditional than that which emerged from prior eras of re- search (Collins et al., 2000; Maccoby, 2000). Succinct formulas for good parenting have been replaced by an appreciation for the many ways in which parents adjust what they do in response to the needs and character- istics of their children, the conditions in which they live, and the circum- stances of their own lives (Cowan and Cowan, 1992; Elder, 1991; Holden and OâDell, 1995). Whereas scientists used to study parenting in isolation, contemporary researchers take into account the network of contexts in which parenting is embedded. These contexts include the child care pro- grams that children attend, the peers they associate with, the stability and socioeconomic strata of their families, their parentsâ marital relationship, the neighborhoods they live in, and the times they live in. Challenges to the notion that children are relatively passive players in the socialization process (Bell, 1968; Bell and Chapman, 1986; Engfer et al., 1994) have led to a substantial body of evidence showing the many ways in children contribute to their rearing environments, including influ- ences on the parenting they receive. Researchers now realize that they need to consider the ways in which parents affect children and children affect parents. The growing reliance on research designs that address the inter- play of genetics and socialization has both confirmed the substantial influ- ence of parenting on child development and increased awareness of the complex ways in which parenting intersects with the childâs inherited strengths and vulnerabilities to affect the pathways that are followed en route to adulthood (see Collins et al., 2000; Rutter et al., in press). The methodological challenges involved are considerable, as discussed in more
228 FROM NEURONS TO NEIGHBORHOODS detail in connection with the effects of impaired parenting. Accordingly, research on parenting has become a very complex endeavor. Bringing Fathers into the Picture The research discussed in this chapter on the multifaceted dimensions of parenting is primarily focused on mothering. Fathering, in contrast, has received less attention, and this literature has tended to focus on menâs economic contributions to their families, the developmental consequences of father absence, and distinctions between the roles of fathers and mothers (Lamb, 1999; Parke, 1996; Pleck and Pleck, 1997). This began to change in the 1970s with a growing emphasis on family dynamics, including the marital relationship, as they affect child development (see Belsky, 1984; Cummings and OâReilly, 1997; Dunst, 1985) and is continuing to change as an increasingly interdisciplinary group of scholars is exploring how fa- thers affect developmental trajectories (see Cabrera et al., 2000). Contemporary research on fatherhood has highlighted several themes. First, fathers seem to be both more and less involved in their childrenâs lives today than was true even a decade ago, revealing a growing dichotomy in childrenâs experiences of fathering. On one hand, there is evidence that paternal involvement has increased over the past three decades, as seen in higher rates of single fathers raising children, greater involvement of fathers in child care while their wives are in the labor force, and more self-reported time spent by fathers with their children (Pleck, 1997; Yeung et al., 1998). At the same time, unprecedented numbers of children are now spending part or all of their childhoods in families headed by single mothers (see Chapter 10). While there is a growing appreciation of the extensive father involvement that can characterize children in single-mother families and extensive policy interest in the issues involved, scientists are only beginning to explore the factors that predict this involvement (Coley and Chase- Lansdale, 1999; W. Johnson, 1998) and its effects on children (see Garfinkel et al., 1994). It certainly appears to be the case that fathersâ economic situation is closely involved. The consequences of these markedly different experiences of fathering for childrenâs development, for their conceptions of parenting, and for their assumption of parenting roles remain largely unexamined. Second, fathering is increasingly viewed as involving multiple functions that go well beyond the role of breadwinner (Amato and Rivera, 1999; Lamb et al., 1985a; Parke, 1996; Parke and Buriel, 1998). Indeed, there is growing acceptance that father involvement per se is not necessarily linked to positive outcomes for children (see, for example, Hoffman et al., 1999). Rather, it is the variety of ways in which fathers take responsibility for their children that many now believe to be the most important component of
NURTURING RELATIONSHIPS 229 fathering (Lamb, in press). This entails not only financial responsibility, but also functions that have typically been thought of as the purview of mothersâtasks such as taking children to the doctor or to lessons, arrang- ing for and transporting the child to and from child care, monitoring the childâs safety and whereabouts, and scheduling play dates. As with moth- ers, the emotional quality of the father-child relationship also appears to be extremely important to childrenâs adjustment and well-being and may, in fact, influence the benefits of increased involvement and responsibility. Finally, despite the rapid changes affecting the ethnic and racial com- position of the nationâs families, there is almost no research on how the roles of fathers and other men in young childrenâs lives are evolving in the context of diverse values and family structures (Cabrera et al., 2000). Both theoretical models and empirical work need to incorporate culturally di- verse conceptions of fatherhood related to race and ethnicity, as well as other dimensions of culture such as immigrant status and religion. In the following discussion of parenting, we note the research that specifically addresses fathers. The examples are far from plentiful, but we are hopeful that the renewed attention to fathering that is now characteriz- ing developmental science will foster expanded efforts to study parenting in all of its varieties and certainly as it involves both mothers and fathers. ATTACHMENT RELATIONSHIPS What gives the parent a special place in the young childâs life? What does the close emotional relationship with the parent provide that other adults cannot replicate? To answer such questions, researchers have fo- cused on the development of security, confidence, and trust between infants and toddlers and their parents. This central feature of early relationships is captured by the concept of âattachment security.â In the rare situations in which infants do not have the opportunity to form an attachment with even one trusted adult, their development can deteriorate rapidly and dramati- cally. The remarkable recovery that these infants display once they receive stable care and loving attention further reveals the importance of the childâs earliest intimate relationships. Indeed, long ago the field was riveted by evidence that toddlers who were languishing in institutional settings could be made to thrive cognitively, emotionally, and physically simply by pro- viding them with loving careâeven if this meant that they were moved onto wards for young women with mental retardation who held them, played with them, hugged them, and lavished attention on them. As dramatic, the remarkable recovery observed today in children adopted from orphanages in Romania and other areas of the world speaks to the power of consistent care, attention, and affection in the lives of young children. Virtually all infants develop close emotional bonds, or attachments, to
230 FROM NEURONS TO NEIGHBORHOODS those who regularly care for them in the early years of life. These early attachments constitute a deeply rooted motivational system that ensures close contact between babies and adult caregivers who can protect, nurture, and guide their development. Indeed, the infant appears to be so strongly motivated and prepared to develop attachments to one or more caregivers that, given the opportunity to interact regularly with even a modestly re- sponsive caregiver, he or she will develop an emotional tie to that person. Those who study attachment believe that childrenâs first relationships, especially with their parents or other primary caregivers, address two fun- damental needs (Ainsworth, 1973; Ainsworth et al., 1978; Belsky and Cassidy, 1994; Bowlby, 1969; Cassidy, 1999; Sroufe, 1996). First, the caregiverâs company reduces a young childâs fear in novel or challenging situations and enables the child to explore with confidence (so-called secure base behavior) and to manage stress (Ainsworth, 1967; Emde, 1980; Emde and Easterbrooks, 1985; Gunnar, in press; Gunnar et al., 1996). âStay here so I can do it myself!â captures this emotional regulation function of early attachments in the words of a toddler. Second, attachment relationships strengthen a young childâs sense of competence and efficacy. The adultâs contingent responding strengthens a young childâs awareness of being able to influence others and affect the world (Carson and Parke, 1996; Cassidy et al., 1992; Denham et al., 1997; Hooven et al., 1994). This might be called, therefore, the self-efficacy function of early attachment relation- ships. Well before the first birthday, infants clearly exhibit preferences for and special responsiveness to certain adults. About the time children be- come more mobile (i.e., 6-12 months), they organize their behavior to maintain proximity to one or a few people. They advance into the world to explore, but return periodically to touch base with these people. If fright- ened, they seek proximity and physical contact, and when forced to be separated from them, they often protest, sometimes frantically. In short, they appear to use these people as secure bases. Secure base behavior describes the presence of an attachment bond, and toddlers show in these behaviors that they are gradually acquiring an awareness of the psychologi- cal qualities of other people (Stern, 1985; Tomasello et al., 1993) and constructing expectations for their behavior (Gekoski et al., 1983; Lamb and Malkin, 1986). Security of Attachment Although virtually all infants become attached to their caregivers, at- tachment relationships differ in how much security they provide. Assess- ments of attachment security, whether conducted in a laboratory or at home, focus on the childâs exploratory behavior in the presence of the
NURTURING RELATIONSHIPS 231 caregiver, responses to separation, and reactions upon reunion. A secure attachment is assumed to exist when the infant or toddler explores comfort- ably in the presence of his or her caregiver, keeps track of and seeks prox- imity with the caregiver, happily and eagerly seeks contact after having been separated, and, in general, shows signs of trust and delight in the caregiverâs presence. In contrast, children whose exploratory play is dis- rupted because they are preoccupied with the caregiver, who avoid or resist contact after separation, display distress and anger upon reunion, and are not easily comforted are considered insecurely attached. An insecure at- tachment is not, however, equivalent to no attachment at all. Even a young child who is insecure about the caregiverâs nurturance derives important emotional support from her presence that is not derived from the company of someone to whom the child has no attachment at all. After all, even a resistant infant turns to the caregiver for help. Recent research on children who have experienced highly disruptive, sometimes abusive care has led to important refinements in views of inse- cure attachment. Studies of physically abused infants and toddlers have noted significantly elevated proportions of insecure attachments (Crittenden, 1988; Lyons-Ruth et al., 1987), as have studies of children of clinically depressed mothers (DeMulder and Radke-Yarrow, 1991; Lyons- Ruth et al., 1990, 1991). Studies of neglected children, such as those reared in orphanages or removed from their homes because of severe neglect, have shown that some, but certainly not all, of these children do not seem to organize their behavior in meaningful ways around one or a few adults. They do not fit typical patterns of insecurity, but rather display inconsistent and disorganized responses to their caregivers. The field is just beginning to document these unusual patterns of attachment behavior and to explore their clinical roots and implications for childrenâs development. We are far from being able to say anything definitive about these disordered patterns of attachment behavior, but they form one of the cores of the nascent field of infant mental health (Osofsky and Fitzgerald, 2000; Zeanah, 2000). This field of clinical research, albeit new, highlights what has become in- creasingly evident: infants and young children have rich emotional/psycho- logical lives and can suffer in ways that heretofore had never been realized. The interest in documenting unusual patterns of attachment behavior in search of a better understanding of infant mental health and disorder increases the need to broaden cultural understanding of attachment and the assessment of its security. It is important to realize that the laboratory assessments that have formed the basis for much of the research on attach- ment security have been designed to produce only mild challenges for the infant. The meaning of the laboratory assessment depends on whether the challenges are both mild and meaningful within the childâs culture and life history.
