Miami University 21st Century

As we have read and explored parenting in chapters 8 and 9, we have been presented with many topics and information about parenting today and the highs and lows of it all.

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Our book presents many of them and you are not limited to this; you may bring up any challenges that you see that you want to bring up in this discussion and do your best to make course connections to these insights.


This chapter responds to the first part of the committee’s charge—to identify core parenting knowledge, attitudes, and practices that are associated with positive parent-child interactions and the healthy development of children ages birth to 8. The chapter also describes findings from research regarding how core parenting knowledge, attitudes, and practices may differ by specific characteristics of children and parents, as well as by context. The chapter begins by defining desired outcomes for children that appear frequently in the research literature and inform efforts by agencies at the federal, state, and local levels to promote child health and well-being. It then reviews the knowledge, attitudes, and practices identified in the literature as core—those most strongly associated with healthy child development—drawing primarily on correlational and experimental studies. This is followed by brief discussion of the family system as a key source of additional determinants of parenting. The chapter concludes with a summary. The core knowledge, attitudes, and practices identified in this chapter serve as a foundation, along with contextual factors that affect parenting, for the committee’s review of the effectiveness of strategies for strengthening parenting capacity in subsequent chapters of this report.

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To determine the salient features of core parenting knowledge, attitudes, and practices, the committee first identified desired outcomes for children. Identifying these outcomes grounds the discussion of core parenting knowledge, attitudes, and practices and helps researchers, practitioners, and policy makers establish priorities for investment, develop policies that provide optimal conditions for success, advocate for the adoption and implementation of appropriate evidence-based interventions, and utilize data to assess and improve the effectiveness of specific policies and programs.

Child outcomes are interconnected within and across diverse domains of development. They result from and are enhanced by early positive and supportive interactions with parents and other caregivers. These early interactions can have a long-lasting ripple effect on development across the life course, whereby the function of one domain of development influences another domain over time. In the words of Masten and Cicchetti (2010, p. 492), “effectiveness in one domain of competence in one period of life becomes the scaffold on which later competence in newly emerging domains develops . . . competence begets competence.” From the literature, the committee identified the following four outcomes as fundamental to children’s well-being. While the committee focused on young children (ages 0-8), these outcomes are important for children of all ages.


Children need to be cared for in a way that promotes their ability to thrive and ensures their survival and protection from injury and physical and sexual maltreatment. While such safety needs are important for all children, they are especially critical for young children, who typically lack the individual resources required to avoid dangers (National Research Council and Institute of Medicine, 2000). Rather, young children rely on parents and other primary caregivers, inside and outside the home, to act on their behalf to protect their safety and healthy development (Institute of Medicine and National Research Council, 2015). At the most basic level, children must receive the care, as reflected in a number of emotional and physiological protections, necessary to meet normative standards for growth and physical development, such as guidelines for healthy weight and receipt of recommended vaccinations (Institute of Medicine and National Research Council, 2015). Physical health and safety are fundamental for achieving all of the other outcomes described below.


Children need care that promotes positive emotional health and well-being and that supports their overall mental health, including a positive sense of self, as well as the ability to cope with stressful situations, temper emotional arousal, overcome fears, and accept disappointments and frustrations. Parents and other caregivers are essential resources for children in managing emotional arousal, coping, and managing behavior. They serve in this role by providing positive affirmations, conveying love and respect and engendering a sense of security. Provision of support by parents helps minimize the risk of internalizing behaviors, such as those associated with anxiety and depression, which can impair children’s adjustment and ability to function well at home, at school, and in the community (Osofsky and Fitzgerald, 2000). Such symptoms as extreme fearfulness, helplessness, hopelessness, apathy, depression, and withdrawal are indicators of emotional difficulty that have been observed among very young children who experience inadequate parental care (Osofsky and Fitzgerald, 2000).


