Browsing by Title

Aims. Parents are most important communication partners for young child, and language, learning and memory skills develop via everyday parent-child interaction. Shared book reading is an interactive moment that fosters parents to use richer and more diverse language than they would otherwise be using in everyday life. Previous research on shared reading has focused particular on the association between reading and children’s language development and vocabulary. However, there are indications that shared reading could also support the development of a child’s later learning skills and memory. The aim of this study was to examine how shared reading (2;7–4;2 years) is connected to the language skills, learning skills and memory functions assessed by the parent of a five-year-old child. In addition, it is explored how shared reading (2;7–4;2 years) manages to explain the child's skills at the age of five, when the background factors are controlled. Methods. The study sample consisted of 70 typically developed Finnish-speaking children. The study sample is part of the LEINIKKI-study. Data on the amount of parents’ reading to a child was collected on a parent-report form. Children’s receptive and expressive language skills at the age 2,7-4,2 years were assessed with the Reynell Developmental Language Scales III. The children's skills at the age of five were assessed using the following sections from the The Five to Fifteen -parent-report questionnaire: Language, Learning, and Memory. The connection between the shared reading and the Language, Learning, and Memory skills at the age of five was analyzed with Spearman correlation, Mann-Whitney U-test, and linear regression analysis. Results and conclusions. Children, whose both parents red books often, had significantly better scores in all three skill areas (Language, Learning and Memory). Regression analysis showed that the more parents red to their 2.7 to 4.2 aged children the higher scores in Learning-section children had at the age of five. However, parents’ active reading to their child may enhance the development of the child’s later learning skills and potentially support children’s language skills and memory. The results of the study can be used to encourage parents to read to their children. Future studies should use larger sample size to confirm the longitudinal association of shared reading and later language, learning, and memory skills.

Objectives: Depression and parenting stress can have a dramatic influence on parenting. They are also associated with various negative emotional states that can affect influence parent's assessment of their child. For example, maternal depression is linked with more negative evaluation of an infant's temperament. However, for parenting stress, previous research on the topic has been limited so far. The aim of this study is to investigate whether symptoms of depression and parenting stress are associated with more negative assessment of infant temperament at six months of age. Potential gender differences in assessment of temperament are also examined. Additionally, study examines how different domains of parenting stress impact the assessment of temperament. Methods: The study utilized data from the DyslexiaBaby project investigating the language development of children at risk for dyslexia. A total of 168 parent dyads were selected for the sample. The study used data on infant's temperament (IBQ-R-VSF), maternal depression (EPDS), and parenting stress of both parents (PSI-SF) at the age of 6 months. The association between depression and parenting stress with temperament assessment were examined using canonical correlation analysis. Results: Higher parenting stress, especially in mothers, was associated with more negative assessment of temperament. Maternal depression was not associated with a more negative assessment of temperament. Negative affect and effortful control affected the assessment of the temperament the most. Higher parenting stress in mothers was associated with lower assessments of an infant's surgency and effortful control, and higher assessments of negative affect. The infant's gender did not influence the assessment of early temperament. However, depression and parenting stress affected the assessment of temperament slightly differently on boys and girls. Parenting stress related to child's difficulty had the most significant impact on the assessment of temperament out of all the different domains of parenting stress. Conclusions: This study suggests that parenting stress can lead to a more negative assessment of a child's temperament. Previously, also depression has been linked to a more negative assessment of temperament. Because high parenting stress can affect the way that parents interpret their child's behavior, the effects of parenting stress need to be considered in future research and clinical work. Further research is needed to examine the simultaneous effects of parenting stress and depression on temperament in more clinical populations, in both mothers and fathers. More comprehensive assessment of temperament should also be considered in future research. In clinical settings, the identification of parenting stress holds significant importance not only for facilitating child development but also for promoting parental well-being. Challenges of families should be addressed early on, with a particular focus on providing preventive support to individuals at a higher risk of experiencing parenting difficulties during the transition to parenthood.