232 FROM NEURONS TO NEIGHBORHOODS For example, the standard laboratory assessment (termed the âstrange situationâ) relies on brief (e.g., 3 minute) separations from the parent. In cultures in which infants are frequently separated from parents for brief periods, the childâs reactions are presumably influenced by expectations, based on previous history, that the parent will return and be helpful. In cultures in which separations rarely occur, it is presumed that these experi- mentally imposed separations may take on a very different meaning for the infant. Indeed, research on Japanese infants who are rarely separated from parents during their first year initially demonstrated high rates of presum- ably insecure attachment (Takahashi, 1986, 1990). Later reinterpretations of the results, however, emphasized the vast difference in the strange situa- tion between the Japanese and European-American cultures (van IJzendoorn and Sagi, 1999). A study of desirable and undesirable attachment behavior among white and Hispanic (Puerto Rican) mothers provides a compelling illustration of these differences (Harwood et al., 1995). The white mothers preferred that toddlers balance autonomy and relatedness (playing at a distance and in- volving the mother prior to separation and greeting the mother happily during the reunion), and they disliked clinginess (clinging to the mother prior to separation, crying continuously during separation, and being un- happy during the reunion). In contrast, Puerto Rican mothers preferred that toddlers display respectfulness (sitting near the mother and waiting for a signal before playing with the toys prior to separation, waiting quietly for the mother to return during separation), and they disliked highly active or avoidant (ignoring the mother before, during, and after separation) behav- ior. This and other cross-cultural evidence on attachment raises significant issues regarding the ways in which parents and young children form expec- tations about each other and, in turn, behave and react in each otherâs presence (and in the strange situation). We strongly suspect that, across all cultures, children form attachments and use parents as sources of security and comfort. Even when the relationship is somewhat insecure, children seek comfort and maintain proximity to parents, deriving important emo- tional support from the caregiverâs presence that other adults cannot pro- vide; however, they do not derive the same developmental benefits that accrue from a secure attachment. Specific attachment patterns result from an intricate interplay among characteristics of the child, the capacities of the parent, and the broader context of their relationship (see Isabella, 1995; Lamb et al., 1985b; Thompson, 1999a, for reviews). Secure attachments are seen more often in the context of parenting that is dependable and sensitive to the childâs intentions and needs, enabling the child to count on the caregiverâs future availability and assistance (Ainsworth et al., 1978; Belsky, 1999; De Wolff
NURTURING RELATIONSHIPS 233 and van IJzendoorn, 1997; Isabella, 1995; Thompson, 1997, 1998a). In- fants and toddlers are less likely to establish secure attachments with caregivers who are generally detached, intrusive, erratic, or rejecting. The important role of sensitive caregiving in the establishment of secure attach- ments is compellingly illustrated by a recent intervention that randomly assigned low-income mothers of infants who were observed in the first two weeks of life to be irritable to a program designed to enhance maternal sensitivity and responsiveness or to a control group. After 9 months, the mothers who had received the programs were significantly more responsive and stimulating than the control group mothers and their infants engaged in more sophisticated exploratory behavior and were significantly more likely to be securely attached (van den Boom, 1994, 1995). A follow-up when the children were 31/2 years old documented sustained effects in maternal sensitivity, attachment security, and the childrenâs observed coop- eration with the mother. Interestingly, the husbands of mothers who par- ticipated in the intervention were also more responsive to their preschoolers. Adoption studies add to the evidence regarding the importance of sensitive, responsive care. Toddlers fostered or adopted from conditions of extreme neglect have been found to reorganize their attachment behavior over time, exhibiting behavior reflective of secure expectations of support and com- fort as they adapt to foster or adoptive parents who provide sensitive, responsive, and consistent care (Chisholm, 1998; Dozier, in press a, in press b; OâConnor et al., 1999). Providing sensitive, responsive, and consistent parenting of infants and toddlers is challenging work. Both characteristics of the child and of the parent can make this type of parenting difficult to achieve. For example, newborns who continue to react to repeated stimuli after other newborns have tuned out or habituated to the repeated stimulation are somewhat more likely to form insecure attachment relationships to caregivers (Warren et al., 1997). Babies who become disorganized when stressed and those who get very upset when limits are placed on their actions are also some- what more likely to develop insecure attachments (Fox, 1985; Gunnar et al., 1996; Izard et al., 1991). These infant characteristics donât predestine children to insecure attachment; rather they shift the odds. This may be because it is harder for people to provide the sensitive parenting such children need. It may be because it is not clear what the baby needs or because the needs of such infants exceed the time, attention, and sensitivity that the parents can provide given all of the demands on them. Indeed, when parents can manage to maintain high degrees of sensitivity and re- sponsiveness, even temperamentally difficult infants develop secure and trusting relationships (Goldberg, 1990; Mangelsdorf et al., 1990; van IJzendoorn et al., 1995). Challenging parental life circumstances can also result in an imbalance between the infantâs needs and what the parent can
234 FROM NEURONS TO NEIGHBORHOODS provide. Emotional problems such as depression, economic stress, and marital conflict can interfere with sensitive and responsive parenting, be disruptive of secure attachments (see Belsky and Isabella, 1988; Thompson, 1999b; Waters, 1978), and constitute a significant source of instability over time in attachment security. It also appears to be the case that atypical attachments are more com- mon among atypical samples, including premature infants, children with Down syndrome, and children with autism (Atkinson et al., 1999; Capps et al., 1994). In particular, a significantly larger share of children at the extremes of reproductive risk or who have an identifiable developmental disability display disorganized or unclassifiable patterns of attachment to their mothers. Much remains to be understood about the meaning and consequences of atypical attachments. They may arise from problems par- ents experience in being sensitive to their child (i.e., difficulty of reading the infantâs cues), from these childrenâs cognitive limitations, from the added stress that can accompany raising a child with special needs, or from limita- tions of the typical model for studying attachment when applied to these special populations. There is a tremendous need for research in this area, given its role in elucidating child factors and surrounding conditions that impinge on early attachments, as well as the developmental significance of behavioral differences in patterns of relating to important others among both atypically and typically developing children (see Vondra and Barnett, 1999). Mothers and Others The large majority of research on early attachments has focused on the parent-child relationship and, specifically, on the mother-infant relation- ship, despite the fact that young children establish close relationships with a surprising variety of people, including relatives, child care providers, and friends. Children certainly develop secure attachments to their fathers that do not depend on the security they derive from their attachments to moth- ers (Thompson et al., 1985). Grandmothers are also important attachment figures, and their support of the mother can facilitate secure attachment in infants (Crockenberg, 1987; Myers et al., 1987). Grandmothers are an especially important source of child care during the earliest months and years of life, as we discuss in Chapter 11. Howes (1999) proposed the following three criteria for identification of attachment figures other than the mother: provision of physical and emotional care, continuity or consistency in the childâs life, and emotional investment in the child. We do not know whether there is a specific limit to the number of people with whom very close emotional connections can be established at different ages. Regardless of their number and variety, from
NURTURING RELATIONSHIPS 235 the childâs perspective, close personal relationships are not interchangeable. The child may turn to a substitute attachment figure or even a relatively unfamiliar but friendly person when the preferred one is not available, but the distress about the loss of one beloved person is not easily alleviated by the ongoing availability of the others, as many parents faced with their childrenâs reactions when a beloved babysitter or child care teacher goes out of their lives can attest. Young children clearly benefit from opportunities to develop close rela- tionships with different caregivers. As with the mother, the security of these relationships is based primarily on the trust and confidence that each adult has inspired in the child. It is also clear that the childâs primary caregiver (usually the mother) remains central in this constellation of at- tachment relationships (Berlin and Cassidy, 1999; Howes, 1999; NICHD Early Child Care Research Network, 1997a). The security of attachment between a mother and her child is more influential on early psychosocial growth than are the relationships a child has with other caregivers at home or outside the home, and even children in extensive child care continue to show an overwhelming preference for their mothers (Easterbrooks and Goldberg, 1990; NICHD Early Child Care Research Network, 1997a, 1998a, 1998b, 1999a, in press(a)). Although there once was concern that spending many hours in nonparental care might undermine the childâs primary relationships, recent studies now reassure parents that this is not the case (Berlin and Cassidy, 1999; Easterbrooks and Goldberg, 1990; Howes, 1999; NICHD Early Child Care Research Network, 1997a). Moreover, attachment relationships are specific to each adult, so that an insecure attachment to one caregiver may develop at the same time that a secure relationship grows with another (Howes et al., 1988; Suess et al., 1992). For example, children often exhibit secure attachment behavior with one parent but not the other (Belsky et al., 1996a). Infants and toddlers who develop secure attachments either to their mothers or their child care providers are observed to be more mature and positive in their interactions with adults and peers than are children who lack a secure attachment. However, the most socially skilled children are those who have established secure attachments with both their mothers and care pro- viders (Howes et al., 1995a). In this context, it is important to recognize that child care can be used effectively to provide respite for highly stressed parents who may be prone to child abuse or at risk of having their children placed in foster care (Crittenden, 1983; Kempe, 1987; Roditti, 1995; Subramanian, 1985). Unfortunately, as a result of pervasively high turn- over in child care providers and frequent changes in arrangements, children are more often insecurely than securely attached to their child care provid- ers (Galinsky et al., 1994; Howes, 1999; Seltenheim et al., 1997; Whitebook et al., 1990).
