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Background:The quality of caregiving in mothers with substance abuse problems appears to be compromised. However, divergent findings, methodological variability, and sample characteristics point to the need for research synthesis.Methods:A comprehensive systematic search was undertaken. Studies were eligible if they (1) compared substance-misusing mothers with non–substance-misusing mothers, (2) involved children from birth to 3 years, and (3) maternal sensitivity and child responsiveness were measured using observational methodology.Results:A global meta-analysis for maternal sensitivity (n = 24 studies) and child responsiveness (n = 16 studies) on 3433 mother-infant dyads yielded significant population effect sizes and significant heterogeneity. Subgroup analyses found reduced heterogeneity when the meta-analysis was conducted on studies where groups were matched on key demographic characteristics; although the effect size was small, it was still significant for maternal sensitivity but not child responsiveness.Conclusions:Compromised quality of caregiving is found in high-risk, substance-misusing mothers, emphasising the importance of early intervention that draws from attachment-based interventions.

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Background: The research explored parents' role constructions for themselves and other caregivers in promoting physical activity, limiting screen time, and ensuring their young child is not sedentary or restrained for extended periods. Method: Using a qualitative social constructionist epistemological position, 10 mothers and 10 fathers (aged 22-49 years) from different households in South East Queensland, Australia, were interviewed. The interviews were transcribed verbatim and analysed using thematic analysis. Results: Thirteen themes emerged in parents' descriptions of their role, aligning with three of the four key influences on parents' role constructions for involvement in their child's behaviour: beliefs about desired child outcomes, beliefs about who is responsible for the outcomes, and parental behaviours related to the beliefs and expectations. Conclusions: Current findings indicate that parents commonly describe active manifestations of parent role constructions that are conducive to facilitating childhood physical activity-related behaviours. Because many young Australian children are still not sufficiently active, future interventions should seek to target processes influencing parents' ability to fulfil their constructed roles and translate them into actions, including knowledge and skills, self-efficacy for helping their child, and developing the ability to manage the mix of demands on their time.

Background: Early diagnosis of children with fetal alcohol spectrum disorder (FASD) assists in implementing critical early support. The challenge lies in having a diagnostic process that enables valid and reliable assessment of domains of functioning in young children, with the added complexity that many children will also have co-occurring exposure to childhood adversity that is likely to impact these domains. Methods:The aim of this study was to test a diagnostic assessment of FASD in young children using the Australian Guide to the Diagnosis of FASD. Ninety-four children (aged 3 to 7 years) with confirmed or suspected prenatal alcohol exposure were referred to two specialist FASD clinics for assessment in Queensland, Australia.Results: There was a significant risk profile with 68.1% (n = 64) children having had contact with child protection services, and most children living in kinship (n = 22, 27.7%) or foster (n = 36, 40.4%) care. Forty-one percent of the children were Indigenous Australians. The majority (64.9%, n = 61) of children met criteria for FASD, 30.9% were classified as "At Risk" for FASD (n = 29), and 4.3% received no FASD diagnosis (n = 4). Only 4 (4%) children were rated as severe for the brain domain. Over 60% of children (n = 58) had two or more comorbid diagnoses. Sensitivity analyses indicated that the removal of comorbid diagnoses in the Attention, Affect Regulation, or Adaptive Functioning domains resulted in a change in 7 of 47 cases (15%) to an "At Risk" designation.Conclusions: These results highlight the complexity of presentation and the extent of impairment in the sample. The use of comorbid diagnoses to substantiate a "severe" designation in specific neurodevelopmental domains raises the question of whether there were false-positive diagnoses. The complexity of determining causal relationships between exposure to PAE and early life adversity on developmental outcomes continues to be a challenge in this young population.