Impact of a Behavioral Parenting Intervention in Infancy on Maternal Emotion Socialization

Abstract

Research has demonstrated the effect of parent emotion socialization on later child emotion development and behavior. Given these findings, the goal of the present study was to examine the effect of an early parenting intervention on a component of emotion socialization: parent emotion talk. We also examined the indirect effect of behaviorally-based parenting skills on the relation between the intervention and parent emotion talk. Participants were 58 mothers and their 12- to 15-month-old infant. Families were randomly assigned to standard pediatric primary care or a brief in-home intervention targeting parenting skills to promote positive infant behavior. Families completed assessments at baseline, post-intervention, and a 3-month follow-up. Assessments included a 10-min infant-led play task, which was coded for parent emotion talk. Results demonstrated a significant effect of the intervention on parent emotion talk. Specifically, mothers in the intervention group displayed a higher frequency of parent emotion talk at post-intervention. Indirect effects of behaviorally-based parenting skills were significant, demonstrating that increases in behaviorally-based parenting skills at the post-intervention led to increases in parent emotion talk at the follow-up. Findings highlight the effect of a brief, home-based behavioral parenting intervention with infants on maternal emotion socialization.

Introduction

Emotion development in childhood is an early and complex process that encompasses emotion knowledge, emotion expression, and emotion regulation. By 5 months, infants begin to respond to emotion cues from their parents and other infants[1–3], which provides an important foundation for understanding and verbalizing simple emotions [4]. By 18 months, infants begin to identify simple emotions, such as happy, sad, and angry [5–7]. Following the early onset of emotion understanding, there is a rapid increase in emotion awareness and expression within the subsequent year from 18 to 30 months [8]. Furthermore, increased understanding of emotion has been associated with increases in infant prosocial behavior, such as helping others, showing concern for others when they are hurt, and sharing their personal belongings [9]. Given the early milestones of emotion development, it is important to understand the role of parents, who represent an important source of social interactions throughout infancy. Therefore, the current study examined the effect of a brief parenting intervention on maternal emotion socialization during infancy.

Parent-infant interactions have been shown to play a primary role in the process of infant emotion development. Parenting behaviors, such as maternal negativity, have been shown to be related to difficulties in emotion development, such as excessive tantrums and emotion dysregulation [10]. Additionally, reduced maternal affect and lower social engagement during parent-infant interactions, has been associated with infant negative emotionality and emotion regulation difficulties [11]. Given that parent-infant interactions are one of the first contexts in which infants learn about emotions, it is also important to examine how factors, such as parenting behaviors, may affect maternal emotion socialization during parent-infant interactions.

Parental socialization of emotion is comprised of three elements: how parents express emotions to their infant, teach their infant about emotions, and react to their infant’s emotions [12, 13]. Research indicates that increased use of parental socialization of emotion predicts later child emotion understanding and expression [4], as well as other social, emotional, and behavioral outcomes. One method of assessing these three elements of parental socialization of emotion is by examining emotion talk between parents and their infant. For example, preliminary evidence suggests that the extent to which parents use emotion terms (e.g., happy, sad) and desires (e.g., wants, needs) is associated with infant empathy and prosocial behavior [14]. Parent emotion talk also has been shown to be associated with more positive parent-infant interactions [15], which includes warmth and praise of appropriate infant behaviors [16, 17].

Behavioral parenting interventions have been shown to be efficacious in improving parent–child interactions by increasing positive parenting behaviors, such as praise, and reducing negative parenting behaviors, such as criticism, which we will refer to as behaviorally-based parenting skills. Some of the most well established behavioral parenting interventions targeting young children include Parent–Child Interaction Therapy (PCIT) [18], the Incredible Years [19, 20], Helping the Non-Compliant Child [21], and the Triple P Positive Parenting Program [22]. However, these behaviorally-focused interventions do not target parent emotion talk, which can have important implications for child emotion development. Although some researchers have examined adaptations of PCIT to include an emotion coaching component, such as PCIT-ED [23], little is known about the effect of standard behavioral parenting interventions on emotion socialization and on emotion talk. Given that the traditional components of behavioral parenting interventions target improvements in parent–child interactions, which have been associated with positive emotion socialization practices, it is possible that these typical intervention components are a mechanism for increases in parent emotion socialization practices.

