Do Parents Influence Children’s
Self-Regulation During Feeding?
Sheryl O. Hughes, PhD
Baylor College of Medicine
Children’...
Environment

Glass, McAtee, Soc Sci Med, 2006

Biology
Percent of US children &
adolescents who are obese*

Centers for Disease Control and Prevention, http://www.cdc.gov
*BMI-f...
Ecological perspective on child obesity
COMMUNITY
Corner stores &
restaurants
School &
childcare
meals

Food
available

Pa...
Benefits of Optimal Parenting
Academic Achievement
Peer Relationships
Emotional Competence

Attachment
Parents socialize their children
through helping them to internalize
goals, values and beliefs in order to
become producti...
Presentation Overview
• Parenting styles and their relationship to child weight
status
• Feeding styles and their relation...
Parenting Styles
& child weight
Styles of general parenting
Reflect the larger context within which
practices are expressed
Lo

High

Uninvolved

Indulgen...
Parenting Style
-Overall attitude
toward child

Child Willingness
to be Socialized

Socialization
Goals & Values

Child Ea...
NICHD Early Child Care and Youth Development Study

R

% Obese

• Over 800 1st grade children studied at 10 sites across t...
In a sample of middle-class,
predominantly White parents, this
study showed that the authoritarian
style is highly related...
Feeding Styles,
eating
behaviors, &
child weight
Feeding styles
Reflect the larger context within which
feeding practices are expressed

Responsiveness

Demandingness

Lo
...
Feeding style influences on child
eating behaviors and weight
Parent-report and observational studies of:
• 231 Hispanic a...
Parents with Authoritative Feeding Styles
Report 1:

– More monitoring of eating
– Make fruit and vegetables more availabl...
Parents with Authoritarian Feeding Styles
Report 1:

– More restriction, pressure to eat
– Make fewer fruit and vegetables...
Parents with Indulgent Feeding Styles
Report 1:

– Less restrictive feeding
Observed at meals to be 2:

– Less involved in...
In samples of low-income minority
parents, our studies consistently
showed that the indulgent feeding
style is related to ...
Parenting Style
-Overall attitude to
child

Child Willingness
to be Socialized

Socialization
Goals & Values

Child Eating...
Moderating effect of feeding styles
•

99 Hispanic, Black, and White low-income families
(child age 6 to 11 years)

•

Rur...
Moderating effect of styles on relationship
between restrictive practices and LNED foods

Hennessy, Hughes, Goldberg & Hya...
Moderating effect of styles on relationship
between parent monitoring and LNED foods

Hennessy, Hughes, Goldberg & Hyatt, ...
Summary and Conclusions
• Evidence of association between indulgent
feeding style and higher child weight
- Based on paren...
Observations
at dinnertime
Observations during the dinner meal

Goal: To better understand
indulgent feeding through
observation including the
emotio...
Observational study of meal times
•

177 Hispanic and Black low-income families with preschoolers

•

3 evening meal obser...
Differences in Emotional Climate Variables
across Feeding Styles

Emotional Climate
Variables

Overall F = 2.98

p < .001
...
Emotional Climate and Feeding Styles

Hughes et al, under review
Emotional climate of the meal
• Authoritarian parents were observed to be HIGHER on
– Negative Affect / Intrusion

• Uninv...
Feeding style differences on observed
feeding practices
Helps

F = 1.00

ns

Spoon Feeds

F = 3.67

p < .05

Physically In...
Feeding style differences on observed
feeding practices
Authoritative
Spoon Feeds
the child

Authoritarian

Indulgent

Uni...
Practices during the meal
• FS w/high demand used some practices more
frequently than FS w/low demand
– Verbal prompts to ...
Indulgent Feeding Style was
observed to be:
• High on Detachment
• Low on Negative Affect &
Intrusiveness

• Made few dema...
Overall Conclusions
• Observations of both emotional climate during the
meal and specific feeding practices strongly
suppo...
Current coding of audio/video tapes
• Level of Directiveness (risk low with moderate levels)
• Responses to internal cues ...
Level of Directiveness
High