Objective. Parenting sense of competence (PSOC) is a key factor in parenting and for the development and well-being of a child. Preterm birth is one of the risk factors for early parenting, which can challenge early development of PSOC, and can increase the risk for parents’ depressive symptoms. The results about associations between preterm birth and PSOC are controversial. Research has also focused only on the first year after preterm birth and the dimensions of PSOC have been studied narrowly. Additionally, the factors which can affect the relationship between preterm birth and PSOC, are largely unknown. The aim of the current study was to investigate the associations between preterm birth and PSOC, and its subdimensions parenting self-efficacy and satisfaction, when the child was between 1–6 years old. Additionally, it was explored whether mothers’ symptoms of depression moderate or mediate these associations. Methods. The data in this study is part of the Finnish Prediction and prevention of preeclampsia and intrauterine growth restriction (PREDO) study. The sample (N=2420) includes 101 mothers whose child was born preterm (< 37 weeks of gestation) and 2319 mothers of children born full-term (37 – 41+6 weeks of gestation). Mothers evaluated their parenting sense of competence (Parenting Sense of Competence) and symptoms of depression (Beck Depression Inventory-II) when the child was between 1–6 years old. The associations, including steps of mediation analysis, were examined with linear and logistic regression models. Results and conclusions. The results of this study show that preterm birth is associated with lower PSOC and its subdimension of parenting self-efficacy, but not with satisfaction, when the child was between 1–6 years old. Mothers’ symptoms of depression did not moderate or mediate these associations. The results indicate that preterm birth can be one of the risk factors for PSOC and especially for parenting self-efficacy, and also regardless of mothers’ depression symptoms. The results add to previous knowledge about how preterm birth can affect parenting after child’s first year of life. Thus, after preterm birth, supporting PSOC as part of other parenting is recommendable long into childhood.

Objectives. Although children with language impairment typically have difficulties processing linguistic structures and with pragmatics, they have also been described as resourceful in conversations. Difficulties in linguistic skills affect speech production, causing communication breakdowns in conversations. When a problem occurs in a conversation, people can use compensatory strategies to get their message understood. These compensatory means can be verbal or non-verbal. There is only little research on children’s compensatory skills and how they act when a communicational problem occurs. Previous research has also been focused mainly in verbal communication. In order to gain an accurate understanding of a child’s linguistic performance, it is beneficial to gather individual information on how the child behaves in natural contexts. Especially the child’s parents are a valuable source of information in addition to a specialist’s assessment. The aim of this study was to examine the interactional skills of school-age children with specific language impairment and to describe what kind of compensatory strategies they use based on their parents’ observations. In addition, this study gathered information on parents’ experiences of the support the families have received. Methods. Twelve parents were interviewed in nine interviews for this study. The interviews were done in 2018. At the time, the children were aged between 6;2–10;0 years. This study used a semi-structured theme interview, and the data were analysed using a theory-driven content analysis. Results and conclusions. The parents reported that their children use several verbal and non-verbal compensational strategies. Pointing and the use of circumlocutions were the most reported strategies. It was also typical for the children that they relied on adult’s help to solve communicational breakdowns. The parents reported that they have found the best solutions and support methods for their family in daily living, but they also have received some advice from professionals. Family courses on SLI and peer support were reported as especially helpful and important support methods.

Aims and objectives. The field of speech and language therapy nowadays emphasizes the participation of client’s environments, such as the family. The importance of close environments is highlighted by e.g. the ecological systems theory, the ICF classification and the concept of zone of proximal development. To learn to communicate using a communication aid, a child needs modeling from a more competent interaction partner. Parents are usually essential interaction partners for their children, yet they need guidance and support to be able to model the use of the communication aid for their child. Previous research on parents’ experiences of guidance and support received for aided communication has been scarce. However, it has been noticed that inadequate support for parents can lead to abandonment of the communication aid. The objective of this study was to explore parents’ experiences of guidance and support on using their child’s communication aid. In addition, parents’ experiences of the challenges in the communication aid service delivery were studied, as well as experiences of their own role in the process. The study also examined parents’ views on how the support and guidance practices could be developed. Methods. The data of this study were gathered through semi-structured interviews. From seven different families, nine parents of children who were using a communication aid with an extensive vocabulary participated in the interviews. Data were analyzed using data driven content analysis. Results and conclusions. The results of this study indicated that parents receive guidance and support on using their child’s communication aid from several actors. The guidance and support were mainly considered insufficient in quantity but their content was mostly perceived adequate. Parents had positive experiences of e.g. guidance and support received from their child’s speech therapist, communication instruction, peer support, and technical support provided by the manufacturers and importers of communication aids. One of the main challenges parents had experienced in the process was that the communication aid was not always actively used in the daycare or school settings. Most of the parents had had an active, self-imposed role in the service delivery process, for example in finding services and information. Parents would develop the services provided to families e.g. by offering more guidance and support at the beginning of the process, by training professionals more comprehensively on augmentative and alternative communication, and by informing families more effectively of the services and support that are available. Based on the results of this study, the guidance and support on using a communication aid do not seem to be completely equally available for families, and parent’s own activeness appears to affect the access to services. Practices on providing guidance and support, informing parents of services and training professionals on aided communication may need to be improved and clarified. Parents’ experiences of the guidance and support vary individually, but the results of this study can help professionals develop their practices to support families.