Moreover, although infancy is a critical period for the development of parent–child emotion socialization [4], no study to our knowledge has examined the impact of behavioral parenting interventions delivered in infancy on maternal emotion socialization, including parent emotion talk. Targeting parenting practices during infancy is promising and can be brief in duration relative to interventions delivered later in childhood [24]. The main outcome paper examining a home-based adaptation of PCIT for high-risk infants, the Infant Behavior Program (IBP), showed a positive impact on behaviorally-based parenting skills [25] with the same sample as the current study, but did not examine the effect of the IBP on maternal emotion talk.

The existing body of research points to a need to examine the extent to which behavioral parenting interventions delivered in infancy impact parent emotion socialization behaviors through changes in behaviorally-based parenting skills. Research has demonstrated the effect of behavioral parenting interventions, such as PCIT, on behaviorally-based parenting skills (defined above) [26]. Although behaviorally-based parenting skills are the direct target of these programs, research has demonstrated that other parenting behaviors are often impacted by changes in behaviorally-based parenting skills. For example, findings from another study, with the same sample as the current study, showed the IBP increased maternal warmth and sensitivity through changes in positive behaviorally-based parenting skills, such as praise [27]. Thus, it is possible that the impact of behavioral parenting interventions on changes in parent emotion socialization skills is due, in part, to changes in positive behaviorally-based parenting skills. Specifically, given that parent emotion socialization skills, and particularly emotion talk, include positive attention to child behavior, we focused on positive behaviorally-based parenting skills.

In the present study, we examined the effect of the IBP on changes in parent emotion talk in a randomized controlled trial (RCT) in which families were randomly assigned to receive the IBP or standard pediatric primary care. The IBP targets improvements in the parent-infant interaction, and thus is an appropriate intervention for examining the impact of a behavioral parenting interventions on emotion socialization-based behaviors. We hypothesized that parents randomly assigned to receive the IBP would show significantly higher levels of emotion talk at a post assessment and at a 3-month follow-up assessment than parents assigned to standard care. Additionally, given the previous findings of the IBP on positive behaviorally-based parenting skills with the same sample as the current study [27], we hypothesized that the effect of the IBP on increases in parent emotion talk at the 3-month follow-up would occur through increases in positive behaviorally-based parenting skills at the post assessment.

Method

The current study is a secondary data analysis of an RCT of the IBP. The primary outcomes of the RCT have been reported elsewhere [25] and demonstrated that infants receiving the intervention displayed significantly lower levels of parent-reported and observed infant behavior problems across post and follow-up compared to infants in the standard care group. In addition, mothers demonstrated significantly higher levels of positive behaviorally-based parenting skills that they were taught to use during an infant-directed play across post and follow-up compared to mothers in the standard care group. Study procedures were approved by the university and hospital Institutional Review Boards.

Participants and Recruitment

Participants were 58 mothers and their 12- to 15-month-old infants. Families were recruited by research staff during well and sick visits at a pediatric primary care clinic in a large children’s hospital in the southeastern United States serving mostly low-income and ethnic minority families. The mother was the identified primary caregiver of all the families participating in the study. For study inclusion, all infant participants were required to be between 12 and 15 months of age at the time of recruitment, and mothers had to rate their infant above the 75th percentile on the Brief Infant–Toddler Social and Emotional Assessment [28], a screener of infant behavior problems. Mothers also had to speak either English or Spanish. If bilingual, mothers chose to complete assessments (and intervention sessions if randomized to the intervention group) in the language in which they felt most comfortable. English-speaking mothers were required to receive an estimated IQ score of 70 or higher based on the Vocabulary and Matrix Reasoning subtests of the Wechsler Abbreviated Scale of Intelligence [29], and Spanish-speaking mothers were required to receive an average scaled score of 4 or higher on the Vocabulary and Matrix Reasoning subtests of the Escala de Inteligencia Wechsler Para Adultos-Third Edition [30].