Children who possess basic social competence are able to develop and maintain positive relationships with peers and adults (Semrud-Clikeman, 2007). Social competence, which is intertwined with other areas of development (e.g., cognitive, physical, emotional, and linguistic), also may include children’s ability to get along with and respect others, such as those of a different race or ethnicity, religion, sexual orientation, or economic background (Institute of Medicine and National Research Council, 2015). Basic social skills include a range of prosocial behaviors, such as empathy and concern for the feelings of others, cooperation, sharing, and perspective taking, all of which are positively associated with children’s success both in school and in nonacademic settings and can be fostered by parents and other caregivers (Durlak et al., 2011; Fantuzzo et al., 2007). These skills are associated with children’s future success across a wide range of contexts in adulthood (e.g., school, work, family life) (Elias, 2006; Fantuzzo et al., 2007).


Cognitive competence encompasses the skills and capacities needed at each age and stage of development to succeed in school and in the world at large. Children’s cognitive competence is defined by skills in language and communication, as well as reading, writing, mathematics, and problem solving. Children benefit from stimulating, challenging, and supportive environments in which to develop these skills, which serve as a foundation for healthy self-regulatory practices and modes of persistence required for academic success (Gottfried, 2013).

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The child outcomes described above provide the context for considering the range of parenting knowledge, attitudes, and practices and identifying those that research supports as core. As noted in Chapter 1, the term “knowledge” for the purposes of this report refers to facts, information, and skills gained through experience or education and understanding of an issue or phenomenon. “Attitudes” refers to viewpoints, perspectives, reactions, or settled ways of thinking about aspects of parenting or child development, including parents’ roles and responsibilities. Attitudes may be related to cultural beliefs founded in common experience. And “practices” refers to parenting behaviors or approaches to childrearing that can shape how a child develops. Generally speaking, knowledge relates to cognition, attitudes relate to motivation, and practices relate to ways of engaging or behavior, but all three may emanate from a common source.

These three components are reciprocal and intertwined theoretically, empirically, and bidirectionally, informing one another. For example, practices are related to knowledge and attitudes, and often involve the application of knowledge. According to behavior modification theory (Ajzen and Fishbein, 1980; Fishbein et al., 2001), a person’s attitude often determines whether he or she will use knowledge and transform it into practice. In short, if one does not believe in or value knowledge, one is less likely to act upon it. What parents learn through the practice of parenting can also be a source of knowledge and can shape parents’ attitudes. Parenting attitudes are influenced as well by parenting self-efficacy, which has been broadly defined as the level of parents’ self-belief about their ability to succeed in the parenting role (Jones and Prinz, 2005).

Parenting knowledge, attitudes, and practices are shaped not only by each other but also by a number of contextual factors, including children’s characteristics (e.g., gender, temperament); parents’ own experiences (e.g., those from their own childhood) and circumstances; expectations learned from others, such as family, friends, and other social networks; and cultural systems. Of particular relevance to this study, the contextual factors that influence parenting knowledge, attitudes, and practices also include the supports available within the larger community and provided by institutions, as well as by policies that affect the nature and availability of supportive services.

In response to the study charge (Box 1-2 in Chapter 1), this chapter presents the evidence on core parenting knowledge, attitudes, and practices separately. However, it should be noted that in the research literature, the distinctions among these concepts, especially knowledge and attitudes, are not well-delineated and that the applications of these concepts to parenting often are equally informed by professional wisdom and historical observation.


Parenting is multidimensional. To respond to the varied needs of their children, parents must develop both depth and breadth of knowledge, ranging from being aware of developmental milestones and norms that help in keeping children safe and healthy to understanding the role of professionals (e.g., educators, child care workers, health care providers, social workers) and social systems (e.g., institutions, laws, policies) that interact with families and support parenting. This section describes these areas of knowledge, as well as others, identified by the available empirical evidence as supporting core parenting practices and child outcomes. It is worth noting that the research base regarding the association between parental knowledge and child outcomes is much smaller than that on parenting practices and child outcomes (Winter et al., 2012). Where data exist, they are based largely on correlational rather than experimental studies.



[Some parents recognized the need for education related to providing care for young children.]

“I am a new parent and even though I have a bachelor’s degree from India, I do not have a particular education in child care. Just because I have a degree, it does not mean it is a degree on how to take care of a child.”

