Table 4.

Summary of Nursing Research on Adolescents as Parents. The Parent–Child Relationship: The Discovery and Assessment Approaches

Source	Design	Focus/Dependent Variable	Sample Description	Results
Discovery
SmithBattle and Leonard (2006)	Hermeneutic case analysis	Parenting practices and factors that shape children’s lives	10 families: 10 mothers (6 non-Hispanic White, 4 African American), 1 partner, 9 grandparents, 8 index children; Teens now 15–17 years old, 4 girls, and 6 boys; Mothers now between 31 years and 35 years old; Income ranged from low to high, but most marked by poverty and limited resources United States	Fifth wave of data collection and analyses. Two very low-income Black families were paradigm cases. The teens had drifted into mothering, and they continued to drift in their 20s and 30s with little sense of future, an over reliance on their own mothers, and their children drifted into risky situations. When mothering was perceived as a rite of passage into adulthood and a life commitment, the teens’ worlds and identities became structured with a sense of future and expectations for themselves and their children.
Assessment
Diehl (1997)	Descriptive, correlational	Adolescent mothers’ interactions with their infants Measures: NCATS scores for parent and child, Hudson Index of Self-Esteem, Denver II, indicators of father involvement, and living situations	36 mothers: mean age = 16.1 years; 36% African American, 47% Caucasian, 17% Hispanic; 1 was married Infants were 1–17 months old, M = 6.9 months United States	Mothers with more education responded more appropriately to infant distress and were more contingently responsive to the behavior of the infants. Mothers with higher self-esteem responded more positively to infant distress. Mothers who reported paternal financial or child-care support had significantly higher parent contingency, cognitive-growth fostering, and social-emotional-growth fostering scores.
Dormire et al. (1989)	Descriptive, correlational	Social support, stress, synchrony of parent–infant interaction. Measures—Maternal: Norbeck Social Support Questionnaire; NCATS; Parenting Stress Index Infant: NCATS Child Scale	18 first-time mothers between 15 years and 19 years old (M = 17.5, SD = 1.2); 16 African American; all low income; 3 were married; 1.3 adults and 1.1 children in the home. Newborn infants were term (M = 38.9 weeks, SD = 1.4); Birth weight: M = 3,262, SD = 563.6 g. United States	The sample was found to have less social support and higher stress than normative samples. Social support was significantly related to interactive capacities of the adolescent mothers with their infants. High scores on social support were related significantly to diminished parenting stress and vice versa. Stress was found to be strongly associated with the inability to intervene in a comforting way with a distressed infant.
Patterson (1997)	Descriptive, correlational	Examine the relationship between child–mother and child–grandmother with children of adolescent mothers. Measures: Structured interview and the Ainsworth et al. Strange Situation procedure	32 adolescent mothers: age—M = 22.6 years, SD = 2.3; 19% unemployed, 13% in school. Grandmothers: age—M = 39.4 years, SD = 4.2; education—44% high school, 31% some college; 63% teen mothers themselves. Child: M age = 4.5 years; 16 boys, 16 girls; 22% African American, 78% White United States	Time with mother was not related to attachment security, in contrast to the amount of waking time spent with grandmother, which was strongly and positively related to secure attachment. If children insecurely attached to their mothers, they were 4.5 times more likely to enjoy secure grandmother attachment.
Ross and Youngblut (2005)	Descriptive comparison, secondary data analysis	Mother–infant attachment Measures: Attachment subscale of the Parenting Stress Inventory (PSI), family income, maternal education, number of children in the home, race, family structure, maternal employment; Infant: sum of adaptability, demandingness, mood, hyperactivity/distractibility subscale of the PSI, gestational age	43 adolescent–adult pairs: adult mothers’ M age = 25.6 years; 41% single; 49% unemployed; 69% high school educated; adolescent mothers’ M age = 16.6 years, SD = 1.42; 51% single; 57% unemployed; 64% high school educated; 51% Caucasian and 49% African American; 86 preschoolers: M age not reported United States	Adolescent mothers and adult mothers perceived their attachments similarly at T1 and T2. Age was not a significant predictor of attachment scores, but child temperament (difficult), partner status (single), and race (African American and Hispanic) were.
Ruff (1990)	Descriptive, correlational	Mother–infant interaction Measures: NCAFS mother and child scores	95 unmarried, adolescent, African American mothers: M age = 17.0 years; mean grade level attained = 10.5; 13% had a previous pregnancy and subsequent abortion; 77% of deliveries were vaginal; infants: newborn to 12 weeks; 52% males; birth weight was 5–8 lbs; 10% breast-fed United States	Mothers: sensitivity to cues was high at T1 and T2, response to distress was low and got lower at T2, and social-emotional-growth fostering was low at T1 but increased at T2; cognitive-growth fostering was extremely low at T1 and T2. Infants: clarity of cues improved from T1 to T2, responsiveness to parent was low at T1 and T2, but improved at T2. Very carefully conducted study with huge implications for practice.
Rich (1990)	Descriptive	Maternal–infant bonding among a group of homeless adolescents. Measures: NCAFS mother and child scores	19 mother–infant pairs. Mothers: all homeless; M age = 16.7 years (15–18 years); 11 were African American, 2 were Latino, 4 were Caucasian; 50% had a previous pregnancy; most infants were delivered vaginally; all formula fed. Setting: Capable Adolescent Mothers Program United States	The sample achieved a parent score of 41.9 out of 50 (NCAST mean 41.6). Reasons for the surprising result may be that the sample had (a) a strong desire to be good mothers, (b) educational emphasis on parenting, (c) excellent role models, and (d) experience with child care. Infant scores for the study subjects were significantly different from the NCAST reference group, perhaps because of the very young age of the infants (all under 4 weeks) or because of infant state. The total feeding score was lower than the NCAST reference sample, most likely because of the infant scores.

NCAFS, Nursing Child Assessment Feeding Tasks; NCAST, Nursing Child Assessment Satellite Training; T1, time 1; T2, time 2.