Infants were between the ages of 12 and 15 months, with an average age of 13.52 months (SD = 1.31) at the baseline assessment. Most of the infants were male (55%). Based on maternal report, most infants were of Hispanic ethnicity (94.8%) and White race (82.8%). Mothers were on average 29.9-years-old (SD = 5.3), and most reported they were of Hispanic ethnicity (90%) and White race (80%). The mean T-scores (across Vocabulary and Matrix Reasoning subtests) for mothers was 46.35 (SD = 12.55), and the majority of mothers (60%) reported attending some college. Most mothers reported income below the poverty line (60%) and Spanish as their primary language (57%). Demographic characteristics of families in the intervention and standard care groups are listed in Table 1.

Table 1.

Demographic and baseline characteristics

Characteristics	Full sample (n = 58)	Standard care group (n = 28)	Intervention group (n = 30)	Test statistic	p
	M (SD) or n (%)	M (SD) or n (%)	M (SD) or n (%)
Child age (months)	14.45 (1.42)	14.18 (1.30)	14.71 (1.50)	t = − 1.44	0.155
Child sex (male)	31 (53.4%)	14 (50%)	17 (56.7%)	χ2 = 0.26	0.611
Child ethnicity (Hispanic)	55 (94.8%)	28 (100%)	27 (90%)	χ2 = 2.95	0.086
Mother age	29.88 (5.28)	29.11 (5.72)	30.60 (4.80)	t = − 1.08	0.285
Mother English speaking (vs. Spanish)	24 (41.4%)	8 (28.6%)	16 (53.3%)	χ2 = 3.66	0.056
High school graduate or less	23 (39.7%)	12 (42.9%)	11 (36.7%)	χ2 = 0.23	0.630

Procedure

Families that met study criteria at the time of the screening were scheduled for a baseline assessment conducted in their home. The baseline assessment included administration of parent-rating forms and videotaped behavioral observations of mother-infant interactions. At the completion of the baseline assessment, families were randomized using a computer-generated random numbers list to receive the intervention or standard care. In the standard care group, infants received their usual care at the pediatric primary care clinic but did not receive the IBP. A second assessment was conducted approximately 2 months following the baseline assessment and represented the post assessment. The 3-month follow-up assessment was conducted approximately 3 months after the post-intervention assessment. Assessments took place in the families’ homes, and families were compensated $50 for completion of each assessment. The behavioral observations conducted at each assessment consisted of 10 min of infant-led play, in which the mother was instructed to let their child lead the play with three standardized sets of creative, constructive toys (e.g., blocks, farm house), and was used to code mother-infant interactions.

Sixty mother-infant dyads consented to participate and were randomly assigned to the intervention or standard care group. However, two families did not complete the baseline assessment (including the behavioral observation) and therefore data for the current study included the 58 families that completed the baseline assessment. Of the 58 families that completed the baseline assessment, 48 families (83%) completed the post-intervention assessment, and 46 families (79%) completed the 3-month follow-up assessment. Of the 28 families that completed the baseline assessment and were randomized to receive IBP (and had started the intervention), 20 (71%) families completed the intervention.

Intervention

The IBP is a home-based adaptation of the Child-Directed Interaction (CDI) phase of PCIT for infants with behavior problems and their families [31]. Parents who participated in the intervention were taught to follow their infant’s lead in play by increasing their use of behaviorally-based parenting do skills and decreasing their use of behaviorally-based parenting don’t skills. The acronym PRIDE is used to facilitate learning of the do skills, (i.e., Praising the infant, Reflecting the infant’s speech, Imitating the infant’s play, Describing the infant’s behavior, and expressing Enjoyment in the play). Therapists taught and coached parents to avoid the don’t skills (i.e., questions, commands, and negative talk). Parents were also taught to ignore disruptive behaviors, such as temper tantrums and whining, and direct the PRIDE skills toward positive infant behaviors. Parent emotion socialization skills, including parent emotion talk, were not taught or targeted during the intervention. Consistent with standard PCIT, the first session of the intervention is a teaching session during which parents learn the do and don’t skills and role-play the skills with the therapist. The following sessions consisted of live coaching targeting increases in behaviorally-based parenting do skills and decreasing their use of behaviorally-based parenting don’t skills.

