Parenting style associations with sensory threshold and behaviour: a prospective cohort study in term/preterm infants

Abstract

Aim: Early-life atypical sensory functioning and behavioural profiles are often associated with long-term developmental problems, especially in former preterm infants. We tested whether parenting style is associated with atypical sensory threshold or behavioural outcomes in preterm and term infants assessed during early childhood.

Methods: We prospectively evaluated parenting style for a cohort of term and preterm infants who had previous assessments of sensory development and behaviour. We used standardised tools to evaluate parenting style, sensory neurological threshold at one year, and internalising and externalising behavioural tendencies at two years. Covariates included gestational age, sex and maternal education.

Results: For the entire cohort (n = 82), children of more permissive parents were 2.7 times more likely to demonstrate abnormal sensory neurological thresholds compared to children of parents with less permissive styles (CI: 1.4-4.9). More permissive parenting scores were also associated with 2.4 times increased internalising (CI: 1.3-4.2) and 3.0 times increased externalising (CI: 1.6-5.6) tendencies. In the preterm group only, higher authoritative parenting scores were associated with fewer behavioural problems.

Conclusion: Permissive parenting is associated with worse infant sensory and behavioural outcomes. Authoritative parenting is associated with fewer behavioural problems in preterm children. Modification of parenting style may improve sensory development and behavioural outcomes.

Keywords: Behavioural and learning problems; Neurodevelopment; Parenting; Preterm children.

Figure 1

Progression and influences on infant neurodevelopment (modified from Maitre review of Neurorehabilitation) (4). The neonatal brain at birth is immature and is influenced by prenatal, birth and postnatal events. Development of the sensory system, one of the first systems to develop, is influenced by both brain maturation and experience, and in turn influences behaviour. Although parenting is a key environmental factor in infants, associations between parenting and sensory systems and behavioural outcomes are not well studied.

Figure 2

Study population. Subjects were derived from a cohort of preterm and term infants whose parents completed the Parenting Styles and Dimensions Questionnaire (PSDQ). Multiple imputation was used to account for missing data. Results for both ITSP and CBCL were available in 73 infants. CBCL = Child Behavior Checklist; ITSP = Infant/Toddler Sensory Profile.

Figure 3

Odds ratios with 95% confidence intervals for associations between each parenting style and abnormal neurological threshold for the entire cohort and in group analysis by term or preterm status. The adjusted analysis accounts for gestational age at birth. Permissive parenting is associated with abnormal neurological thresholds in all groups.

Figure 4

Associations between parenting style and internalising (A) and externalising (B) tendencies at two years corrected age for the cohort. Odds ratios and 95% confidence intervals are adjusted for gestational age and sex. Permissive parenting (high responsivity/low demandingness style) is associated with increased internalising and externalising scores.

Figure 5

Odds ratios (triangles) with 95% confidence intervals (lines) for associations between parenting styles and internalising (A,B) and externalising (C,D) tendencies for single groups [preterm (A,C), term (B,D)]. Panels E and F show the odds ratios (OR) and 95% confidence intervals (CI) for associations between permissive (E) and authoritative (F) parenting and atypical sensory neurological threshold and internalising and externalising behaviours in children. Since no significant associations were found between authoritarian parenting and outcomes, these data were not included. CIs not crossing one are statistically significant with p-values <0.05* on odds ordinal logistic regression analysis. More authoritative parenting is associated with fewer internalising and externalising behaviours in preterm children. More permissive parenting is associated with more internalising behaviours in term children and more externalising behaviours in term and preterm children.