Low

Verbal

Threats
Punishments
Begs
Tells

Suggests
Asks questions
Hints

Non-verbal

Spoon...
Responses to Internal Cues
How much is
enough?
• Explicit – hunger & fullness
statements
• Implicit – stops eating, serves...
Was the parent feeding style in this
sample (assessed by observation)
related to child weight status?
Design for preliminary coding of the
dinner meal audio/videotapes
Hispanic:
Male

Female

Normal weight

n = 26 (10)

n = ...
Coding of Mealtime Behaviors:
Feeding Styles (assessed by observation)
and Child Weight

Percent of
overweight/obese
child...
Balance between Responsiveness and
Demandingness

Responsiveness
-Sensitivity/warmth to child

Demandingness
-Encouragemen...
Acknowledgements
• Research was supported by funds from USDA NRI grant
2006-55215-16695
• Research was supported by funds ...
Future research!
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  • When you think back in your early childhood (for better or worse), your parents were the most important figures in your life. A lot of their influence was based on their parenting.As psychologists, when we think of parenting we think about how parents raise their children to be productive members of society. We call this ‘socialization’. This socialization process has been linked to many areas of children’s lives including better emotional competence and attachment, better peer relations, and better academic achievement in children who have been properly socialized.
  • We know that parents socialize their children by getting them to internalize goals and values that parents deem important.When it comes to eating, the parenting environment remains the first and most fundamental context in which children’s eating behaviors are socialized—Eating socialization refers to the processes by which children learn to adopt eating norms, values, attitudes, and behaviors that are practiced in their culture and accepted in their family. These internalized goals and values help children to learn to self-regulate their own behavior as they get older and are in many situations away from their parents.
  • General parenting styles and the seminal article linking PS to child weight.Over 40 years of research in developmental psychology have investigated styles of general parenting and their outcomes on children. General PS depict the climate of the parent-child relationship &amp; set the emotional tone for specific practices parents use to direct their children’s behavior. PS are thought to be trait-like – much like personality. This means that PS will probably not be amenable to change. But practices within those styles are likely to be modified with intervention.
  • The 4 styles of have been distinguished from parenting practices. Styles are different from practices in that styles reflect an attitude toward the child whereas practices are goal directed behaviors that parents use to get their children to do something specific.Parenting styles reflect the larger context within which parenting is expressed.My research and other researchers in the field have shown that styles of parenting definitely impact child eating behaviors and weight status.
  • To summarize………..
  • Similar to PS, styles of feeding depict the overall climate of the feeding relationship &amp; set the emotional tone around eating that provides context for the specific practices parents use to get their children to eat.My body or research has drawn on developmental psychology literature to look at parenting styles specific to the eating context – which we call feeding styles. Like general PS – these styles are considered to be trait-like in that they are not amenable to change. However, being able to identify these parent characteristics are important for intervention purposes.
  • Much of the work evaluating feeding styles and children’s eating and weight has been conducted in the past half decade (much of the work conducted by our group of researchers)—on this slide I’ve described the participants in five studies that link FS to child eating and weight.
  • Based on these studies – we found that parents who
  • What we found is somewhat different from the Rhee study of white, middle class families. In her study, authoritarian parents had children with the highest rates of obesity.
  • So back to our original picture ….Parenting and feeding styles have been hypothesized to moderate the relationship between practices and child outcomes.Meaning that practices may work differently for some of the feeding styles.
  • We found that:In the presence of an indulgent feeding style, more parental restriction of snack foods was related to higher intake of snack foods defined as LNEDs (low nutrient, energy dense foods such as cheetos).One possible explanation for these results is that when an indulgent parent tries to set restriction or limits, then the child is not likely to follow those rules (since the next time they are likely to get what they want anyhow given an indulgent feeding environment. This would be especially true as the child gets older and can gain access to certain foods on their own. The children in this study were older (mean age of 9) and they are out of their parents control more often than preschoolers.