Objective: Coparenting refers to co-operation and division of labour between parents in child rearing. The importance of coparenting for the well-being of whole family has been recognized in earlier studies, and interventions focusing on coparenting have been developed. However, the research on the effects of usual parenting interventions on coparenting is insufficient. The aim of the current study is to examine whether it is possible to support coparenting relationship between parents through usual parenting intervention that are municipally provided in Finland. In addition, the study focuses on the association between parents’ adverse childhood experiences (ACE), coparenting relationship and its possible change during interventions. There is widely demonstrated association between ACEs and worse overall well-being in adulthood. However, the research on the association between ACEs and coparenting is limited, and therefore that is investigated in this study. Methods: The current study is a part of a larger effectiveness study of Finnish community-based parenting interventions conducted by Tampere University in co-operation with University of Helsinki, and University of Turku. The study sample consisted of 245 mothers (having a baby younger than 1 year or expecting a baby) that participated in community-based parenting interventions in capital area of Finland (Helsinki, Espoo, Vantaa). 41 of the participants received practical support, 37 received short-term psychological services, and 83 intensive therapeutic support. Control group comprised 84 mothers recruited during routine visits to the child health clinics in the capital area of Finland. Coparenting difficulties were measured with Parenting Alliance Inventory in three measurement points: pre- and post-intervention and six months after the second measurement (control group was measured at the beginning of the study and six and twelve months after the first measurement). ACEs were measured by applying A Revised Inventory of Adverse Childhood Experiences at the beginning of the intervention (for control group at the beginning of the study). Changes in coparenting difficulties during the interventions and follow-up as well as the effect of ACEs on this change were evaluated using generalised linear mixed models and Gamma link function. The association between ACEs and coparenting difficulties at baseline was analysed using generalized linear model with Gamma link function. Results and conclusions: According to this study, coparenting difficulties declined during intervention and follow-up in all other groups except practical intervention group. Additionally, cumulative ACEs were associated with more coparenting difficulties at baseline. This is an important new finding that supports the previously observed association between ACEs and wide negative outcomes in adulthood. Furthermore, the effect of ACEs on the change of coparenting difficulties in control group was unlike that in therapeutic intervention group. In control group ACEs constituted a risk factor for coparenting difficulties, while therapeutic intervention seemed to protect from that risk. This result supports the above-mentioned association between ACEs and coparenting difficulties and suggests that ACEs also constitute a risk factor for the development of coparenting relationship. According to this study, especially therapeutic intervention seems to have potential supporting a coparenting relationship, which may be explained by the therapeutic elements. However, more research with larger sample sizes is needed to investigate different parenting interventions and their possibilities on supporting coparenting relationship, especially in risk groups like ACEs group.