236 FROM NEURONS TO NEIGHBORHOODS At a minimum, this knowledge indicates that the significance of a young childâs attachments to caregivers other than their mothers and fa- thers merit respect and consideration. It also raises very significant issues for intervention efforts focused exclusively on parent-child relationships and suggests the value of extending these efforts to embrace other signifi- cant adults in the young childâs life. Links to Development Early attachments are important not only as an indicator of the parent- child relationship, but also for their significant effects on other aspects of the childâs functioning. They appear to have their most consistent and enduring influence on young childrenâs social and emotional development, although they also foster the exploratory behavior that is so vital to early learning and seem to bolster parentsâ efforts to support learning (Matas et al., 1978; also, see Thompson, 1998b and 1999a, for reviews). We are, however, only beginning to understand the mechanisms that underlie these connections between parent-child attachment and developmental outcomes. Longitudinal studies suggest that early attachments set the stage for other relationships, as children move into the broader world beyond the immediate family (Bretherton and Munholland, 1999; Sroufe and Fleeson, 1986, 1988; Thompson, 1998a). This occurs as young children acquire the ability to encode their early attachment relationships at the level of mental representations, which, in turn, guide their expectations about the avail- ability and responsiveness of other partners. In this sense, research on internal representations of relationships converges with cognitive research on the childâs unfolding theory of mind, as reviewed in Chapter 6. Securely attached young children compared with their insecurely attached peers have an easier time developing positive, supportive relationships with teach- ers, friends, and others whom they encounter as they grow up (Sroufe and Egeland, 1991; Sroufe et al., 1993; Thompson, 1998a, 1999a). Securely attached children may respond more positively to unfamiliar people (such as new classmates, a family acquaintance, or a substitute teacher) as well. It appears, however, that the positive expectations for close relationships that are inspired by a secure parent-child relationshipâor, in the case of inse- curely attached children, their distrust or ambivalenceâare most apparent in their encounters with familiar partners. There is also emerging evidence that securely attached young children are found, for example, to have a more balanced self-concept (Cassidy, 1988; Verschueren et al., 1996), more advanced memory processes (Belsky et al., 1996b; Kirsh and Cassidy, 1997), a more sophisticated grasp of emotion (Laible and Thompson, 1998), a more positive understanding of friendship (Cassidy et al., 1996; Kerns, 1996; Park and Waters, 1989) and
NURTURING RELATIONSHIPS 237 they show greater conscience development (Kochanska, 1995, 1997; Laible and Thompson, in press) than insecurely attached children. These associa- tions are especially evident when attachment security and other behaviors are measured at the same point in time, thus displaying a dense web of associated outcomes. Beyond these specific developmental outcomes, secure attachments seem to play a very important role in shaping the systems that underlie childrenâs reactivity to stressful situations. As discussed in Chapter 8, experiments with animals have yielded similar findings (Suomi, 1997) and further sug- gest that early mothering can affect the neural circuitry that governs behav- ioral stress responses in the offspring (Caldji et al., 1998; Liu et al., 1997). The development of noninvasive means of studying the activation of the stress-hormone system that produces cortisol has allowed the study of stress physiology in the everyday lives of infants and young children. The results of these studies indicate that, as in the work on nonhuman primates (Gunnar et al., 1981; Levine and Wiener, 1988) and human adults (Cohen and Wills, 1985), stress in young children is intimately linked with social experiences. About the time that infants begin to form specific attachments to adults, the presence of caregivers who are warm and responsive begins to buffer or prevent elevations in stress hormones, even in situations that elicit behav- ioral indicators of distress in the infant (Gunnar et al., 1996; Nachmias et al., 1996; Spangler and Schieche, 1994). In contrast, insecure attachment relationships are associated with higher cortisol levels in potentially threat- ening situations (Gunnar et al., 1992; Hertsgaard et al., 1995; Nachmias et al., 1996; Tout et al., 1998). For example, in one study, toddlers were exposed to a live clown who entered the room and invited them to âcome over and play.â Toddlers who were securely attached to the parent who accompanied them showed no rise in stress hormones to this strange event, even if they were frightened and wary of the clown and were generally described by the parent as more temperamentally fearful and anxious. In contrast, toddlers who showed the same behavioral signs of fear and wariness and were described as hav- ing a similarly fearful and anxious temperament, but who had an insecure attachment to the parent who was with them, showed significant elevations in this stress hormone. This was true despite the fact that the security of the attachment relationship was assessed separately, on a different day, and in a different context (i.e., the strange situation; Nachmias et al., 1996). These studies with infants and young children seem to be saying that secure emotional relationships with adults appear to be at least as critical as individual differences in temperament in determining stress system reactiv- ity and regulation. Beyond this emerging evidence regarding physiological reactions to stress, there is much to learn about how secure attachments function to
238 FROM NEURONS TO NEIGHBORHOODS promote and protect early development. Some have proposed that secure attachments enhance the childâs receptivity to other facets of parentsâ so- cialization efforts. From this standpoint, a secure attachment inducts the child into what has been characterized as a âmutual orientation of positive reciprocityâ between parent and child (Kochanska, 1997; Maccoby, 1983, 1992; Maccoby and Martin, 1983). This mutuality, in turn, heightens the childâs receptivity to the many ways in which parents socialize their chil- dren to get along with others, deal effectively with conflict, and become motivated early learners (Kochanska, 1997; Kochanska and Thompson, 1997; Waters et al., 1991). The children, in effect, are more receptive to the parentâs instruction, guidance, and teaching, which then reinforces the parentâs sensitive parenting and, in all likelihood, further binds their secure attachment. This evidence of the developmental significance of secure attachments supports the focus on relationship building in early intervention studies with high-risk populations of children. It is also important to recognize, however, that the effects of early attachment relationships are provisional and contingent on many other influences on psychosocial growth, as well as on continuity or change in the parent-child relationship itself (Sroufe et al., 1990, 1999). The security or insecurity of attachment relationships can change in the early years of life. A child who begins with an insecure relationship may, for example, later have opportunities to develop a sense of secure confidence in the same caregiver. Changes in attachment may arise from changing family circumstances, such as the birth of a sibling or periods of family stress (Cummings and Davies, 1994a; Teti et al., 1996a; Vaughn et al., 1979). There is therefore no guarantee that the influence of early attachment security will endure, unless that security is maintained for the child in the years that follow. The instability of early attachments renders efforts to trace long-term consequences very difficult. At best, we can conclude that the effects of early secure attachments are conditional. They shift the odds toward more adaptive development, but subsequent experiences and relationships can modify their longer-term impacts, some- times substantially. BEYOND ATTACHMENT SECURITY Although the attachment relationship may bolster the parentâs attempts to produce desired behavior in the child, fostering a secure attachment relationship is far from all that parents do in the early years of the childâs life to promote healthy development. In essence, parents must have the personal skills to interact constructively with their children, the organiza- tional skills to manage their lives inside and outside the home, and the problem-solving skills to address the many challenges that children invari-
NURTURING RELATIONSHIPS 239 ably present. Doing this well requires sensitivity to the child and an ability to read, interpret, and anticipate what the child needs and how the child is responding to the world. It also requires supports, like child care and social networks, and resources that come with economic security. Capturing the almost infinite variety of ways in which parents carry out their childrearing responsibilities is, of course, an impossible task. Some variations are related to the cultural context in which the family lives. Others are related to the economic resources that are available to them. Still others are forged in response to the characteristics and needs of indi- vidual children, or represent the best efforts of parents who are struggling with problems of their own. Even within relatively homogenous groups, parents deploy their childrearing responsibilities in widely differing ways. Confronted with this task, researchers have continued to pursue the dimen- sions of control and warmth, but they have also extended their reach to capture the ways in which parents support learning and make investments and choices that affect the well-being and future prospects of their children. There is also a growing interest in the ways in which parents convey cul- tural values and traditions to their children and adjust what they do in light of the attributes they want their children to have. We have organized our discussion of these issues by addressing parentsâ role in fostering coopera- tion and the development of a conscience, encouraging exploration and learning, and raising their children to live adaptively in differing cultural contexts. Fostering Cooperation and the Development of a Conscience The growth of cooperation in the context of close relationships has been studied much less intensively in young children than has the growth of love in the context of attachment. Yet at the same time that attachment security is taking shape late in the first year through the sensitivity and warmth of the caregiver, another dimension of the relationship is being forged by the negotiation of conflict between parent and child. Develop- mental scientists are showing renewed attention to this aspect of the parent- child relationship because of its relevance to the early origins of psychoso- cial problems in young children, including defiance, withdrawal, and conduct problems (Caspi et al., 1995; Moffitt, 1990; White et al., 1990), as well as its contribution to the emergence of conscience, moral values, and consideration for others (Kochanska and Thompson, 1997). Young children can experience conflict with virtually every family mem- ber, as well as with the peers with whom they play. As noted earlier, for example, getting along with peers is one of the central developmental tasks of early childhood. Sibling relationships are also a potent arena for conflict between young children, as well as for empathy, cooperation, and social
240 FROM NEURONS TO NEIGHBORHOODS comparison (Dunn, 1993; Dunn and Kendrick, 1982). How parents man- age these episodes of conflict can be significant for how young children learn about the feelings of others, the skills of competent sociability, and how to negotiate and cooperate. Even more important, however, is conflict between a young child and a parent because of the significance of their attachment relationship and the adultâs capacity to guide the child in learn- ing how to manage disagreement and defiance. Young childrenâs conflicts with caregivers who are skilled at helping them learn to manage experiences of disagreement and defiance early in life can provide a foundation for the growth of empathy and prosocial motiva- tion, as well as the development of skills for negotiating and successfully resolving conflicts with others (Eisenberg and Murphy, 1995; Goodnow, 1996, 1997). These conflicts do not need to be momentous; in fact, they often arise in the context of everyday exchanges in which, for example, parents say ânoâ to a childâs request (e.g., for a snack, for a particular dress) or attempt to gain the childâs cooperation (e.g., picking up toys or taking a bath). In this light, how young children experience conflict with their caregivers provides a forum for learning how to address conflict in their encounters with others throughout life. Conflicts and the negotiations they entail also provide essential practice as children learn acceptable ways to elicit help and to be assertive about their own needs and interests. They also provide opportunities for parents to learn how best to issue directives and make requests of their child. Little is currently known with assurance about how these experiences become catalysts for the growth of prosocial behavior and the rudiments of conscience, or the development of dysfunc- tional social behavior. It is clear, however, that nothing focuses a young childâs attention on what others are thinking, feeling, and expecting better than the realization that conflict with that person must be resolved. Research in this area has moved away from static characterizations of parenting style (e.g., authoritarian, permissive) toward a more dynamic understanding of what parents are doing when they set limits, create incen- tives, and administer punishments. As a result, researchers are now trying to understand how parents and others work with young children to foster capacities for safe, socially acceptable, self-regulated behavior in the con- text of conflict. This, in turn, shifts attention from whether parents are doing the right things or the wrong things to limit unacceptable behaviors, to how they encourage the joint resolution of conflict and the social under- standing and skills that come with it. The focus of inquiry is thus less on the moment of conflict, anger, or frustration and more on what happens next. This perspective also focuses attention on moments of ânegotiable dis- agreementâ (Goodnow, 1996), in which children try out a variety of strat- egies and in which parentsâNorth American parents at leastâteach chil- dren about the more or less acceptable ways to phrase a dissent or to
NURTURING RELATIONSHIPS 241 negotiate a compromise (Kuczynski, 1993; Kuczynski and Kochanska, 1990). Among the strategies that children learn are deferral (âlater, ok?â), offering a compromise, offering a reason for not complying, and acting as if no directive or request had been made (Kuczynski and Kochanska, 1990; Leonard, 1993). The phenomenon of interest then becomes the particular areas on which negotiation or divergence in values are more or less accept- able, and the particular ways in which differences are accepted, negotiated, or encouraged (Goodnow, 1997). The second and third years of life appear to be pivotal for the childâs emerging capacities and inclination to be coop- erative and considerate toward others. Toddlers are developing the cogni- tive skills to understand parental standards and apply them to their own behavior and achieving capacities for self-regulation that enable them in- creasingly to comply with internalized standards of conduct (Kopp, 1982, 1987; Kopp and Wyer, 1994). They are also becoming increasingly aware of the feelings and perspectives of others, which provides a resource for empathic responding to another in distress (Zahn-Waxler and Radke-Yar- row, 1990; Zahn-Waxler et al., 1992). At the same time, the parent-child relationship is changing, as the childâs growing assertiveness and the parentsâ growing use of prohibitions and sanctions lead to what can sometimes seem like endless conflicts of will (Biringen et al., 1995; Campos et al., 1992b). Parents now use emotional signals to convey approval or disapproval, sometimes before the obviously contemplated act of misbehavior even occurs (Emde and Buchsbaum, 1990; Emde et al., 1987). All young children internalize messages from these interactions; what is of interest is what they internalize. These experiences during the toddler years provide the first opportuni- ties for the child to answer the question, âWhat must I do to maintain good relations with others?â In the years that follow, the childâs understanding of how to manage conflict becomes elaborated as the behavioral expectations of parents expand to incorporate consideration for others, basic skills at self-care, safety concerns, and compliance with family routines and man- ners (Gralinski and Kopp, 1993). The strategies used by parents to elicit cooperation also change to build on the childâs maturing capacities for self- regulation. Specifically, they begin to rely more on explanations, bargain- ing, indirect guidance, and other nonassertive strategies (Belsky et al., 1996c; Crockenberg and Litman, 1990; Kuczynski et al., 1987). At the same time, however, children are also asserting their own independent judgment, mak- ing the preschool years ones of greater cooperation and greater conflict between parents and their offspring (Kuczynski and Kochanska, 1990; Kuczynski et al., 1987). Young children tend to comply more with behav- ioral standards as they reach the preschool years, but they also show a greater tendency to refuse before they comply and to negotiate, compro- mise, and display other indicators of self-assertion (Gralinski and Kopp, 1993; Vaughn et al., 1984).