—Father from Omaha, Nebraska

The importance of parents’ knowledge of child development is a primary theme of many efforts to support parenting. Evidence-based recommendations issued by the American Psychological Association Task Force on Evidence-Based Practice with Children and Adolescents (2008), the Centers for Disease Control and Prevention (CDC) (2015b), and the World Health Organization (WHO) (2009) emphasize the need for policy and program initiatives to promote parenting knowledge. As they suggest, to optimize children’s development, parents need a basic understanding of infant and child developmental milestones and norms and the types of parenting practices that promote children’s achievement of these milestones (Belcher et al., 2007; Benasich and Brooks-Gunn, 1996, p. 1187; Bond and Burns, 2006; Bornstein and Cote, 2004; Hess et al., 2004; Huang et al., 2005; Larsen and Juhasz, 1985; Mercy and Saul, 2009).

A robust body of correlational research demonstrates tremendous variation in parents’ knowledge about childrearing. Several of these studies suggest that parents with higher levels of education tend to know more about child developmental milestones and processes (Bornstein et al., 2010; Conrad et al., 1992; Hess et al., 2004; Huang et al., 2005), as well as effective parenting strategies (Morawska et al., 2009). This greater knowledge may reflect differential access to accurate information, differences in parents’ trust in the information or information source, and parents’ comfort with their own abilities, among other factors. For example, research shows that parents who do not teach math in the home tend to have less knowledge about elementary math, doubt their competence, or value math less than other skills (Blevins-Knabe et al., 2000; Cannon and Ginsburg, 2008; Vukovic and Lesaux, 2013). However, parents’ knowledge and willingness to increase their knowledge may change; thus, they can acquire developmental knowledge that can help them employ effective parenting practices.


[Some parents recognized the need for comprehensive parenting education.]

“I always prefer education for the parents, from the beginning to the end. From pregnancy, some don’t know when to go to the doctor, and after birth, when to go to the hospital or the doctor. So we need education from the beginning to the end.”

—Mother from Omaha, Nebraska

The focus on parental knowledge as a point of intervention is important because parents’ knowledge of child development is related to their practices and behaviors (Okagaki and Bingham, 2005). For example, mothers who have a strong body of knowledge of child development have been found to interact with their children more positively compared with mothers with less knowledge (Bornstein and Bradley, 2012; Huang et al., 2005). Parents who understand child development also are less likely to have age-inappropriate expectations for their child, which affects the use of appropriate discipline and the nature and quality of parent-child interactions (Goodnow, 1988; Huang et al., 2005).

Support for the importance of parenting knowledge to parenting practices is found in multiple sources and is applicable to a range of cognitive and social-emotional behaviors and practices. Several correlational studies show that mothers with high knowledge of child development are more likely to provide books and learning materials tailored to children’s interests and age and engage in more reading, talking, and storytelling relative to mothers with less knowledge (Curenton and Justice, 2004; Gardner-Neblett et al., 2012; Grusec, 2011). Fathers’ understanding of their young children’s development in language and literacy is associated with being better prepared to support their children (Cabrera et al., 2014). And parents who do not know that learning begins at birth are less likely to engage in practices that promote learning during infancy (e.g., reading to infants) or appreciate the importance of exposing infants and young children to hearing words and using language. For example, mothers who assume that very young children are not attentive have been found to be less likely to respond to their children’s attempts to engage and interact with them (Putnam et al., 2002).

Stronger evidence of the role of knowledge of child development in supporting parenting outcomes comes from intervention research. Randomized controlled trial interventions have found that parents of young children showed increases in knowledge about children’s development and practices pertaining to early childhood care and feeding (Alkon et al., 2014; Yousafzai et al., 2015).

Some studies have found a direct association between parental knowledge and child outcomes, including reduced behavioral challenges and improvements on measures of cognitive and motor performance (Benasich and Brooks-Gunn, 1996; Dichtelmiller et al., 1992; Hunt and Paraskevopoulos, 1980; Rowe et al., 2015). In an analysis of data from a prospective cohort study that controlled for potential confounders, children of mothers with greater knowledge of child development at 12 months were less likely to have behavior problems and scored higher on child IQ tests at 36 months relative to children of mothers with less developmental knowledge (Benasich and Brooks-Gunn, 1996). This and other observational studies also show that parental knowledge is associated with improved parenting and quality of the home environment, which, in turn, is associated with children’s outcomes (Benasich and Brooks-Gunn, 1996; Parks and Smeriglio, 1986; Winter et al., 2012), in addition to being contingent on parental attitudes and competence (Conrad et al., 1992; Hess et al., 2004; Murphy et al., 2015).

