PEDIATRICS Vol. 104 No. 6 December 1999, pp. 1264-1273
Parental Stress and Parent-rated Child Behavior in Relation to Otitis Media in the First Three Years of Life
Received Mar 25, 1999; accepted May 26, 1999.
,,,, and
From the * Department of Pediatrics, University of Pittsburgh
School of Medicine; Department of Pediatrics, Children's Hospital
of Pittsburgh; § Department of Communication Science and Disorders,
University of Pittsburgh; ¶ Department of Audiology and Communication
Disorders, Children's Hospital of Pittsburgh; # Department of
Biostatistics, University of Pittsburgh Graduate School of Public
Health; ** Department of Family Medicine and Clinical Epidemiology,
University of Pittsburgh School of Medicine; and Department of
Otolaryngology, University of Pittsburgh School of Medicine,
Pittsburgh, Pennsylvania.
Objective. As part of a long-term study of possible effects of early-life otitis media on speech, language, cognitive, and psychosocial development, we tested relationships between parents' ratings of parent-child stress at ages 1, 2, and 3 years, and of their children's behavior problems at ages 2 and 3 years, and the children's cumulative duration of middle-ear effusion (MEE) in their first 3 years of life.
Methods. We enrolled healthy infants by age 2 months who presented for primary care at 1 of 2 urban hospitals or 1 of 2 small-town/rural and 4 suburban private pediatric practices. We obtained standardized baseline measures of parental stress; we intensively monitored the children's middle-ear status by pneumatic otoscopy, supplemented by tympanometry, throughout their first 3 years of life; we monitored the validity of the otoscopic observations on an ongoing basis; and we treated children for otitis media according to specified guidelines. We obtained parent ratings of parental stress using the Parenting Stress Index/Short Form when the children reached ages 1, 2, and 3 years, and parent ratings of children's behavior using the Child Behavior Checklist when the children reached ages 2 and 3 years.
Results. In 2278 children we found no substantial relationships between parents' ratings of parent-child stress when the children reached ages 1, 2, and 3 years, or of their children's behavior problems at ages 2 and 3 years, and the cumulative duration of the children's MEE during antecedent periods. On the other hand, ratings both of parent-child stress and of behavior problems were consistently highest among the most socioeconomically disadvantaged children and lowest among the most socioeconomically advantaged children. Ratings also tended to be highest among children whose parents' baseline stress scores were highest.
Conclusions. Parent-child stress and children's behavior problems in the first 3 years of life, as rated by parents, bear little or no relationship to the children's previous cumulative duration of MEE. Key words: parent-child stress, behavior, behavior problems, otitis media, middle-ear effusion, parent ratings.
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