242 FROM NEURONS TO NEIGHBORHOODS Complicating this process is the fact that young children want to feel that they are in control of their lives. Long before babies understand that they are the ones making things happen, the controllability and predictabil- ity of stimulation affects their attention, emotions, and behavioral reactions (Sullivan et al., 1991). In studying face-to-face interactions between young infants and their caregivers, for example, researchers have noted that after a period of back and forth smiles and vocalization that often build in intensity, babies will look away. Skilled caregivers react by remaining quiet for a moment. The baby then looks back and the two begin to interact again. Unskilled caregivers or ones who are depressed sometimes ignore the cue or try even harder to get the babyâs attention when he looks away. This often makes the baby fussy and irritable and increases the time he looks away. Overall, in pairs in which the baby controls the action (by looking toward and away), the caregiver keeps the infantâs attention longer and elicits more smiles, coos, and active infant participation. Social interac- tion with a baby, however, is somewhat of a one-way street. Let the adult be the one to turn away and ignore the baby (e.g., to answer the phone), and the baby often doesnât wait patiently for the adult to look back; he gets more demanding. By 1 year of age, being able to control the action can actually alleviate fearful responses to potentially frightening events. In one study discussed earlier (Gunnar, 1980), 12-month-olds were presented with a toy monkey that clangs symbols and flashes its eyes and can be quite frightening to children this young. The infants who were able to turn the toy on for a few seconds at a time did so repeatedly and often smiled and laughed. They liked it. In contrast, the children who could not control its actions were often upset, cried, and tried to get away from it. For older children, issues of control have been studied in the context of more subtle situations in which, for example, adults offer rewards if children engage in certain activi- ties or are highly directive and intrusive while children are at work on a task (Fagot, 1973; Hamilton and Gordon, 1978; Lepper et al., 1973). These circumstances presumably undermine childrenâs sense of autonomy and feelings that they are engaged in an activity because they want to do it. In fact, following these manipulations, childrenâs levels of interest and persis- tence decline significantly. These situations are not unlike those in which a parent insists that a child clean up his room before he can play outside or finish her dinner before she can have dessert. The challenge for parents is one of encouraging cooperation while also fostering feelings of control and self-determination that lead the child to cooperate because he or she wants to. This also entails learning when to push for cooperation and when not to; when to go along with the childâs requests and when to say âno.â As we saw earlier (Parpal and Maccoby, 1985), children are more likely to coop- erate with parents who have on a previous occasion shown that they are willing to follow a childâs interests.
NURTURING RELATIONSHIPS 243 Beginning in early childhood, as these examples illustrate, cooperation is not primarily a matter of whether parents consistently and firmly enforce their intentions on offspring, but is rather an interactional process in which a childâs capacities to understand, agree with, and be motivated to comply by a positive parent-child relationship are also important (Grusec and Goodnow, 1994; Kuczynski et al., 1997). Interactions that, at one extreme, become highly coercive and engage parents and children in escalating battles of will can contribute to the mix of factors that place children on a path toward dysfunctional social behavior (Dodge, 1990; Patterson et al., 1992). Alternatively, when these interactions are characterized by clear and consis- tently enforced limits, low levels of emotional arousal, ample affection, and a deemphasis on the use of power, threats, and criticism (Campbell, 1997; Herrera and Dunn, 1997; Lepper, 1981; Maccoby, 1992; Zahn-Waxler et al., 1979), children learn to observe and ultimately internalize their parentsâ standards of conduct. Caregivers who are warm and provide clear expectations for child behavior that are consistently enforced also encourage early conscience development (Eisenberg and Murphy, 1995; Kochanska, 1991, 1993, 1995). At times, this can involve directly focusing the childâs attention on the consequences of misbehavior (especially when those consequences in- volve harm to others) or their responsibility for harm, explaining why certain actions are inappropriate or harmful, or drawing attention to the needs of another person whom the child can assist (Hoffman, 1983, 1988; Zahn-Waxler and Kochanska, 1990; Zahn-Waxler et al., 1979). The ben- efits of these activities for the child are enhanced when parents themselves model morally responsible behavior and respond prosocially to others. In short, when parents are clear about their expectations (e.g., âyou need to put your action figures back in the box before we eat lunchâ) and direct but noncoercive in enforcing them (e.g., âweâll eat lunch as soon as you are doneâ), rather than threatening (e.g., âif you donât hurry up, you wonât see those action figures for a weekâ) in the context of a warm relationship with the child, early moral understanding is most likely to thrive (Eisenberg and Murphy, 1995). Early conscience also grows significantly in contexts other than direct conflict over misbehavior. When parents and offspring converse about the dayâs events, for example, moral lessons are often implicit in what the adult conveys and what the child learns from their conversation (Dunn, 1987, 1988; Dunn et al., 1995). In these situations, moreover, children can reflect on what they hearâwhether the conversation concerns the reasons for a siblingâs outburst, the parentâs response to being wronged, or a recounting of the childâs own previous misbehaviorâwithout the heightened emotion that may make it difficult for a young child to learn the same lessons in the context of a discipline encounter. Moreover, everyday family life is charac- terized by routines that enlist the young childâs cooperation in rituals like
244 FROM NEURONS TO NEIGHBORHOODS bedtime, storyreading, waking, mealtimes, bathing, and other recurrent, predictable events (Fiese et al., 1999; Miller and Goodnow, 1995). The presence of these routines is one way of making expectations known and of avoiding constant confrontations. Children thus learn cooperation not only in the context of conflictual encounters and occasions for mutual give and take, but also in the predictable flow of daily life. Interactions with siblings as well as parents are also important catalysts to early moral understanding, especially in relation to disputes over rights, possessions, and territory (Dunn and Munn, 1987; Slomkowski and Dunn, 1992; Tesla and Dunn, 1992). And at times, parents foster early conscience development when they devise alternative control strategies, such as avoid- ing a discipline encounter by proactively structuring circumstances or pro- viding anticipatory guidance, each of which succeed in enlisting the childâs cooperation in a nonconfrontational manner (Belsky et al., 1996c; Holden, 1983). Although these influences have been studied almost exclusively in the context of parent-child relationships (especially mother-child interac- tions), there is reason to believe that they are also important in the childâs relationships with other caregivers, including fathers, grandparents, child care providers, and teachers. The ways that caregivers can best support early conscience develop- ment also depend on the young childâs temperamental characteristics (Kochanska, 1991, 1993, 1995). Depending on the extent to which a child is dispositionally more inhibited and fearful, for example, the parentâs dis- ciplinary efforts may either provoke cooperation or distressed withdrawal. Relatively gentle discipline characterized by suggestions and reasoning ap- pears to be especially important for these children, for whom power asser- tive techniques are neither necessary nor effective. It is important for caregivers to calibrate their response to misbehavior according to the childâs personality attributes, as well as the childâs tolerance for stress and capaci- ties for understanding. Regardless of temperament, however, developmen- tal researchers have found that a secure, positive relationship with the parent is the best predictor of early moral growth. In a sense, a relationship of warmth and mutual responsiveness provides a context in which the parentâs values and standards are most likely to be believed, accepted, and adopted by the young child (Kochanska, 1991, 1993, 1995). Encouraging Exploration and Learning Our prior discussion of childrenâs emerging capacities for communica- tion and learning (Chapter 6) documented the many ways in which parents support young childrenâs linguistic and cognitive development. Much of early learning, in short, requires environmental supports, and children are dependent on their parents for providing them.
NURTURING RELATIONSHIPS 245 Starting in infancy, researchers have sought to identify the facets of parenting that are associated with higher scores on various tests of develop- mental status and cognitive abilities. The contingency and sensitivity with which parents respond to their babyâs cues emerge consistently as impor- tant correlates of early cognitive outcomes (Beckwith and Cohen, 1989; Beckwith and Parmelee, 1986; Donovan and Leavitt, 1978; Landry et al., 1997; Vietze and Anderson, 1980). Infants whose parents can interpret, adjust their own behavior, and respond appropriately to their bids for attention, moods and states, expressions of interest, and efforts to commu- nicate their needs are more advanced on virtually all assessments of devel- opmental and cognitive status. Sensitive give and take between parent and infant appears to get children off to a good start on early markers of cognitive growth, just as it facilitates secure attachments. Other aspects of parenting that have shown positive associations with these outcomes in- clude encouragement of exploration (in contrast to highly restrictive parenting), provision of a rich verbal environment, and ample amounts of nurturance and warmth (Clarke-Stewart et al., 1979; Cowan et al., 1991; Olson et al., 1986; Pettit et al., 1997). These features point to parentsâ role in creating an environment that is playful and nurturing, is rich in conver- sation, strikes a balance between safety and freedom to explore, and, in general, builds a belief in the child that the world is a receptive and respon- sive place. A related literature has focused more directly on the interplay between the childâs emerging capacities and the parentsâ ability to structure learning opportunities to both bolster and challenge these capacities. Originally proposed by the Russian psychologist Vygotsky (e.g., Vygotsky, 1978), childrenâs learning is assumed to proceed optimally when parents (and teachers) present material in the childâs âzone of proximal development.â This zone is defined in terms of tasks that are difficult for the child to perform independently but have components that can be accomplished with assistance. These kinds of processes, which have been portrayed as scaffolding (Wood, 1986; Wood et al., 1976), emphasize the ways in which parents orchestrate childrenâs experiences to provide them with the most effective levels of support. Although most of the studies in this area have been concerned with cognitive development, parents have been observed to engage in the same kinds of supportive activities as they facilitate their childrenâs entry into peer groups, with demonstrated benefits for the childâs later social skills (Finnie and Russell, 1988). They undoubtedly apply, as well, to other situations in which parents attempt to manage or shape childrenâs experiencesâfrom making play dates to arranging child careâso that they remain within the childâs tolerances for stimulation and challenge, while also fostering new capabilities (see, for example, Parke and Buriel, 1998).