Experimental studies of parent education interventions support these associational findings. In an experimental study of parent education for first-time fathers, fathers, along with home visitors, reviewed examples of parental sensitivity and responsiveness from videos of themselves playing with their children (Magill-Evans et al., 2007). These fathers showed a significant increase in parenting competence and skills in fostering their children’s cognitive growth as well as sensitivity to infant cues 2 months after the program, compared with fathers in the control group, who discussed age-appropriate toys with the home visitor (Magill-Evans et al., 2007). Another experimental study examined a 13-week population-level behavioral parenting program and found intervention effects on parenting knowledge for mothers and, among the highest-risk families, increased involvement in children’s early learning and improved behavior management practices. Lower rates of conduct problems for boys at high risk of problem behavior also were found (Dawson-McClure et al., 2015).


Parents’ knowledge of how to meet their children’s basic physical (e.g., hunger) and emotional (e.g., wanting to be held or soothed) needs, as well as of how to read infants’ cues and signals, can improve the synchronicity between parent and child, ensuring proper child growth and development. Specifically, parenting knowledge about proper nutrition, safe sleep environments, how to sooth a crying baby, and how to show love and affection is critical for young children’s optimal development (Bowlby, 2008; Chung-Park, 2012; Regalado and Halfon, 2001; Zarnowiecki et al., 2011).

For many parents, for example, infant crying is a great challenge during the first months of life. Parents who cannot calm their crying babies suffer from sleep deprivation, have self-doubt, may stop breastfeeding earlier, and may experience more conflict and discord with their partners and children (Boukydis and Lester, 1985; Karp, 2008). Correlational research indicates that improvement in parental knowledge about normal infant crying is associated with reductions in unnecessary medical emergency room visits for infants (Barr et al., 2015). That knowledge leads to changes in behavior is further supported in systematic reviews by Bryanton and colleagues (2013) of randomized controlled trials and Middlemiss and colleagues (2015) of studies with various design types, with both groups reporting that increases in mother’s knowledge about infant behavior is associated with positive changes in the home environment, as well as improvements in infant sleep time.

Specific knowledge about health and safety—including knowledge about how to access health care, protect children from physical harm (e.g., the importance of wearing a seat belt or a helmet), and promote good hygiene and nutrition—is a key parenting competency. Experimental studies show, for example, a positive link between parents’ knowledge of nutrition and both children’s intake of nutritious foods and reduced calorie and sodium intake (Campbell et al., 2013; Katz et al., 2011). In a randomized controlled trial, Campbell and colleagues (2013) found that children whose parents received knowledge, skills, and social support related to infant feeding, diet, physical activity, and television viewing consumed fewer sweet snacks and spent fewer minutes daily viewing television relative to children whose parents were in the control group (Campbell et al., 2013). Also associated with children’s intake of nutritious foods is parents’ modeling of good eating habits and nutritional practices (Mazarello Paes et al., 2015).

In addition, although limited in scope, correlational evidence shows that parents with knowledge about immunization are more likely to understand its purpose and comply with the timetable for vaccinations (Smailbegovic et al., 2003); that parents with more knowledge about effective injury prevention practices are more likely to create safer home environments for their children and reduce unintentional injuries (Corrarino, 2013; Dowswell et al., 1996; Middlemiss et al., 2015; Morrongiello and Kiriakou, 2004); and that parents with knowledge about asthma are more likely to use an asthma management plan (Bryant-Stephens and Li, 2004; DeWalt et al., 2007; Harrington et al., 2015). Other studies have found that parents with more information about the purpose of vaccinations had greater knowledge of immunization than parents in the control group (Hofstetter et al., 2015; Jackson et al., 2011), and parents with more knowledge about sun safety provided sunscreen and protective clothing for their children, who presented with fewer sunburns (Crane et al., 2012).