  • Along with restriction, in the presence of an indulgent FS, high monitoring of snack foods was associated with higher intake of those foods.
  • It appears based on this data that practices may work differently in the presence of some FS.
  • This is a picture of a typical family meal in the 50s or 60s. Dinners back then all had a familiar feel (at least those depicted on TV). Mothers wore aprons, pearls and high heels and served huge pot roasts. Fathers wore ties to the dinner meal. The children were all bright-eyed and well-scrubbed.Conversation was cheery and everyone was happy. Life lessons were discussed over mashed potatoes and peas. Children were always treated with respect and patience.Whether this is still what happens or ever happened at dinnertime is unknown? Based on our observations, probably not!
  • Differences were found across the 4 FS on 3 of the 4 emotional climate variables.Negative affect are things like displays of anger, contempt, glaring at the child. Includes tone, affect, verbalizations, and non-verbal behavior.Intrusiveness was defined as the extent to which parents force their own agendas on children with no regard for the children’s feelings.“I made this dinner and you are going to eat all of it.”Parental detachment is considered lack of involvement or investment in the child’s behavior during dinner such as ignoring the child.
  • To put it another way, authoritarian parents were observed to be higher on negative affect and intrusion.Uninvolved parents were observed to be higher on negative affect and detachmentBoth authoritative and indulgent parents (who are high on responsivity) were observed to be lower on negative affect and intrusion.
  • We found that…………..Authoritarian parents were observed to be more demanding across all the feeding practices in trying to get their children to eat.Indulgent parents were observed to be less demanding across all the feeding practices.These practices included…….
  • More specifically, FS (characterized by high demand) used verbal prompts more frequently than those with low demand.Authoritarian parents (characterized by highly directive behaviors and low responsivity) used spoon feeding, telling the child to eat a small amount and hurrying the child more frequently than other FS.
  • Bottom line is that …..We found that the indulgent FS was observed to be:High on detachment Low on…Detachment not only describes lack of involvement but lack of investment in the child’s eating behaviors.
  • An more generally, this work represents an attempt to define the infrastructure of parent-child interactions during mealtime eating.
  • We are also interested in parents’ responses to internal cues of satiety. We want parents to facilitate these internal cues by being sensitive to when children say “I am still hungry” or “I am full”. Parents who are sensitive to these cues will probably have children who are okay. Parents who override these cues will probably have children who become overweight/obese.We are coding explicit statements such as “I am full” and mom’s response to those statements. Does mom then override that statement and say “Clean you plate”. Similarly, we are coding when the child serves themselves more food or stops eating and mom’s response to those child behaviors.
  • Finally, in the live coding results that I showed you, parents were classified into the 4 FS based on their self-reported information on the CFSQ questionnaire. We then supported these FS with live coding of parent emotions and practices during the meal.Our next step was to determine if FS assessed by observation (not self-report) was related to child weight.
  • Given the time and effort it takes to code these videotapes (about 5 hours of coding per average meal of 17 minutes), we decided that in our first attempt to code our families, we would choose 80 families equally distributed by child gender, child weight status, and ethnicity. This translated into 10 children per cell. We choose these 80 families out of a total of 138 families with complete data – that is audio/videotapes of the meal and measured BMI on the child. We decided to first code only the 2nd observation on each of these families so as to reduce reactivity.
  • Results from the in-depth coding of these 80 families are consistent with the earlier findings from our previous studies. Observations show that 85 percent of the mothers with the most indulgent parenting styles (those who engaged in less than ten influence attempts per meal and who were above the mean on positive affect) had overweight /obese children, although only half of the children in this sample were overweight or obese.  Interestingly, most of these highly indulgent mothers were Hispanic.  Further analyses of other influence strategies and directives in the observations are currently underway.
  • In conclusion, we have evidence that supports the need for balance between responsivity and demandingness when parenting preschool children around food. An imbalance in these two dimensions results in less optimal child outcomes such as overweight and obesity.
  • Sheryl presentation 5 26 11 version 5 sh2

