Parenting stress in infancy and psychosocial adjustment in toddlerhood: a longitudinal study of children with craniofacial anomalies.

Objective: To evaluate the association between parenting stress during infancy and child psychosocial adjustment during toddlerhood, within a sample of children with craniofacial anomalies (CFAs).

Design: Retrospective chart review.

Setting: Urban medical center department of reconstructive plastic surgery.

Participants: Parents of 47 children aged birth to 24 months at time 1 and 24 to 46 months at time 2.

Main Outcome Measures: Parenting Stress Index/Short Form completed at times 1 and 2; Child Behavior Checklist completed at time 2.

Results: Relative to norms, more parents of children with CFAs experienced serious levels of parenting stress at times 1 and 2; however, fewer children with CFAs experienced serious levels of adjustment problems. Parenting stress during infancy predicted psychosocial adjustment in toddlerhood but was mediated by parenting stress in toddlerhood. Parents high on stress at both assessments showed clinical levels of total parenting stress and parent-child dysfunctional interaction when their children were infants; their toddlers showed higher levels of maladjustment than those with parents elevated on parenting stress during only infancy.

Conclusions: Elevated levels of parenting stress during infancy may be stable through toddlerhood for families having a child with a CFA. The relation between parenting stress and child adjustment is likely to be reciprocal. These findings should be replicated with a larger sample and multiple informants.