Still, knowledge alone may not be sufficient in some cases. For example, knowing about the importance of using car seats does not always translate into good car seat practices (Yanchar et al., 2012, 2015), and knowledge about the advantages of vaccines may not result in parents choosing to vaccinate their children. Some findings suggest that using multiple modes of delivery is important to advancing parents’ knowledge. In an experimental study, for example, Dunn and colleagues (1998) found that parents who received educational information about child vaccinations via videotape as well as in written form showed greater gains in understanding about vaccinations than parents who received the information in written form alone.

The evidence linking parental knowledge about the specific ways in which parents can help children develop cognitive and academic skills, including skills in math, is limited. However, the available correlational data show that parents who know about how children develop language are more likely to have children with emergent literacy skills (e.g., letter sound awareness) relative to parents who do not (Ladd et al., 2011). Several studies over the past 20 years have described parents’ increasing knowledge and use of approaches for supporting children’s literacy (Clark, 2007; National Research Council, 1998; Sénéchal and LeFevre, 2002). Much of this work has focused on book reading and parent-child engagement around reading (Hindman et al., 2008; Mol et al., 2008; Morrow et al., 1990). As early as the 1960s, Durkin (1966) and others referred to the important role of the home literacy environment and parents’ beliefs about reading in children’s early literacy development.


Little is known about parents’ knowledge of various supports—such as educators, social workers, health care providers, and extended family—and the relationship between their conceptions of the roles of these supports and their use of them.

To take an example, parents’ knowledge about child care and their school decision-making processes are informed in a variety of ways through these different supports. In their literature review of child care decision making, Forry and colleagues (2013) found that many low-income parents learn about their child care options through their social networks rather than through professionals or referral agencies. While many parents say they highly value quality, their choices also may reflect a range of other factors that are valued. Parents tend to make child care decisions based on structural (teacher education and training) and process (activities, parent-provider communication) features, although their choices also vary by family income, education, and work schedules. Sosinsky and Kim (2013), for example, found that higher maternal education and income and being white were associated with the likelihood of parents choosing higher-quality child care programs that were associated with better child outcomes. Based on a survey of parents of children in a large public school system, Goldring and Phillips (2008) found that parents’ involvement, not satisfaction with their child’s school, was associated with school decision making. It should be noted that while parents may know what constitutes high-quality child care and education, structural (availability of quality programs and schools), individual (work, income, belief), and child (temperament, age) factors also influence these decision-making processes (Meyers and Jordan, 2006; Shlay, 2010).

Taking another example, limited studies have looked at parental awareness of services for children with special needs. A study that utilized a survey and qualitative interviews with parents of children with autism indicated that parents’ autism spectrum disorder service knowledge partially mediates the relationship between socioeconomic status and use of services for their children (Pickard and Ingersoll, 2015).


Although considerable discussion has focused on attitudes and beliefs broadly, less research attention has been paid to the effects of parenting attitudes on parents’ interactions with young children or on parenting practices. Few causal analyses are available to test whether parenting attitudes actually affect parenting practices, positive parent-child interaction, and child development. Even less research exists on fathers’ attitudes about parenting. Given this limited evidence base, the committee drew primarily on correlational and qualitative studies in examining parenting attitudes.

Parents’ attitudes toward parenting are a product of their knowledge of parenting and the values and goals (or expectations) they have for their children’s development, which in turn are informed by cultural, social, and societal images, as well as parents’ experiences and their overall values and goals (Cabrera et al., 2000; Cheah and Chirkov, 2008; Iruka et al., 2015; Okagaki and Bingham, 2005; Rogoff, 2003; Rosenthal and Roer-Strier, 2006; Whiting and Whiting, 1975). People in the United States hold several universal, or near universal, beliefs about the types of parental behaviors that promote or impair child development. For example, there is general agreement that striking a child in a manner that can cause severe injury, engaging in sexual activity with a child, and failing to provide adequate food for and supervision of young children (such as leaving toddlers unattended) pose threats to children’s health and safety and are unacceptable. At the same time, some studies identify differences in parents’ goals for child development, which may influence attitudes regarding the roles of parents and have implications for efforts to promote particular parenting practices.

