Maternal Perception of Child Vulnerability in Preschoolers Born Very Low Birth Weight Peggy MacLean, Ph.D., Sarah Erickson, Ph.D., & Jean Lowe Ph.D. Perceptions held by parents that one’s child is highly vulnerable to illness, injury, and/or death Many have discussed the risk of PPCV among parents of children born preterm Are parents of children born preterm more vulnerable to PPCV? Few studies comparing preterm versus full-term Findings are mixed (Perrin et al., 1989; Stern et al., 2004) Although warranted & potentially adaptive at first, the continuation of PPCV after a child is considered healthy may be maladaptive

PPCV has also been associated with a host of maternal psychosocial, child neonatal health factors, & maternal socio- demographic factors  More current child health factors have not fully examined though Study Overview Examine the relationship between PPCV & observed maternal behaviors (i.e., maternal overprotection, maternal hostility, maternal responsiveness) during mother-child interaction tasks Clarify the relative role of health-related variables in PPCV Examine the role of contextual factors in PPCV, more specifically maternal psychosocial factors, child health-related factors, & socio-demographic factors

Sample Information: 54 children (21 girls, 34 boys) between 36 & 54 months with: Birth weights <1500g (mean= , SD= ) Gestational ages < 32 wks (mean= 29.25, SD= 2.32) 13 were Caucasian, 31 were Hispanic, 5 were Native American, & 5 were African Americans Mean length of NICU hospitalization= 57.39, SD=36.28 Study Variables/ Measures PPCV →Child Vulnerability Scale Maternal intrusiveness, hostility, & responsiveness→ National Institute of Child Health and Human Development Early Child Care Study coding system Neonatal illness severity→ Length of ventilation Post-neonatal health → # of rehospitalizations, # of current medication, & height & weight for age Functional health impairment → Health Status Classification System-Preschool Version

Study Variables/ Measures Cont’d Socio-demographic factors →Maternal age, household income, maternal relationship status, maternal education level, child age, child gender Maternal psychosocial factors  Depression symptoms → Beck Depression Inventory-II  Anxiety symptoms → State-Trait Anxiety Inventory  Maternal sense of parenting confidence → Sense of Competence Scale of the Parenting Stress Index  Maternal perception of social support → Personal Resource Questionnaire When looking at the whole sample: Scores on the CVS were generally low (mean of 5.65, SD=3.96) PPCV was not significantly related to observed maternal intrusiveness, hostility, & responsively, even after controlling for child health factors When examining relative contributions of child health-related factors: child rehospitalization (b =.314, t(1, 51) = 2.59, p <.05)

When examining relative contributions of all factors: Maternal depressive symptoms (b =.457, t(2, 48) = 3.768, p <.001) & child rehospitalization (b =.366, t(2, 48) = 3.018, p <.01) When looking at mothers who scored in the clinical range: Correlation between CVS & observed maternal responsiveness=.572 (ns) When examining relative contributions of all factors: only child’s functional health impairment (b =.795, t(1, 9) = 3.708, p <.01) Implications: Overall low scores, comparable to mothers of full-term healthy children Highlights the importance of examining PPCV in older children born preterm Importance of current health factors # of rehospitalizations→ Reminder of continued health difficulties?  McCormick et al., 1993 Child functional health impairments → Daily reminders? Importance of maternal psychosocial health → Depressive symptoms