The intervention consisted of weekly 60- to 90-min sessions in the parents’ home. In between sessions, parents were instructed to practice skills they learned with their infant for 5 min each day and document practice using weekly homework logs. Families were offered a maximum of seven sessions, including the teaching session. Families completed the intervention in an average of 6.1 sessions, with a range of 5–7 sessions. In accordance with PCIT international guidelines, advanced doctoral students were trained in PCIT by a licensed clinical psychologist and PCIT Master Trainer (second author). The advanced doctoral students participated in weekly group supervision to discuss each case. In addition, there were several practical and ethical considerations to implementing the intervention in the home that were carefully addressed for these families (e.g., therapists traveled to families’ homes in pairs). All sessions were videotaped, and 37% of sessions were randomly selected and coded for integrity by an undergraduate research assistant. Integrity, defined as the percent with which the therapist adhered to key elements of each session detailed in the IBP manual, was 97% with an excellent average kappa of 0.94.

Measures

Screening Measures

The Brief Infant–Toddler Social Emotion Assessment (BITSEA)[28] is a 42-item parent-rating scale designed to assess behavior problems and competencies in 12- to 36-month-olds. The problem scale is comprised of 31 items and has excellent test–retest reliability (r = 0.91–0.92) [32] and support for discriminative validity yielding excellent sensitivity and good specificity for those scoring above the clinical cutoff of the 75th percentile[33]. Items are rated on a scale of 0 (not true/rarely), 1 (somewhat true/sometimes), or 2 (very true/often), and examples of items on the problem scales include “restless and can’t sit still,” is “destructive,” and “hits, bites, or kicks.” Cronbach’s alpha for the problem scale in the current sample was 0.77. The BITSEA was administered at the screening, and infants scoring above the 75th percentile on the BITSEA problem scales based on their age and sex were included in the study.

The Wechsler Abbreviated Scale of Intelligence (WASI) [29] and the Escala de Intelligencia Wechsler Para Adultos—Third Edition (EIWA-III) [30] are reliable English and Spanish measures of intelligence, designed for use with individuals aged 6–89 years. The WASI two-subtest form consists of the Vocabulary and Matrix Reasoning subtests and yields a Full-Scale Intelligence Quotient (FSIQ-2), which has a mean score of 100 with a standard deviation of 15. An FSIQ-2 score ≥ 70 was used as a cutoff for the current study. The WASI FSIQ-2 correlated 0.87 with the FSIQ of the Wechsler Adult Intelligence Scale—Third Edition (WAIS-III) [29] and had high test–retest reliability, ranging from 0.83 to 0.90 [29]. The WASI also had high test–retest reliability and good concurrent validity [29]. The EIWA-III is the Spanish version of the WAIS and was used as a cognitive screening measure for Spanish-speaking caregivers. The same EIWA subtests as in the WASI (Vocabulary and Matrix Reasoning) were administered, and an average scaled score ≥ 4 (i.e., two standard deviations below the mean) was used as a cutoff for the current study. Reliability coefficients ranged from 0.65 to 0.96 for subtest scores and from 0.95 to 0.97 for performance and verbal scores. The reliability coefficient associated with the full-scale score was 0.98 [30, 34].

Parenting Measures

Observations of parent-infant interactions at each assessment were coded using the Dyadic Parent–Child Interaction Coding System, Third Edition (DPICS-III) [35] to evaluate parenting practices. The DPICS is a behavioral coding system that measures the quality of parent–child interactions. To examine changes in positive behaviorally-based parenting skills, we created a composite category of do skills (behavior descriptions, reflections, and praises) reflecting verbalizations parents are taught to use during play. Consistent with previous work in this sample examining the IBP, we examined the total frequency of do skills as positive behaviorally-based parenting skills [27]. Advanced graduate students were trained to 80% agreement with a criterion tape and were masked to group assignment. For purposes of reliability coding, 20% of the baseline observations were coded a second time by a graduate student and yielded an excellent average kappa of 0.89 across all codes.