While there is variability within demographic groups in parenting attitudes and practices, some research shows differences in attitudes and practices among subpopulations. For example, qualitative research provides some evidence of variation by culture in parents’ goals for their children’s socialization. In one interview study, mothers who were first-generation immigrants to the United States from Central America emphasized long-term socialization goals related to proper demeanor for their children, while European American mothers emphasized self-maximization (Leyendecker et al., 2002). In another interview study, Anglo American mothers stressed the importance of their young children developing a balance between autonomy and relatedness, whereas Puerto Rican mothers focused on appropriate levels of relatedness, including courtesy and respectful attentiveness (Harwood et al., 1997). Other ethnographic and qualitative research shows that parents from different cultural groups select cultural values and norms from their country of origin as well as from their host country, and that their goal is for their children to adapt and succeed in the United States (Rogoff, 2003).

Similarly, whereas the larger U.S. society has historically viewed individual freedom as an important value, some communities place more emphasis on interdependence (Elmore and Gaylord-Harden, 2013; Sarche and Spicer, 2008). The importance of intergenerational connections (e.g., extended family members serving as primary caregivers for young children) also varies among and within cultural communities (Bertera and Crewe, 2013; Mutchler et al., 2007). The values and traditions of cultural communities may be expressed as differences in parents’ views regarding gender roles, in parents’ goals for children, and in their attitudes related to childrearing.


[One parent described differences between men and women in parenting roles.]

“Mothers play the main role as parents in [certain cultures]. Culturally men aren’t that involved. The dad is the outer worker; the mother is the inner worker. If you are talking about the mom, they are the ones who care about the kids. They aren’t typically working outside the home. But now, in the United States, the mothers are working outside the home.”

—Father from Omaha, Nebraska

Although slowly changing, attitudes about the roles of men and women in the raising of young children often differ between men and women and among various communities in the United States. Longitudinal research on mothers’ attitudes toward fathers’ involvement in childrearing has made reference to the “gatekeeping” role of mothers of children with nonresidential fathers (Fagan and Barnett, 2003; Schoppe-Sullivan et al., 2008). Research has shown that fathers of young children participate in child caregiving activities in increasing numbers (Cabrera et al., 2011), but has not examined the specific attitudes that fathers bring to particular parenting behaviors across the life span. Parents’ values and goals related to childrearing, both overall and for specific demographic groups, also may shift from one generation to the next in the United States based on changing norms and viewpoints within social networks and cultural communities, as well as parents’ knowledge of and access to new research and information provided by educators, health care providers, and others who work with families.

Relatively little research has been conducted on parents’ attitudes toward specific parenting-related practices. Much of the extant research focuses on practices related to promoting children’s physical health and safety. Studies of varying designs indicate that parental attitudes and beliefs about the need for and safety of vaccination influence vaccination practices (Mergler et al., 2013; Salathé and Bonhoeffer, 2008; Vannice et al., 2011; Yaqub et al., 2014). Maternal attitudes and beliefs about breastfeeding (e.g., views about breastfeeding in public, the belief that it will be uncomfortable) are associated with initiation and continuation of breastfeeding and appear to factor into differences in breastfeeding rates and practices observed across cultural and other demographic groups in cross-sectional survey and qualitative research (Vaaler et al., 2010; Wojcicki et al., 2010). Other studies have found differences among parents (e.g., those living in rural versus urban areas) in attitudes about the importance of monitoring children’s activities and whereabouts (Armistead et al., 2002; Jones et al., 2003) and parents’ beliefs about young children’s literacy development (Lynch et al., 2006).

Parental involvement in children’s education has been linked to academic readiness (Fan and Chen, 2001). However, parents differ in their attitudes about the role of parents in children’s learning and education (Hammer et al., 2007). Some see parents as having a central role, while others view the school as the primary facilitator of children’s education and see parents as having less of a role (Hammer et al., 2007). These attitudinal differences may be related to cultural expectations or parents’ own education or comfort with teaching their children certain skills. Some parents, for example, may have lower involvement in their children’s education because of insecurity about their own skills and past negative experiences in school (Lareau, 1989; Lawrence-Lightfoot, 2003). And as discussed above, some parents view math skills as less important for their children relative to other types of skills and therefore are less likely to teach them in the home.