Vanhuspalvelulaki astui voimaan vuonna 2013. Lain tehtävänä on ohjata kuntien toimintakäytänteitä turvaamaan tervettä ja toimintakykyistä ikääntymistä sekä parantamaan palveluiden laatua ja vaikuttavuutta iäkkäille. Suun terveydenhuollon osalta vanhuspalvelulaki edellyttää tarpeenmukaisten suun terveydenhuollon palvelujen järjestämistä iäkkäille. Aikuisväestön suun terveydentilan positiivisesta kehityssuunnasta huolimatta iäkkäät tarvitsisivat tutkimusten mukaan apua suun puhdistukseen sekä ammattilaisen suorittamaa hoitoa ja ennaltaehkäisyä suun terveyden parantamiseksi. Vanhuspalvelulain tärkeys perustuukin pitkälti iäkkäiden tarpeenmukaisen hoivan turvaamiseen, mutta sen toimeenpano asettaa kunnille haasteita niin resurssien kuin asenteidenkin puolesta. Tämän tutkimuksen tavoitteena oli selvittää ikääntyvien suun terveydenhuollon järjestämiseen liittyviä keskeisiä haasteita sekä kartoittaa kuntien käyttämiä keinoja vanhuspalvelulain huomioimiseksi palveluita järjestettäessä. Tutkimusaineisto kerättiin lähettämällä vuosina 2015 ja 2017 kuntien ylihammaslääkäreille sähköpostitse linkki e- lomakkeella toteutettuun kyselyyn. Tutkimusaineisto muodostuu siis kahdesta erillisestä poikkileikkaustutkimuksesta, joiden vastaajat vaihtelevat. Vuosien 2015 ja 2017 tuloksia verrattiin keskenään tilanteen sekä toimintakäytäntöjen kehittymisen arvioimiseksi pohtien, onko vanhuspalvelulaki ollut olennaisena syynä mahdollisiin muutoksiin. Tutkimuksessamme tarkastelemme kotona ja palveluasumisen piirissä asuvien, pitkäaikaispäätöksen laitoshoidosta saaneiden ja ympärivuorokautisessa hoivayksikössä asuvien vanhusten suun terveydenhuollon palveluita ja niiden järjestämistä. Tutkimustulostemme mukaan vanhuspalvelulaki on vaikuttanut eniten kotihoidon piirissä olevien ikääntyvien suun terveydenhuollon järjestämiseen. Suurin lain tuomia muutos on terveydenhuollon eri tahojen yhteistyön lisääntyminen. Yleisimpiä ongelmia vanhusten suun terveydenhuollon järjestämisessä ovat resurssipula, hoitohenkilöstön riittämättömyys sekä vanhusten vaikea hoidettavuus muiden sairauksien vuoksi. Sosiaali- ja terveydenhuollon uudistuksen (sote-uudistuksen) uudistaessa koko julkista sosiaali- ja terveydenhuoltoa, tullaan uusia toiminta- ja ratkaisumalleja varmasti pohtimaan aktiivisesti tulevina vuosina laajemmassakin mittakaavassa. Iäkkään väestön terveyden, hyvinvoinnin ja toimintakyvyn ylläpito, parantaminen sekä ennaltaehkäisy oikeaan aikaan ovat tärkeitä tekoja kunnille eettisesti, sosiaalisesti kuin taloudellisestikin kestävän palvelujärjestelmän rakentamista ajatellen. Tutkimustuloksiamme voidaan huomioida tavoitellessa parempia ja tehokkaampia ratkaisuja vanhusten suun terveydenhuollon järjestämisessä aiheen ollessa sosiaali- ja terveydenhuollon uudistuksen vuoksi hyvin ajankohtainen.

Syömishäiriöt usein nuorella iällä alkavia, vakavia ja pitkäkestoisia sairauksia. Suomessa joka kymmenes nuori tai nuori aikuinen on sairastanut syömishäiriön. Varhaisella puuttumisella voidaan lyhentää hoitamattoman syömishäiriön kestoa, parantaa taudin ennustetta ja välttää monet pitkäaikaiskomplikaatiot. Varhaisen puuttumisen esteenä on viive sekä hoitoon hakeutumisessa että hoitoon pääsyssä. Eri maissa on kehitetty erilaisia ratkaisuja. Britanniassa kehitetty varhaisen puuttumisen malli (FREED, First episode rapid early intervention for eating disorders) painottaa nopeaa hoitoonpääsyä ja aikaista psykoedukaation aloitusta. Hoitoon voi hakeutua myös ilman lähetettä, mikä osaltaan nopeuttaa hoitoonpääsyä. Psykoedukaatiossa sairastuneelle kerrotaan syömishäiriön vaikutuksista aivoihin sekä kehoitetaan pohtimaan sosiaalisen median ja suurten elämänmuutosten vaikutusta oireisiin. FREED-mallilla hoidetuista potilaista 60% saavutti normaalipainon vuoden seurannassa, kun taas tavanomaisesti hoidetuista potilaista normaalipainoon pääsi vain 17% potilaista. Suomessakin on kehitetty alueellisia hoitomalleja syömishäiriöiden hoidon tehostamiseksi. Pietarsaaren Fredrika-klinikka on syömishäiriöihin erikoistunut yksikkö, jossa painotetaan kokonaisvaltaista hoitoa, perheen aktiivista osallistumista sekä nopeaa hoitoonpääsyä. Hoitotulokset vastaavat FREED-mallin tuloksia.