    1. 1. Do Parents Influence Children’s Self-Regulation During Feeding? Sheryl O. Hughes, PhD Baylor College of Medicine Children’s Nutrition Research Center
    2. 2. Environment Glass, McAtee, Soc Sci Med, 2006 Biology
    3. 3. Percent of US children & adolescents who are obese* Centers for Disease Control and Prevention, http://www.cdc.gov *BMI-for-age >95th%tile
    4. 4. Ecological perspective on child obesity COMMUNITY Corner stores & restaurants School & childcare meals Food available Parenting/ Feeding styles & practices Food stores FAMILY Eating Behavior Caregiver’s diet and behaviors CHILD CHILD t OBESITY Neighborhood safety Computers/TVs in home Physical activity Activity parenting Sedentary behavior Dietary Intake School PE Sports programs Parents’ activity Parents’ weight Work demands Culture Recreational facilities SES Adapted from Davison, Birch, Obes Rev, 2001
    5. 5. Benefits of Optimal Parenting Academic Achievement Peer Relationships Emotional Competence Attachment
    6. 6. Parents socialize their children through helping them to internalize goals, values and beliefs in order to become productive members of society.
    7. 7. Presentation Overview • Parenting styles and their relationship to child weight status • Feeding styles and their relationship to child eating behaviors and child weight status – moderating effect of FS on the relationship between feeding practices and child eating behaviors • Current ongoing research on observations during mealtime in low-income families
    8. 8. Parenting Styles & child weight
    9. 9. Styles of general parenting Reflect the larger context within which practices are expressed Lo High Uninvolved Indulgent Authoritarian Authoritative Lo Demands On Child High Responsiveness To Child Baumrind, Dev Psych Monographs, 1971; Maccoby & Martin, 1983 9
    10. 10. Parenting Style -Overall attitude toward child Child Willingness to be Socialized Socialization Goals & Values Child Eating and Weight Outcomes Parenting Practices -Goal directed behaviors Darling & Steinberg, Psych Bull, 1993
    11. 11. NICHD Early Child Care and Youth Development Study R % Obese • Over 800 1st grade children studied at 10 sites across the US n = 263 n = 132 *Adjusted for income/needs ratio and race Rhee, K. E. et al., Pediatrics, 2006 n = 298 n = 179
    12. 12. In a sample of middle-class, predominantly White parents, this study showed that the authoritarian style is highly related to child obesity!
    13. 13. Feeding Styles, eating behaviors, & child weight
    14. 14. Feeding styles Reflect the larger context within which feeding practices are expressed Responsiveness Demandingness Lo Uninvolved Lo High Make few demands on children to eat and are unsupportive Authoritarian Encourage eating using highly directive behaviors and are unsupportive Hughes et al., Appetite, 2005; Hughes et al., JDBP, 2008 High Indulgent Make few demands to eat but those demands are supportive Authoritative Actively encourage eating using nondirective and supportive behaviors
    15. 15. Feeding style influences on child eating behaviors and weight Parent-report and observational studies of: • 231 Hispanic and Black low-income families with preschoolers in TX1 • 718 ethnically-diverse low-income preschoolers in TX, AL2 • 177 Hispanic and Black low-income preschoolers in TX 3 • 99 Hispanic, Black and White low-income rural children in KY, CA, MS, SC 4 Laboratory study • 61 ethnically diverse 5-6 year-old children5 1Hughes et al., Appetite, 2005; 2 Hoerr et al, IJBNPA, 2009; Hughes et al., JDBP, 2008; 3Hughes et al., under review; 4 Hennessy et al., Appetite, 2010; 5Fisher et al., unpublished;
    16. 16. Parents with Authoritative Feeding Styles Report 1: – More monitoring of eating – Make fruit and vegetables more available Observed at meals to be 2: – Less negative, disapproving – Give more prompts Have children 3: – Smaller self-selected portions – Eat more dairy, vegetables 1Hughes et al., Appetite, 2005; Patrick et al., Appetite, 2005; 2Hughes et al., under review; 3 Fisher et al, unpublished; Patrick et al., Appetite, 2005