Parents within and across different communities vary in their opinions and practices with respect to the role and significance of discipline. Some of the parenting literature notes that some parents use control to discipline children, while others aim to correct but not to control children (Nieman and Shea, 2004). In a small cross-cultural ethnographic study, Mosier and Rogoff (2003) found that some parents regard rules and punishment as inappropriate for infants and toddlers. The approach valued by these parents to help children understand what is expected of them is to cooperate with them, perhaps distracting them but not forcing their compliance. In contrast, many middle-class U.S. parents display a preference for applying the same rules to infants and toddlers that older children are expected to follow, although with some lenience (Mosier and Rogoff, 2003). And ethnographic research provides some evidence of differences in African American and European American mothers’ beliefs about spoiling and infant intentionality (whether infants can intentionally misbehave) related to the use of physical punishment with young children (Burchinal et al., 2010).

Parents’ attitudes not only toward parenting but also toward providers in societal agencies—such as educators, social service personnel, health care providers, and police—which can be shaped by a variety of factors, including discrimination, are important determinants of parents’ access to and ability to obtain support. Studies show a relationship between parents’ distrust of agencies and their likelihood of rejecting participation in an intervention. For example, in systematic reviews of studies of various types, parents who distrust the medical community and government health agencies are less likely to have their children vaccinated (Brown et al., 2010; Mills et al., 2005). Racial and ethnic minority parents whose attitudes about appropriate remedies for young children vary from those of the Western medical establishment often distrust and avoid treatment by Western medical practitioners (Hannan, 2015). While not specific to parents, studies using various methodologies show that individuals who have experienced racial and other forms of discrimination, both within and outside of health care settings, are less likely to utilize various health services or to engage in other health-promoting behaviors (Gonzales et al., 2013; Institute of Medicine, 2003; Pascoe and Smart Richman, 2009; Shavers et al., 2012). In a survey study, African American parents’ racism awareness was negatively associated with involvement in activities at their children’s school (McKay et al., 2003). Longitudinal studies, mostly involving families with older children, indicate that, like other sources of stress, parents’ experience of discrimination can have a detrimental effect on parenting and the quality of the parent-child relationship (Murray et al., 2001; Sanders-Phillips et al., 2009). Adverse outcomes for youth associated with their own experience of discrimination may be weakened by more nurturing/involved parenting (Brody et al., 2006; Gibbons et al., 2010; Simons et al., 2006).

As noted earlier, attitudes are shaped in part by parenting self-efficacy—a parent’s perceived ability to influence the development of his or her child. Parenting self-efficacy has been found to influence parenting competence (including engagement in some parenting practices) as well as child functioning (Jones and Prinz, 2005). Studies show associations between maternal self-efficacy and children’s self-regulation, social, and cognitive skills (Murry and Brody, 1999; Swick and Hassell, 1990). Self-efficacy also may apply to parents’ confidence in their capacity to carry out specific parenting practices. For example, parents who reported a sense of efficacy in influencing their elementary school-age children’s school outcomes were more likely to help their children with school activities at home (Anderson and Minke, 2007). A multimethod study of African American families found that maternal self-efficacy was related to children’s regulatory skills through its association with competence-promoting parenting practices, which included family routines, quality of mother-child interactions based on observer ratings, and teachers’ reports of mothers’ involvement with their children’s schools (Brody et al., 1999). Henshaw and colleagues (2015) found in a longitudinal study that higher breastfeeding self-efficacy predicted exclusive breastfeeding at 6 months postpartum, as well as better emotional adjustment of mothers in the weeks after giving birth.


Parenting practices have been studied extensively, with some research showing strong associations between certain practices and positive child outcomes. This section describes parenting practices that research indicates are central to helping children achieve basic outcomes in the areas discussed at the beginning of the chapter: physical health and safety, emotional and behavioral competence, social competence, and cognitive competence. While these outcomes are used as a partial organizing framework for this section, several specific practices—contingent responsiveness of parents, organization of the home environment and the importance of routines, and behavioral discipline practices—that have been found to influence child well-being in more than one of these four outcome areas are discussed separately.


Parents influence the heal

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