246 FROM NEURONS TO NEIGHBORHOODS These processes have also been examined in the cross-cultural literature on the teaching and learning roles of children and parents. This research has directed attention to the culturally organized ways in which adults involve children in routine activities and interactions, supportively struc- ture their activities, and gradually transfer responsibility for specific tasks as the children acquire understanding and expertise (Goodnow, 1996; Ochs, 1992; Rogoff, 1990). In this sense, early learning is portrayed as a form of apprenticeship that is enacted in different ways in different cultures (Rogoff et al., 1991). For example, in some cultural communities, parents directly instruct children, play with them, and engage in conversations with them that are structured around materials and activities geared to the childrenâs interests and abilities. In other communities, children are expected to learn through observation and participation in adult activities and through play with siblings and peers. The cross-cultural literature has also called attention to the role that parentsâ expectations about the importance of various forms of achieve- ment play in childrenâs early learningâtheir familiarity with particular task strategies, their investments of effort in some tasks and not others, and their readiness to interpret various instructional or learning situations in particu- lar ways (Goodnow, 1998). There are, for example, differences across cultures (e.g., China, Japan, and the United States) in the importance placed on reading compared with mathematics, and in the importance placed on being a well-rounded and happy child compared with being a good student (Stevenson and Lee, 1990). Subgroups within culturesâboys and girls, for exampleâalso encounter different expectations, and childrenâs own assess- ments of importance can influence what parents and others in their commu- nity view as important, as any nonsports-minded parent with a child who excels at baseball can attest. As children reach the preschool years, researchers have turned their attention to the ways in which parents foster skills and abilities that are considered basic elements of school readiness, namely, literacy and number skills. For example, as mentioned earlier, maternal speech patterns predict vocabulary growth during the first three years of life (Hart and Risley, 1995; Huttenlocher et al., 1991), as well as prekindergarten measures of emergent literacy and print-related skills (De Temple and Snow, 1992). Parents encourage learning very explicitly through frequent visits to the library, routines that include regular reading to the child, and involvement in activities that allow children to play with notions of quantity. These behaviors show strong associations with early literacy and numeracy skills and later academic achievement (Ginsberg et al., 1998; Griffin and Morrison, 1997). Children generally benefit from parenting practices that expose them to high amounts of rich discourse and lots of print-related experiences (Beals et al., 1994; Gallimore and Goldenberg, 1993), as well
NURTURING RELATIONSHIPS 247 as opportunities to experiment with numerical concepts (Saxe et al., 1987; Starkey and Klein, 1992). Of particular importance for the early acquisi- tion of literacy and numeracy skills are the language and social interactions that surround such activities as storybook reading and board games that involve number concepts (Case and Griffin, 1990; Snow, 1993). This work on parent-child interactions per se has been extended to encompass the next broader level of influence, namely the quality and quantity of stimulation and support that the overall home environment provides to a child. The home environment is most commonly assessed with the Home Observation for Measurement of the Environment (HOME) Inventory (Caldwell and Bradley, 1984), which assesses the materials, ac- tivities, and transactions that occur within the family setting and are sup- portive of early learning, defined largely in terms of IQ and traditional academic skills. Literally hundreds of studies have reported significant associations between HOME scores and childrenâs IQ, cognitive and lan- guage development, and school performance (Bradley, 1985; Bradley et al., 1989; Clarke-Stewart, 1979; Gottfried, 1984; Linver et al., 1999; Smith et al., 1997; Wachs and Gruen, 1982). These relations hold for white, black, and Hispanic children from low and middle socioeconomic groups, although the patterns of relations may vary somewhat across ethnic groups (Bradley et al., 1989). Virtually every item on the HOME inventory distin- guishes poor from nonpoor families both within and across white, black, and Hispanic families. Efforts to assess the home learning environment raise the question of resources more broadly. Parents play an instrumental role in providing both social (i.e., opportunities for peer interactions, access to other sup- portive adults) and material (i.e., food, books, vacations, lessons) resources for their children. Economists and sociologists, in particular, have been interested in how the resources that families provide for their children influence their life trajectories (Becker and Tomes, 1986; Haveman and Wolfe, 1994). These family decisions are, of course, constrained by the decisions of government policy makers and employers, much more for some families than for others. Unfortunately, with the major exceptions of research on child care and family income (reviewed in the next two chap- ters), the influence on early development of the investments that parents make remains unexamined. Parenting Practices and the Transmission of Cultural Values Efforts to understand the importance of cultural practices in the rearing of young children, as described in Chapter 3, emphasize the extent to which culture is both reproduced and transformed within each child (Miller and Goodnow, 1995). That is to say, the socialization process that is embedded
248 FROM NEURONS TO NEIGHBORHOODS in the development of early relationships is influenced by the transmission of values and behaviors from one generation to the next, the âtransforma- tionâ of those values and behaviors by the contemporary social context, and individual differences among caregivers (GarcÃa Coll and Magnuson, 2000; Harkness and Super, 1992, 1996; Miller and Goodnow, 1995; Super and Harkness, 1997). These processes are of particular importance with respect to immigrant families (Portes, 1996; Rumbaut, 1994; Waters, 1997; Zhou and Bankston III, 1998). There is also a growing appreciation for the ways in which children themselves are not simply passive recipients of cultural influences, but rather active agents who bring both the ability and the willingness to accept, modify, or resist those influences. Current research on differences in childrearing beliefs and practices is directing increased attention toward the scripts that characterize the daily routines of children and their primary caregivers (Farver, 1993; Farver and Wimbarti, 1995; Farver et al., 1995; Greenfield and Suzuki, 1998; Weisner, 1999). These routines are imbued with expectations that are designed to establish a moral order within which the child is expected to adapt (Schieffelin and Ochs, 1986; Shweder et al., 1995). They also create learn- ing environments that vary dramatically across different cultural settings and groups (Rogoff, 1990). In this context, parents and other important caregivers introduce children to both informal routines and formal institu- tions that reinforce their cultural values and goals. When confronted by outside influences that they perceive to be undermining these efforts, care- givers can become highly threatened. Parent belief systems and modes of parent-child interaction provide some of the most important ways in which culture is embedded in the process of child rearing during the early years of life (Levine, 1989; Super and Harkness, 1986). A wide range of cultural practices are salient in this regard, ranging from those related to sleeping, crying, and breast-feeding to those that affect the way parents talk with their children, the way emotion is acknowledged and expressed, and the way a child is expected to respond to praise for an individual achievement (see Chapters 3, 5, 6, and 7 for more detailed discussion). Inuit children are led, through adultsâ repeated teasing, to learn not to display anger (Briggs, 1992). Gusii mothers seldom gaze into the eyes of their infants, and their children are discouraged from looking adults in the eye (which is seen as an act of disrespect), yet they readily establish secure attachments (Levine, 1990). The widely varying views about sleep arrangements are discussed in Chapter 5. The ways in which parents talk with children have been portrayed as one of cultureâs most powerful symbol systems (Harwood et al., 1995; Schieffelin and Ochs, 1986). As we discussed in Chapters 5 and 6, ways of storytelling have emerged as a prime site for exploring the socialization of values (Goodnow, 1997). Parents encourage some forms of storytelling
NURTURING RELATIONSHIPS 249 and not others, sometimes to the point of labeling as âliesâ stories that teachers portray as âimaginativeâ (Heath, 1983). In one study of black families, parents often recounted their everyday experiences in ways that presented themselves in a feisty lightâa style that was repeated by their children in their own stories (Miller and Sperry, 1988). The impact, it is argued, extends beyond the kinds of stories that are transmitted from adult to child, to the childâs emerging views of the self (e.g., If Iâm feisty, thatâs good; if Iâm reticent, thatâs bad), built up by way of the everyday events that are recounted and endorsed among family members (Miller et al., 1990). One very interesting issue that this raises is how children react when they are confronted with differing or even competing messages between parents or among the various important adults in their lives (Goodnow, 1997). Individual differences in parentsâ previous and current interactions with the larger sociocultural context also affect how they raise their children (Parke and Buriel, 1998). The socialization of ethnic minority children, for example, has been conceptualized as a highly complex process that is influ- enced by the socioeconomic resources (i.e., housing, employment, health care, education, jobs) available to the family and the childrearing goals and adaptive strategies that the parents adopt in this context, among other factors (Harrison et al., 1984, 1990; Hughes and Chen, 1997, 1999). Ex- tended family members, notably grandmothers, play a particularly impor- tant role in these processes, contributing, for example, material support, income, child care, and social regulation (Wilson, 1986, 1989). This model highlights the need for greater attention to the efforts that parents make to help their children meet the challenges they will face as members of a minority group in a race-conscious society. In some cases, this leads parents to encourage their children to adapt to two cultural contextsâthat of the childâs primary ethnic group and that of the larger âmainstreamâ society (Boykin and Toms, 1985). This strategy is observed commonly in the lives of many ethnic minority groups in the United States (see, for example, LaFromboise et al., 1993). Most empirical data on biculturalism and on the use of alternative strategies by ethnic minority parents to facilitate their childrenâs adaptation have been collected from adult and adolescent samples (Parke and Buriel, 1998). It is therefore essential that this kind of research be conducted with samples of younger children, be extended to encompass nonminority par- ents, and be used to investigate distinctive strategies that are used by spe- cific groups for raising children in an increasingly multicultural society. An appreciation of the broad range of circumstances in which parents rear young children brings with it tremendous admiration for those who do it well. Conversely, conditions that pose significant challenges to the efforts of parents to get their children off to a good start in life warrant serious
250 FROM NEURONS TO NEIGHBORHOODS concern. We next turn to examine circumstances that seriously threaten and often undermine the parenting process. DISRUPTIONS IN PARENTING The challenges associated with parenting become abundantly evident when we take a look at parents who are struggling. There is an extensive literature on the effects of maternal depression, a relatively common, but potentially very serious, problem for parent-child interactions and child development. Child abuse and neglect represent a more unusual and far more extreme disruption in parenting. The long-standing literature on orphanage-reared children can inform questions about situations that un- dermine the basic and powerful tendency of infants to form relationships and the young childâs capacity to recover from the effects of extremely aberrant care. These examples illustrate circumstances that place young children at risk of highly compromised development. In addition, the behaviors that are seen in young children exposed to these circumstances may be usefully considered as âcanaries in the mineshaftââthat is, as early warning signs of serious problems in children who experience less extreme, but nonetheless harmful, early rearing experiences. Research on the developmental consequences of disrupted parenting is part of a broader literature on environmental influences leading to psycho- pathology (see Rutter, in press; Rutter et al., in press). This is an exceed- ingly complex literature that is fraught with challenges regarding, for ex- ample, the need to elucidate how genetic factors interact with environmental factors to affect susceptibility to risk and the need to consider how children themselves contribute to parental behavior, including behavior that poses risks to their development. A good example of this latter point is provided by the discussion of the work by Ge and colleagues (1996) in Chapter 2, which links childrenâs inherited antisocial tendencies to more harsh parenting by their adoptive mothers and fathers. Another example of how genetic and environmental influences interact is provided by a study of Scandinavian adoptees (Bohman, 1996). The children who were character- ized by neither genetic (indexed by criminality or alcoholism in one or both biological parents) nor environmental risk (indexed by the same in adoptive parents, together with serious adversities in rearing) had a 3 percent rate of adult criminality, the children characterized by only one source of risk had rates of 6-12 percent, and those characterized by both genetic and environ- mental risk had a 40 percent rate of adult criminality. Environmental risk, in other words, led to negative outcomes primarily in the presence of ge- netic risk. Sorting out genetic contributions and the direction of effects in research on parent-child relationships is a daunting task. Longitudinal designs,
NURTURING RELATIONSHIPS 251 studies of adoption, and intervention studies are among the approaches that can be enormously useful; we rely on these when we can in this discus- sion of disruptions in parenting and in the following section on efforts to improve parenting, but they are seldom a panacea. Finally, this discussion focuses on the role of environmental influences deriving from parenting on individual differences among children. Equally important questions about why overall rates of particular childhood behaviors may be rising or falling (e.g., Is the increase in childhood poverty associated with increasing rates of maternal depression and, if so, is increased depression leading to higher rates of childhood disorders?) are not addressed, in large measure because there are virtually no data on secular trends in the relevant young child outcomes. Early Development and Maternal Depression A variety of methods have been used to assess maternal depression, ranging from self-reports to clinical diagnoses. They typically gather infor- mation about the motherâs mood as well as other symptoms of depression, such as sleep disturbances, difficulties with concentration, loss of motiva- tion, and appetite changes (Campbell et al., 1995). Approximately 1 in 10 women with young children experience depression (Dickstein et al., 1998b; Gelfand et al., 1996), with prevalence rates often reaching two times these levels among mothers living in poverty.1 Descriptive data from several recent studies of welfare samples have identified rates of moderate to severe depression in the 13 to 28 percent range (Danziger et al., in press; Lennon et al., 1998; Moore et al., 1995; Olson and Pavetti, 1996). These high prevalence rates are cause for concern about the effects of maternal depres- sion on young children. This focus for this discussion, however, is not meant to minimize the need for societal attention to other forms of mental illness that can disrupt parenting (e.g., anxiety disorders, bipolar disorders, alcoholism). Compared with children of nondepressed mothers, those with depressed mothers show greater risk of developing socioemo-tional and behavior problems, which translate into difficulties in school, poor peer relation- ships, reduced ability for self-control, and aggression (Campbell et al., 1995, Cummings and Davies, 1994b, Dawson and Ashman, in press; Zeanah et al., 1997). Children of depressed parents are also at heightened risk of serious psychopathology (Cummings and Davies, 1994b; Downey 1Prevalence rates vary widely from one study to the next, depending on the measure of depression used and the population being studied, with some as low as 12 percent and others as high as 55 percent (Lennon et al., 1998; Wolf et al., submitted).