    17. 17. Parents with Authoritarian Feeding Styles Report 1: – More restriction, pressure to eat – Make fewer fruit and vegetables available Observed at meals to be 2: – Spoon-feeding, hurrying – Telling child to eat small amount – Disapproving, intrusive Have children 3: – Larger self-selected portions – Eat fewer vegetables 1Hughes et al., Appetite, 2005; Patrick et al., Appetite, 2005; 2Hughes , under review; 3 Fisher et al, unpublished; Patrick et al., Appetite, 2005;
    18. 18. Parents with Indulgent Feeding Styles Report 1: – Less restrictive feeding Observed at meals to be 2: – Less involved in the meal – Less negative and intrusive – Make fewer eating demands Have children 3: – Larger self-selected portions – Eat more energy-dense meals and snacks – At a greater risk for obesity 1Hughes et al., Appetite, 2005; 2Hughes , under review; 3 Fisher et al., unpublished; Hennessy et al., under review; Hoerr et al, IJBNPA, 2009; Hughes et al., JDBP, 2008
    19. 19. In samples of low-income minority parents, our studies consistently showed that the indulgent feeding style is related to less optimal child eating behaviors and obesity!
    20. 20. Parenting Style -Overall attitude to child Child Willingness to be Socialized Socialization Goals & Values Child Eating and Weight Outcomes Parenting Practices -Goal directed behaviors Darling & Steinberg, Psych Bull, 1993
    21. 21. Moderating effect of feeding styles • 99 Hispanic, Black, and White low-income families (child age 6 to 11 years) • Rural families were recruited in four states (KY, CA, MS, and SC) • Multiple measures – – – – Child Feeding Questionnaire (CFQ; feeding practices) Caregiver’s Feeding Style Questionnaire (CFSQ; feeding styles) 24 hour recalls on the children Heights and weights measured Hennessy, Hughes, Goldberg & Hyatt, in press
    22. 22. Moderating effect of styles on relationship between restrictive practices and LNED foods Hennessy, Hughes, Goldberg & Hyatt, in press
    23. 23. Moderating effect of styles on relationship between parent monitoring and LNED foods Hennessy, Hughes, Goldberg & Hyatt, in press
    24. 24. Summary and Conclusions • Evidence of association between indulgent feeding style and higher child weight - Based on parent self-report - Most of these studies were based on lowincome minority samples - Observations are needed to support the selfreported feeding styles in minorities
    25. 25. Observations at dinnertime
    26. 26. Observations during the dinner meal Goal: To better understand indulgent feeding through observation including the emotional climate of the meal and specific feeding practices used by these parents Hughes et al., under review
    27. 27. Observational study of meal times • 177 Hispanic and Black low-income families with preschoolers • 3 evening meal observations on each family • Measures – Caregiver’s Feeding Styles Questionnaire (CFSQ; parent-report) – Live global coding of the emotional climate – Live behavioral coding (feeding practices) Hughes et al., under review
    28. 28. Differences in Emotional Climate Variables across Feeding Styles Emotional Climate Variables Overall F = 2.98 p < .001 Positive Affect F = 1.50 ns Negative Affect F = 5.28 p < .01 Intrusiveness F = 3.64 p < .05 Detachment F = 5.58 p < .001 Hughes et al., under review
    29. 29. Emotional Climate and Feeding Styles Hughes et al, under review
    30. 30. Emotional climate of the meal • Authoritarian parents were observed to be HIGHER on – Negative Affect / Intrusion • Uninvolved parents were observed to be HIGHER on – Negative Affect / Detachment • Authoritative and Indulgent parents (high responsivity) were observed to be LOWER on – Negative Affect / Intrusion