Developmental dyslexia is a heritable learning disorder which according to the predominant theories has its core problems in the processing of speech sounds. Auditory processing deficits have been found in dyslexics and in infants with a genetic risk for dyslexia. It has been shown that infants with a genetic risk for dyslexia have attenuated or more right-hemispheric lateralized auditory event-related potentials (ERPs) to changes in speech stimuli compared to infants with no genetic risk. It has been shown that interventions can ameliorate the reading and writing skills of dyslexics and concurrently influence their ERPs. The aim of the present study was to find out if an early musical intervention can ameliorate the auditory processing skills in infants. Altogether 58 infants with a genetic risk for dyslexia were assigned to three groups where one group listened to vocal music, second group listened to instrumental versions of the same music and the third one was a control group with no intervention. After six months of intervention, auditory ERPs of the infants were recorded while the infants were presented with a repetitive pseudoword /tata/ with random infrequent duration, frequency, or vowel changes in the latter syllable. It was also studied if the ERPs were correlated with the amount of music played during the intervention or with the parents' evaluations of their infant's degree of prelinguistic development. The groups differed from each other in the auditory processing of the repetitive standard sound so that in the control group the ERPs had a different hemispheric pattern compared to the intervention groups and the repetitive sound was processed faster in the control group than in the instrumental group. It was also found that the hemispheric pattern of the ERPs for the vowel changes was different in the instrumental intervention group compared to the other groups. The parents' evaluations of the prelinguistic development of their infant were correlated with the ERPs so that the ERPs to the repetitive standard stimuli were enhanced and reached their peak earlier in the infants who were evaluated to be more mature in their prelinguistic development. According to the results, the ERPs for the repetitive sounds are correlated with children's linguistic development and an early musical intervention can modify the neural network processing speech sounds in infants with a genetic risk for dyslexia. In the future, it should be followed if these intervention effects on brain functions also enhance the linguistic development of the children and it should be also explored how other parts of the auditory environment of the children besides the intervention have possibly affected their auditory skills.

Objectives: Late-life depression is underdiagnosed and undertreated, and more information about its specific risk factors and mechanisms is needed. Early life stress has been shown to predict depressive symptoms in adults as well as a poor course of depression; it is unclear, however, whether this association is still present in older adults. The present study investigated how emotional and physical stress in childhood predicted depressive symptoms in Finns who were older than 60 years. Depressive symptoms were selfrated at two separate measurement points. The effect of neuroticism as a mediator was also examined. Methods: The study sample was a subsample of Helsinki Birth Cohort Study, which consists of 13,345 subjects born in Helsinki in 1934–1944. The sample included those subjects who completed the Traumatic Experiences Checklist (TEC) and either Neuroticism-Extraversion-Openness Personality Inventory (NEO-PI) or Beck Depression Inventory II (BDI-II) in either 2004 or 2010. Sample size varied between 764–1332, depending on the analysis. Linear and logistic regression as well as mediation analyses were used to analyze the data. Results and conclusions: Both types of early life stress were shown to predict more depressive symptoms and higher risk of clinically significant depressive symptoms at both measurement points. High neuroticism mediated the relationship between early life stress and depressive symptoms. Contrary to hypothesis, early life stress did not predict the duration of depressive symptoms. The results indicate that early life stress plays a role in late-life depression, and this effect is mediated by neuroticism.