252 FROM NEURONS TO NEIGHBORHOODS and Coyne, 1990; Zeanah et al., 1997). For example, children of clinically depressed parents are several times more likely to develop major depression then children of parents without such symptoms (Downey and Coyne, 1990). Depression is not a static state. Mothers with major depressive disor- ders have periods when their symptoms abate, along with periods of greater suffering. Examining changes in child functioning in conjunction with changes in maternal functioning can help to disentangle genetic and experi- ential contributions to child outcomes. Work of this sort is being con- ducted in some cases using physiological measures. In adults, depression is associated with changes in neural activity mea- sured over the frontal areas of the brain that control emotion regulation (Davidson, 1994), as well as with altered day-night patterns that are evi- dent in disordered sleeping, eating, and cortisol production. When EEG measures are taken, nondepressed adults typically show evidence of greater activity over the left compared with the right frontal region. But negative emotions evoked using movie clips produce a shift in this asymmetry, re- sulting in greater right than left frontal activity (Davidson et al., 1990). Depressed adults, in contrast, routinely exhibit greater right than left fron- tal activity, thus resembling the pattern evoked by negative emotionality in healthy adults. Frontal asymmetry has been studied in infants and toddlers as well as adults (Dawson et al., 1992). Young children, like adults, show increased activity in the right frontal region relative to the left frontal region when negative emotions are evoked (Fox and Davidson, 1987). However, chil- dren of depressed mothers have been observed to display this asymmetry even when they are at rest or engaged in an activity with someone other than their mother (Dawson et al., 1992). Furthermore, the magnitude of this asymmetry was related to the timing of the motherâs depression. Fron- tal EEG asymmetry in 3-year-olds was more highly related to maternal depression in the childâs second and third years of life than to maternal depression in the childâs first year of life. Interestingly, among three-year- olds, cortisol levels in the children were more highly related to maternal depression in the childrenâs first year than to maternal depression in the year prior to testing. Thus, the neurobiology and neuroendocrinology associated with adult depression is observed in young children of depressed mothers in ways that may be somewhat specific to when, during the young childâs life, the mother (and presumably the child) suffered most severely from the motherâs depressive disorder (Dawson and Ashman, in press; Dawson et al., 1994; Zeanah et al., 1997). This evidence has led some to suggest that infants and toddlers who are acutely dependent on their mothers, whose frontal lobes are experienc- ing rapid growth, and whose attachment, social-emotional, and regulatory
NURTURING RELATIONSHIPS 253 capacities are developing, are particularly vulnerable to the negative effects of maternal depression (Dawson and Ashman, in press; Dawson et al., 1994; Goodman and Gotlib, 1999; Murray and Cooper, 1997; NICHD Early Child Care Research Network, 1998a; Weinberg and Tronick, 1998; Zeanah et al., 1997). While the severity and chronicity of maternal de- pression are clearly predictive of disturbances in child development (Campbell et al., 1995; Cummings and Davies, 1999; Frankel and Harmon, 1996; NICHD Early Child Care Research Network, 1998a), there is no definitive evidence regarding how the timing of maternal depression in the course of a childâs life affects the child (Cummings and Davies, 1994b; Gelfand and Teti, 1990; Seifer et al., 1996). The neurobiological data suggest, however, that this is an area in which careful study of the timing question is warranted. Efforts to understand the processes that underlie the developmental consequences of maternal depression have, not surprisingly, focused on mother-child interactions. Many depressed mothers show disrupted pat- terns of interaction with their infants. They also express self-doubts about their ability to parent well and are more likely than nondepressed mothers to perceive their children as being difficult (Teti et al., 1996b). Maternal depression affects both the emotional availability of the mother and the emotional tenor of her interactions with her child. Specifically, depressed mothers are more likely either to withdraw from their children and respond with little emotion or energy, or to become intrusive and hostile toward them (Frankel and Harmon, 1996; Tronick and Weinberg, 1997; Zeanah et al., 1997). These behaviors undoubtedly contribute to the higher rates of insecure attachment, as well as the withdrawal, reduced activity, and dys- phoria that are observed in infants of depressed mothers (Cummings and Davies, 1994b, 1999; Dawson et al., 1992; Frankel and Harmon, 1996; Murray and Cooper, 1997; Seifer et al., 1996; van IJzendoorn et al., 1992). These disrupted interactions and, more generally, the adverse effects of maternal depression are not seen uniformly. Many depressed women are very good mothers who raise children who are securely attached, do well in school, and do not misbehave (Cummings and Davies, 1994b, 1999; Frankel and Harmon, 1996). This raises important questions about the conditions that either prevent the damaging processes from occurring or protect chil- dren from their effects. Parenting by depressed mothers tends to be dis- rupted primarily when it occurs in conjunction with other sources of stress or adversity. Accordingly, a child of a depressed mother who also experi- ences poverty, marital discord, or maltreatment, or whose mother is also abusing substances or is an adolescent, is much more likely to exhibit some form of compromised development than is the child of a mother whose depression occurs in the context of an otherwise supportive environment (Cummings and Davies, 1994b; Seifer et al., 1996; Zeanah et al., 1997).
254 FROM NEURONS TO NEIGHBORHOODS Unfortunately, depression often goes hand in hand with poverty, substance abuse, and other factors that place early development at risk (Campbell et al., 1995; Seifer, 1995; Zeanah et al., 1997). The role of marital discord and of fathers is especially noteworthy in this regard. When maternal depression occurs in a family experiencing marital harmony, mothers are better able to sustain healthy interactions with their children and the children are less likely to display adverse conse- quences (Cummings and Davies, 1999; Teti, 1999; Teti et al., 1996b). In fact, the occurrence of marital discord in a childâs family may predict certain developmental problems more accurately than maternal depression. Relatedly, involved, psychologically healthy, and supportive fathers can buffer children from the detrimental effects of maternal depression, whereas absent or psychologically unhealthy fathers can amplify the effects (Goodman and Gotlib, 1999). Beyond its direct effects on children, maternal depression can be a major barrier to the effectiveness of early interventions. The high rates of depression among low-income mothers combined with emerging evidence that depression can be a major deterrent to enrollment and full participa- tion in intervention programs, such as home visiting, highlights the critical importance of this relatively hidden issue for those who design, implement, and evaluate early childhood programs (Teti, 1999). Maternal depression can also undermine the intended benefits of early intervention, as illustrated by the New Chance Demonstration. Mothers who participated in this comprehensive program for poorly educated teenage mothers on welfare not only felt more stressed than mothers who did not participate in the program, but the program actually had negative effects on the children of the depressed participants (Quint et al., 1997). It appears that New Chance overwhelmed the capacity of depressed mothers to cope with their situa- tions, with detrimental consequences for their children (Lennon et al., 1998). Early intervention is clearly a complex undertaking for depressed mothers who are also experiencing other sources of stress and for whom mental health services may be a more appropriate first step (see Teti, 1999). Children Exposed to Abuse and Neglect Child abuse and neglect can be devastating for childrenâs development (Cicchetti and Carlson, 1989; Cicchetti and Toth, 2000; Goodman et al., 1998; Kolko, 1996; National Research Council, 1993). In 1996, nearly 1 million children were involved in substantiated reports to child protective services agencies (National Center on Child Abuse and Neglect, 1997), and, based on reports from just 21 states (National Committee to Prevent Child Abuse, 1997), over 64,000 children were removed from their homes and placed in alternate care. Extrapolating from data from 40 states that
NURTURING RELATIONSHIPS 255 provided figures by age of the child, over one-third of these victims were 5 years old or younger and, of the child victims killed in 1995, 77 percent were under age 3 (National Center on Child Abuse and Neglect, 1997). These official figures do not include community violence or the incidence of children who witness domestic violence, which also have pervasive detri- mental impacts on young children (Osofsky, 1999). Moreover, many chil- dren are assumed to suffer multiple forms of maltreatment (Thompson and Wyatt, 1999). Child maltreatment is associated with both short- and long-term ad- verse consequences for children (see reviews by Kolko, 1996; Malinosky- Rummell and Hansen, 1993; Pianta et al., 1989; Thompson and Wyatt, 1999). Physical abuse extracts a substantial toll on young childrenâs social adjustment, as seen in elevated rates of aggression that are apparent even in toddlers (George and Main, 1979) and appear to derive, in part, from biases in social information processing that lead victims of physical harm to overattribute hostile intent to others (Dodge et al., 1990). On average, children who have experienced physical abuse also have lower social com- petence, show less empathy for others, have difficulty recognizing othersâ emotions, and are more likely to be insecurely attached to their parents. Deficits have also been noted in IQ scores, language ability, and school performance, even when the effects of social class are controlled. These adverse effects are not short-lived. Although the vast majority of abused children do not become abusive adults, abused children are overrep- resented among adults involved in both nonfamilial and familial violence (Malinosky-Rummell and Hansen, 1993). Among females, long-term ef- fects manifest themselves as depression, anxiety disorders, and suicidal and self-injurious behaviors. Both men and women who were maltreated as children are at heightened risk for multiple forms of psychopathology (Cicchetti and Lynch, 1995; Kaufman, 1996; National Research Council, 1993). There is less research on physical or emotional neglect, although similar patterns across the same spectrum of outcomes have been reported (see Erickson and Egeland, 1996; Gaudin, 1993; Hoffman-Plotkin and Twentyman, 1984; Maxfield and Widom, 1996, for reviews). As with maternal depression, abuse that occurs in the context of other adverse circumstances, such as multiple out-of-home placements, additional life stressors, and parental depression, reaps worse consequences. Coping and adaptation in the face of abuse are more likely when abuse is relatively isolated from other sources of adversity and, in particular, when the child receives emotional support from another important adult in his or her life (Garmezy, 1983; Rutter, 2000; Werner, 2000). As we discuss in the section below on institutionalization, the presence of a consistently available and emotionally invested adult appears to have a remarkably restorative influ-
256 FROM NEURONS TO NEIGHBORHOODS ence on children who might otherwise be expected to succumb to the del- eterious circumstances of their early lives. Recent work has explored the presence of posttraumatic stress symp- toms in maltreated children, with a special concern for potential alterations in fear-stress physiology that have been found to accompany reactions to trauma among adults and older children. Work is currently ongoing with children 3 years and under to discover how trauma manifests itself in preverbal children (Scheeringa and Zeanah, 1995). By 4 and 5 years of age, however, trauma symptoms typically assessed in older children and adults can be observed (Pynoos and Eth, 1985; Scheeringa et al., 1995). Many children who show these symptoms following traumatic experiences appear to recover when their circumstances improve. In others, however, there is evidence of fairly long-term alterations in the physiology of the fear-stress system, seen in higher levels and atypical daily patterns of cortisol and adrenaline production, that correspond to the duration of maltreatment (De Bellis et al., 1999b; Hart et al., 1996; Kaufman, 1996; Kaufman and Charney, 1999; Pynoos et al., 1996a, 1996b). More severe physiological changes are noted when children suffered for longer periods before rescue (De Bellis and Putnam, 1994; De Bellis et al., 1999b). Do these changes in the physiology of fear-stress in children have devel- opmental consequences? Certainly chronic abuse in childhood is associated with problems in emotion and behavioral regulation (Pynoos et al., 1995). In addition, maltreatment in childhood is a risk factor for multiple forms of psychopathology that are often seen to co-occur with post trauma symp- toms (Cicchetti and Lynch, 1995; Kaufman, 1996; National Research Coun- cil, 1993). Many suspect that chronic activation of the physiology of stress during periods of rapid brain development may be producing pathology because of the effects of stress physiology on brain development (e.g., Cicchetti, 1994). However, there has been only one peer-reviewed scien- tific study that imaged the brains of maltreated children. The 44 children in this study had all been sexually abused, typically beginning between ages 2 and 6, and most had also been physically abused beginning between ages 1 and 3 and had witnessed violence in the home. The duration of abuse varied but averaged around 3 or more years. These children, who were all of school age at the time of testing and had been living in stable, presumably nonabusive circumstances for several years, were all selected to meet clinical criteria for posttraumatic stress disorder, and many also met criteria for depression and other clinical syndromes (De Bellis et al., 1999a). The imaging data showed that, compared with physi- cally and mentally healthy children matched for age and sex, these children had smaller brain volumes, larger lateral ventricles (i.e., the fluid-filled cavities of the brain), and smaller areas of connection (i.e., the corpus callosum) between the left and right sides of the brain. Most importantly,