    31. 31. Feeding style differences on observed feeding practices Helps F = 1.00 ns Spoon Feeds F = 3.67 p < .05 Physically Intervenes F = 3.33 p < .05 Verbal Prompts to Eat F = 2.68 p < .05 Eat Small Amount F = 4.06 p < .01 Eat All F = 0.89 ns Hurries F = 2.79 p < .05 Reasons F = 2.23 p < .09 Comparison F = 0.54 ns Praises/Approves F = 2.07 ns Disapproves/Scolds F = 4.66 p < .01 Positive Comments Food F = 2.23 p < .09 Hughes et al, under review
    32. 32. Feeding style differences on observed feeding practices Authoritative Spoon Feeds the child Authoritarian Indulgent Uninvolved - + - - Physically Intervenes + Verbal Prompts + + Eat Small Amount - + Hurries the child Disapproves/ Scolds + - + -
    33. 33. Practices during the meal • FS w/high demand used some practices more frequently than FS w/low demand – Verbal prompts to eat • Authoritarian FS (highly directive /low responsivity) used specific practices more frequently than other FS – Spoon feeding / Eat a small amount / Hurrying • Authoritarian FS used punitive practices more frequently than FS w/ high responsivity (authoritative and indulgent) – Disapproving/scolded
    34. 34. Indulgent Feeding Style was observed to be: • High on Detachment • Low on Negative Affect & Intrusiveness • Made few demands on their children to eat
    35. 35. Overall Conclusions • Observations of both emotional climate during the meal and specific feeding practices strongly supported self-reported feeding styles • Represents one of the first attempts to examine emotional components of parents during the meal through direct observation • Attempts to define the infrastructure of parent/ child interactions during eating
    36. 36. Current coding of audio/video tapes • Level of Directiveness (risk low with moderate levels) • Responses to internal cues (risk low if responsive and high if overrides) • Responses to exploring food (risk low if positive) – Distinguish between exploring and playing with food • Emphasis on manners (risk low with moderate levels) – Emphasis on sitting properly, being quiet, etc. • Emphasis on developing eating skills and autonomy • Emotional responsiveness (risk low if responsive) – Global ratings of positive affect, negative affect, intrusion, and detachment – Responsiveness to child behaviors (verbalizations , gestures)
    37. 37. Level of Directiveness High Low Verbal Threats Punishments Begs Tells Suggests Asks questions Hints Non-verbal Spoon feeds Physically forces Physically punishes Moves food closer Arranges food Serves Hughes, Goodell, Johnson, Power (in progress)
    38. 38. Responses to Internal Cues How much is enough? • Explicit – hunger & fullness statements • Implicit – stops eating, serves self Hughes, Goodell, Johnson, Power (in progress)
    39. 39. Was the parent feeding style in this sample (assessed by observation) related to child weight status?
    40. 40. Design for preliminary coding of the dinner meal audio/videotapes Hispanic: Male Female Normal weight n = 26 (10) n = 22 (10) Overweight/Obese n = 17 (10) n = 16 (10) Male Female Normal weight n = 16 (10) n = 20 (10) Overweight/Obese n = 11 (10) n = 10 (10) Child Weight Status Black: Child Weight Status Hughes, Goodell, Johnson, Power (in progress)
    41. 41. Coding of Mealtime Behaviors: Feeding Styles (assessed by observation) and Child Weight Percent of overweight/obese children* Hughes, Goodell, Johnson, Power (in progress) * BMI-for-age >85th%tile
    42. 42. Balance between Responsiveness and Demandingness Responsiveness -Sensitivity/warmth to child Demandingness -Encouragement and discouragement Hughes et al Appetite 2005
    43. 43. Acknowledgements • Research was supported by funds from USDA NRI grant 2006-55215-16695 • Research was supported by funds from NICHD grant R01 HD062567 • Research was supported by funds from USDA AFRI grant 2011-68001-30009
    44. 44. Future research!

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