NURTURING RELATIONSHIPS 257 these findings were correlated with the duration of trauma (although not with age of onset), with children who had been abused longer showing greater differences from their matched controls than children who were rescued after shorter periods of abuse. These results are preliminary and require replication, but they suggest that a history of chronic and severe trauma in early childhood can be associated with alterations in fear-stress physiology and in brain develop- ment. At the same time, there is no reason to interpret these results as indicating permanent impairment. Indeed, there is no evidence on whether or how therapeutic interventions may affect the fear-stress system or the neurological development of children who suffer maltreatment early in life. There is, however, compelling evidence from research on children reared in orphanages and then later adopted into loving families of the remarkable capacity of the young child to recover from aberrant early care. Orphanage Rearing and Later Adoption Children growing up in institutions have been the focus of a long- standing literature on early privation (Rutter, 1981a; Skeels, 1966). Studies of orphanage-reared children are now focusing on the wave of Romanian children adopted into families during the early 1990s (Benoit et al., 1996; Groze and Ileana, 1996; Morison et al., 1995; Rutter and the English and Romanian Adoptees [ERA] Study Team, 1998). This literature tells a compelling story about the severe developmental consequences of institu- tional care that affords neither stimulation nor consistent relationships with caregivers, which often confronts children with other physical adversities, including malnutrition, exposure to pathogens, and untreated chronic ill- ness. It also reveals the remarkable recovery that characterizes many chil- dren exposed to these environments once they are adopted into loving homes, as well as the long-term impairments that continue to plague some of them many years after their life circumstances have improved. On both accounts, the fundamental message concerns the vital importance of consis- tent and committed adults in young childrenâs lives. Orphanage-reared infants and toddlers who have received adequate medical care and nutrition, but virtually no social or cognitive stimulation and few opportunities to establish a relationship with a consistent caregiver, show striking delays in motor and cognitive growth over the period of institutionalization (Provence and Lipton, 1962). They become extremely unresponsive, showing minimal crying, cooing, babbling, or motor activity. When tested in the orphanage, the deficits increase over time (Ames, 1997; Dennis, 1973; Provence and Lipton, 1962; Rutter and the English and Romanian Adoptees [ERA] Study Team, 1998). When adequate physical care and developmentally appropriate stimu-
258 FROM NEURONS TO NEIGHBORHOODS lation are provided and only the availability of stable caregivers is lacking, development is substantially less delayed (Hodges and Tizard, 1989a, 1989b; Tizard and Hodges, 1978; Tizard and Joseph, 1970; Tizard and Rees, 1974). This suggests that stable relationships, as distinct from social- cognitive stimulation, are not required to ensure adequate physical, sen- sorimotor, cognitive, and language development. Children who have lacked stable and consistent caregiving, however, are not free of problems. Using parent and teacher reports, these children have been found in several stud- ies to show impairments in regulatory aspects of thinking that involve concentration, attention regulation, and inhibitory control, generalizing problem solutions, and excessive concreteness of thought (Hodges and Tizard, 1989b; Tizard and Hodges, 1978, as reviewed in Gunnar, in press). Importantly, removing children from institutions and placing them in stable families with adequate resources can produce remarkable catch-up growth on developmental milestones and in general cognitive (i.e., mea- sures of IQ) and language development (Ames, 1997; Rutter, 1972, 1981b; Rutter and the English and Romanian Adoptees [ERA] Study Team, 1998). Even children delayed a year or more in behavioral and physical develop- ment can achieve normal levels of functioning once they are given the opportunity to live with a loving family. Nonetheless, a persistent minority of institutionalized children across all studies and samples fails to show this dramatic recovery. They continue to exhibit multiple, debilitating problems in cognition and behavior years after entering their new families. Multiple, often unknown factors are likely to constrain developmental outcomes for this persistent minority. Case by case, these factors may include varying mixtures of genetic, prena- tal, and postnatal conditions. If institutional rearing is involved, the con- tinuing deficits found in some children should show a consistent dose- response relationship with the duration of privation experienced. Duration of orphanage exposure is highly confounded with illness, maltreatment, repeated changes in caregiving, and so on, making it exceedingly difficult to isolate duration as the causal factor. However, recent findings based on the Romanian children offer a reasonable test of this hypothesis (OâConnor et al., 2000; Rutter and the English and Romanian Adoptees [ERA] Study Team, 1998). In fact, a strong dose-response relationship was found (with a 24-point IQ difference between the extremes), in which children who spent more time in the institutions showed more persistently poor out- comes. The study controlled for a series of alternative explanations, includ- ing the possibilities that later-adopted children might have had greater impairments at birth and that the differing outcomes may have been due to the childrenâs degree of malnutrition, which adds to the credibility of the conclusion. The outcomes of institutionalized children may also be constrained by
NURTURING RELATIONSHIPS 259 the capacity of the adoptive family to provide for the special needs of the child and the availability of appropriate remedial treatment. Surprisingly little is known about post-adoption effects on the recovery of children from such neglectful early environments. As with any family of a child with special needs, however, the challenge for such families may tax their emo- tional and financial resources. This may be one reason why the recent work on Romanian adoptees has shown that persistent problems were more common for children when two or more were adopted simultaneously from the orphanage by the same family (Ames, 1997). In contrast to the rapid recovery from gross cognitive and language deficits that is often seen in formerly institutionalized children, social and emotional development appears to be more compromised or more suscep- tible to long-term impacts (Ames, 1997; Hoksbergen, 1981; Rutter and the English and Romanian Adoptees [ERA] Study Team, 1998; Tizard and Rees, 1974; Verhulst et al., 1990, 1992). Specifically, children from the most depriving conditions, which often included illness, malnutrition, fre- quent relocations, and thus disruptions in care, appear to be at increased risk for enduring behavioral problems and difficulties in peer relationships that have been seen well into adolescence (Ames, 1997; Fisher et al., 1997; Hodges and Tizard, 1989b; Tizard and Hodges, 1978; Verhulst et al., 1992). Once again, however, many of the children, including some with the most depriving and adverse early backgrounds, do remarkably well when taken out of those circumstances and given the opportunity to de- velop in stable, loving, and economically resourceful families. The natural experiment provided by orphanage-reared children also affords the opportunity to ask if children deprived of stable, consistent attachment relationships early in life remain capable of forming such rela- tionships when opportunities arise later in childhood (see Thompson, in press(a)). In contrast to expectations from early attachment theory, the window for forming attachments appears to remain open for a rather long period, at least through the early childhood years, and possibly later. Chil- dren seem to be capable of forming their first attachments to parents even when adopted or fostered later in development, although it is unknown how long this adaptive capability endures. Nevertheless, the quality of these childrenâs attachment relationships varies considerably. A substantial minority have difficulties establishing secure attachments with adoptive or foster parents (Chisholm, 1998; Hodges and Tizard, 1989b; OâConnor et al., 1999). Some also display quite shallow relations with others and reduced likelihood of forming intimate relationships with peers later in development (Hodges and Tizard, 1989b). This implicates the importance of stable relationships during infancy for organizing competencies that sup- port the development of attachments that entail strong emotional commit- ments to specific partners (Gunnar, in press).
260 FROM NEURONS TO NEIGHBORHOODS A final look at whether the problems seen in institutionalized children derive from their institutionalized rearing or from other factors is provided by another study of Romanian children (Roy et al., 2000). These investiga- tors compared children reared from infancy in residential group homes and those brought up in individual foster homes. Almost all of the children had biological parents with overt psychopathology. The rearing provided by the foster parents differed significantly and in positive ways from the rear- ing received by the institutionalized children. The findings showed that the institutional children had a much higher level of overactivity and inatten- tion than the foster family children, suggesting that the institutional rearing was the more probable culprit. It is important to note that this finding applies to the children who were studied, namely, those who also came from very high-risk backgrounds. In sum, the literature on orphanage rearing and later adoption illus- trates the dual nature of early experiences. On one hand, highly disrupted or aberrant experiences of early care can have devastating effects on devel- opment. On the other hand, the impacts of even these extreme environ- ments are modified by subsequent experiences. Indeed, the rebound shown by orphanage-reared children when they are adopted into loving homes highlights the vital role that caregiving in all of its facets plays in the lives of young children. The literature attests that early deprivation does not doom children to lives of compromised development. It also reveals, however, that not all children escape unharmed. Some children institutionalized as infants continue to show lingering, persistent, and even severe problems, and a substantial minority show traces of their conditions of early care in what appear to be problems in their capacity or willingness to form inti- mate, secure, and deep relationships with others. Improving care can cer- tainly improve child outcomes, but given the massiveness of the change entailed in adoption (most families involved in international adoptions are middle to upper income, given the expense involved) and the lingering problems of some children, questions are raised about what can realistically be expected from far more modest attempts to alter the consequences for children of adverse early life experiences. EFFORTS TO IMPROVE PARENTING Some of the strongest evidence available on the efficacy of parenting behavior in fostering positive developmental outcomes comes from evalua- tions of interventions focused on parenting. For example, a long-standing parent management training program focused on elementary-age and older children has been instrumental in demonstrating that coercive parenting plays a role in the causal mechanisms leading to antisocial behavior (Dishion et al., 1992; Forgatch, 1991; Forgatch and DeGarmo, 1999; Patterson and
NURTURING RELATIONSHIPS 261 Forgatch, 1995). There have been a number of recent reviews of the literature on parenting interventions (Barnard, 1997; Barnes et al., 1995; Benasich et al., 1992; Brooks-Gunn et al., 2000; Cowan et al., 1998; Farran, 2000; Gomby et al., 1999; Heinicke, 1993; McCollum and Hemmeter, 1997; Olds and Kitzman, 1993). They converge on two fundamental con- clusions. First, parenting is open to change. A number of carefully evalu- ated interventions have successfully improved various dimensions of parenting and, for some, have linked these changes to improved child out- comes. Second, it is not easy to change parenting. There are at least as many failures as there are success stories. Learning from the unsuccessful efforts is vitally important to the intervention enterprise, as well as to understanding the many influences that impinge on parenting. This brief discussion emphasizes the implications of this literature for understanding parenting generally. Chapter 13 discusses this literature in the broader context of interventions aimed at improving young childrenâs well-being and life chances. Parenting interventions do not constitute a coherent field or delimited set of strategies. They range from relatively brief (several months), inten- sive interventions focused on highly specific objectives to multiyear initia- tives that provide a range of services to families aimed at the broad goal of supporting family functioning. The focal points of intervention range from parent literacy to the sensitivity of parent-child interactions to maternal health behaviors. The interventions often, but not always, take place in the home; they rely on a multiplicity of service providers ranging from nurses and highly trained parent educators to paraprofessionals recruited from the same neighborhoods as the clients, who are sometimes (but not always) given substantial training. Increasingly, intervention approaches that were developed on largely middle-class white populations are being extended to families from different ethnic and culturally defined groups and to families at many levels of risk (Cowan et al., 1998). There are surprisingly few studies of efforts to improve parenting that have simultaneously examined the causal influence of changes in parental behavior on child outcomes. The exceptions have, however, provided com- pelling evidence that successfully applying what is known about beneficial parenting to intervention efforts can improve outcomes for children. Care- fully designed intervention programs have proven successful in improving the sensitivity and reciprocity of care that parents give their infants and toddlers, with some programs also succeeding in strengthening the security of attachment in young children as a consequence (van IJzendoorn et al., 1995). The most effective of such interventions (e.g., Heinicke et al., 1998, 1999; Lieberman et al., 1991; Quint and Egeland, 1995; van den Boom, 1994, 1995) strive to improve a caregiverâs sensitivity through sustained, individualized sessions that take into account the motherâs broader life
262 FROM NEURONS TO NEIGHBORHOODS circumstances and needs. The Family Development Service Program in Los Angeles, for example, places a strong emphasis on helping mothers work with the childâs father and with institutions outside the nuclear family (Heinicke and Ponce, 1999) and has documented that a relationship-based intervention can have a significant impact on parent-child interaction and on the infantâs security of attachment. The Infant-Parent Psychotherapy Program in San Francisco emphasizes intergenerational patterns of attach- ment and devotes substantial resources to helping mothers cope with life issues in the world outside the family (Lieberman et al., 1991). It remains difficult, however, to delineate the key mediators involved in the positive findings that these studies are producing. These successful approaches confirm correlational evidence of the ex- tent to which parenting sensitivity is tied to the extent of marital support, socioeconomic stress, demands in the neighborhood, and other life circum- stances that can compete for the adultâs energy and attention to a young childâs needs (Belsky, 1984, 1999). It is therefore not surprising that such intensive strategies also improve child functioning indirectly by improving the sensitivity of the care they receive. It is also important to note that these interventions typically rely on professional staff who are clinically trained to deal with parent-child issues and place a strong emphasis on staff conti- nuity as essential to the central task of supporting relationships. Other similarly intensive, localized programs have been successful in teaching low-income parents to facilitate their young childrenâs early lit- eracy skills (Whitehurst et al., 1994) and improve parentsâ behavior man- agement strategies (Webster-Stratton, 1992), with significant program ef- fects on young childrenâs reading and vocabulary and reduced aggressive and oppositional behavior, respectively. Cowan and Cowan (2000), in a randomized design, showed that largely middle-class parentsâ participation in 16-week therapist-led discussion groups on effective parenting just prior to their childrenâs entry into kindergarten resulted in better school adjust- ment and higher academic achievement for kindergartners and first graders, compared with children whose parents attended discussion groups without an emphasis on effective parenting. While these model programs with explicitly defined goals and painstak- ing attention to implementation and service quality can be effective in changing parenting practices and affecting targeted child outcomes, the literature on larger-scale parenting interventions is substantially less consis- tent. This is not to say that promising results are never found; rather, they are more sporadic and of smaller magnitude. Nevertheless, there are im- portant exceptions among the larger-scale efforts. Randomized trials of the Nurse Home Visitation Program (Olds et al., 1999), for example, have reported reduced maternal smoking, positive changes in maternal attitudes and behaviors related to abuse and neglect, and improved safety of home
NURTURING RELATIONSHIPS 263 environments, as well as fewer reported cases of child abuse and neglect and reduced hospital visits due to injuries and ingestions in the first four years of life. One evaluation of the national Even Start Family Literacy Program that randomized treatment at five sites found positive program effects on school readiness and language scores for 3- and 4-year-olds (St. Pierre et al., 1995a), despite weak effects on the aspects of parenting that were measured. There is, however, little empirical documentation that nonspecific, gen- eral family support interventions for high-risk families are able to produce significant or enduring changes in parenting behavior. For example, a review of 15 randomized trials of home visiting programs aimed at promot- ing the cognitive and linguistic development of young children in low- income families found that only 6 produced significant benefits for children and 5 of the 6 programs employed professional staff (Olds and Kitzman, 1993). A more recent review of six high-quality evaluations (i.e., primarily randomized experiments) of home visitation programs that are being, or have been, implemented nationally called for âa dedicated effort, led by the field, to improve the quality and implementation of existing home visiting services, and a more modest view of the potential of the broad array of home visiting programsâ (Gomby et al., 1999:24). Widely implemented programs that have extended their services beyond home visiting to provide a mix of adult education, job training, parenting education, and child care have also yielded, at best, modest results (Berrey and Lennon, 1998; St. Pierre and Layzer, 1998; St. Pierre et al., 1995a), particularly when they do little to address the multiple risk factors that often characterize the families they are trying to reach and do not focus extensive resources on addressing the parent-child relationship (Cowan et al., 1998). In sum, the question today is not whether interventions focused on parents can be effective, but rather what does it take to change parenting behavior in ways that will be sufficient to produce improved child out- comes (and for whom is this unlikely to be the right approach). The complex evidence on parenting interventions suggests that this is not an easy task for which success can be readily assumed. The challenges become even more daunting in light of the multiple problems that face many at-risk families today. The committee agrees with others (see Cowan et al., 1998; Teti, 1999) who have suggested that these families are likely to require more intensive services than the typical parenting intervention program provides, interventions that go beyond the enhancement of parenting skills to address the serious life issues (e.g., poverty, hopelessness and depression, substance abuse, troubled relationships) they face and involve adults other than just the mother and utilize program staff who are specifically qualified to work with multiproblem families. The growing diversity of families with young children also raises profoundly important questions about how best
264 FROM NEURONS TO NEIGHBORHOODS to match programs to the needs, values, and goals of various ethnic and cultural groups. A final challenge to parenting interventions is posed by the demographics and circumstances of working parents, for whom finding the time to participate in these programs is exceedingly difficult. Evaluations of the next generation of parenting interventions also face a new set of challenges: (1) the importance of subjecting to direct assess- ment the underlying assumption that improving parenting will produce meaningful changes in childrenâs functioning, (2) the need to thoroughly document program implementation and, in particular, to study the interac- tions that transpire between program staff and participating families, and (3) the need to distinguish children and families for whom parenting inter- ventions are effective from those for whom an alternative intervention strategy holds more promise. Figuring out the conditions and mechanisms that underlie successful efforts to change parenting will contribute not only to more successful interventions but also to efforts to understand parenting more generally. SUMMARY AND CONCLUSIONS Relationships are among the most significant influences on healthy growth and psychological well-being. The mother-child relationship is the primary one for most children, but relationships with others inside and outside the home have become increasingly important as young children receive care from many different individuals. These are not new conclu- sions, but research during the past quarter-century has highlighted how early relationships are influential, how diverse are their consequences, and how significant are the harms resulting from relational abuse or neglect on young children. Early in life, a young child enjoys relationships that are unique to different partners. Relationships with mothers are different from relation- ships with fathers, grandparents, and a caregiver in child care, but each relationship can be supportive and secure in its own way. Moreover, relationships are established and sustained in a cultural context in which how children and adults regard each other is influenced by the beliefs, values, and expectations of the wider social community. Indeed, a central function of early caregiving relationships addresses the childâs socialization into a specific cultural niche within society. In these ways, early relation- ships are diverse and multifaceted and have different effects on young children. Despite their diversity, however, all young children seem to require certain things from early abiding relationships. These include: (a) reliable support that establishes confident security in the adult, (b) responsiveness that strengthens a young childâs sense of agency and self-efficacy, (c) pro-
NURTURING RELATIONSHIPS 265 tection from the harms that children fear and the threats of which they may be unaware, (d) affection by which young children develop self-es- teem, (e) opportunities to experience and resolve human conflict coopera- tively, (f) support for the growth of new skills and capabilities that are within the childâs reach, (g) reciprocal interaction by which children learn the mutual give-and-take of positive sociability, and (h) the experience of being respected by others and respecting them as human beings. In these ways, relationships shape the development of self-awareness, social com- petence, conscience, emotional growth and emotion regulation, learning and cognitive growth, and a variety of other foundational developmental accomplishments. Relationships are also important because these attachments buffer young children against the development of serious behavior problems, in part by strengthening the human connections and providing the structure and monitoring that curb violent or aggressive tendencies. But strong, supportive early attachments do not inoculate young children against later difficulty. Relationships may begin well but decline over time, and many other influences affect early psychosocial growth. Stability and consistency in these relationships is important, as are the adultâs sensitivity, love, availability, and unflagging commitment to the childâs well-being. Fulfilling these responsibilities does not always come naturally, nor is it easy. The circumstances that surround parents and other caregivers, as well as their own mental health, exert a powerful influence on their capacity to fulfill the responsibilities that are entailed in raising chil- dren. Characteristics of the child can also make good parenting difficult to achieve. It should come as no surprise that early child-caregiver relation- ships can go awry in many ways. When they do, children suffer and the harms they experience can be life-threatening. Short of this, they include alterations in fear-stress physiology, blunted capabilities for emotion and attention regulation, delays in cognition and learning, and social dysfunc- tion. Remarkably, when young children are removed from these deleteri- ous conditions, many recover amazingly well. The capacity to rebound in supportive relationships speaks to the growth-fostering importance of close relationships for young children. Nonetheless, not all children who experi- ence harmful care early in life rebound so well. Why one child recovers while another struggles is difficult to know without being privy to all the harmful influences the child experienced prior to being rescued. But there is evidence that the longer children remain in care that is threatening or fails to meet their basic needs, the greater the challenge in getting them on a healthy trajectory. Early relationships can improve if they begin badly. It is thus vitally important for society to do everything possible to enable parents to estab- lish good relationships with their children from the beginning and, when
266 FROM NEURONS TO NEIGHBORHOODS this fails, to help parents become better caregivers. The quality of an adultâs caregiving can be strengthened, but it is not easy to do. Because the quality of caregiving has diverse roots in the family ecology, marital rela- tionship, and the adultâs individual past, improving the quality of care requires carefully designed interventions that take these contextual features of families into consideration. It also involves reducing the stresses that impinge on parents from circumstances beyond the family unit, ranging from work-related pressures to community violence. The central and irre- placeable nature of young childrenâs close relationships also point to the importance of evaluating the impact of programs affecting families (such as welfare reform, child care policies, and economic/child support policies) through the prism of young childrenâs relational needs.
T267 Family Resources10 he previous chapter illustrated the many ways in which young childrenâs relationships with their care- givers at home influence the course of their development. A central mes- sage was that parenting and its consequences always occur in a context larger than the family unit. In this chapter and the next two, we examine these contexts, looking first at the socioeconomic resources available in childrenâs families and then at the child care and community settings in which children grow up. Questions about the developmental consequences of parental education, family income, parental work and occupational sta- tus, and family structureâthe indicators of family socioeconomic re- sourcesâhave long occupied the attention of scientists. They have also been an enduring focal point of policy making on behalf of children and families, starting with the War on Poverty in the 1960s and leading up to present-day welfare reforms. Today, this work is undergoing a transition from asking whether fam- ily resources affect child development to asking why research shows so consistently that they do. This shift in emphasis is described in this chapter, starting with the evidence linking family resources to developmental out- comes and then summarizing what has been learned about the mechanisms that account for the links. New in this research is an emphasis on the dynamic nature of resourcesâincluding changes in family income and em- ployment and movements in and out of povertyâas well as the differential impact of poverty depending on the childâs age. Questions are now being asked, as well, about how much improvement in income or parental educa-