Emotion Talk Coding System [14] Parent emotion talk was coded as parent verbalizations of emotions (e.g., happy, sad, angry) and desires (e.g., wants, needs) during the observations of parent-infant interactions at each assessment. Parent emotion talk was coded for utterances of simple affect, desires, elaboration/explanation/inferences, empathy, and mental state talk (i.e., mental state utterances and internal state utterances). Simple affect, desires, and elaboration/explanation/inferences are comprised of production and elicitation of emotion. Production of emotion is a statement that does not require a response (e.g., you look happy), while elicitation of emotion requires the child to respond to the parents’ inquiry surrounding the emotion (e.g., Why are you sad?). Given that the intervention targets reductions in questions, only production statements were examined in the current study. Specifically, we use simple affect, elaboration/explanation/inferences, and empathy to create a composite in the analyses to focus on emotion-specific statements. Table 2 includes Parent Emotion Talk codes, definitions, and examples used in the current study. This coding scheme has been used in studies with infants to examine parent emotion talk and has demonstrated good reliability and validity [9, 14]. An advanced graduate student (first author) and 2 undergraduate research assistants were trained to 80% agreement with a criterion tape. For purposes of reliability coding, 20% of the baseline observations were coded a second time by an undergraduate research assistant, and inter-rater reliability was adequate and yielded an excellent average kappa of 0.84 across all codes.

Table 2.

Parent emotion talk coding system

Category	Criteria	Examples
Simple affect production (SAP)	Nouns, verbs, adjectives, or adverbs naming emotional feelings or behaviors, or states of preference, desire, or intention without expan-sion or emotion imitation	“You are happy”
		“You really love your ice cream”
		“Boo hoo”, “grr”, “hahaha”
Elaboration/explanation/inferences production (EP)	Phrases or statements that explain or clarify the reason or possible cause or reason for a particular emotion, or that provide background or context for the emotion to help the child understand it, or that elaborate or explain how one infers or knows that a given emotion is being experienced	“You are sad because you dropped your ice cream”
		“You are scared because it is dark”
Empathy statements/sounds (EMP)	Statements or emotion-related sounds that promote empathy with a character’s emotion	“Poor baby”
		“Awwww”
		“Uh oh”

Coding system developed by Drummond and Brownell (see Drummond et al. [14])

Data Analyses

Data were analyzed using SPSS v. 25. Missing data due to incomplete assessments occurred at a low rate with less than 15% of data missing, overall. Little’s MCAR test was not statistically significant, χ² (8) = 4.169, p = 0.842, indicating no evidence of bias due to missing data, and therefore data were assumed to be at least missing at random (MAR). Given this assumption, an expectation maximization (EM) algorithm was used to account for missing data. Data analysis thus includes the full sample of 58 participants for whom any data were present. For examination of intervention effects on parent emotion talk, analyses of covariance (ANCOVAs) were conducted with a two-group (intervention or standard care) comparison and using baseline scores as a covariate to increase statistical power [36].

Structural equation modeling with Mplus 8 was used to test the study’s main hypotheses. Figure 1 describes our analytic approach. First, we examined the total effect of the intervention on parent emotion talk at the post-intervention and 3-month follow-up (Fig. 1a). Specifically, intervention group (0 = standard care group and 1 = IBP group) was used as the independent variable with the composite of parent emotion talk modeled at post-intervention and follow-up as the outcomes. The composite of parent emotion talk included the total frequencies of SAP, EP, and EMP. Second, we examined an indirect effect model, with behaviorally-based parenting skills (do skills) at post-intervention explaining the relation between the intervention and parent emotion talk at 3-month follow-up (Fig. 1b), accounting for baseline parent emotion talk and baseline behaviorally based-parenting skills. Confidence intervals for total and indirect effects were examined using the Monte Carlo Method for assessing multilevel mediation [37] in R Version 3.6.

Fig. 1.

Conceptual summary of analytic models. a Direct effect model and b Indirect effect model

A full information maximum-likelihood estimator was used to account for missing data, which provides parameter estimates using all available data and is the recommended method for handling missing data when data meet the assumption of missing at random [38]. Robust standard errors were used to account for skew and kurtosis among our key variables. We examined the Comparative Fit Index (CFI) and Root Mean Square Error of Approximation (RMSEA) fit indices to determine model fit; CFI values ≥ 0.95 and RMSEA values ≤ 0.05 are indicative of excellent fit [39].

Results

Descriptive Analyses

Prior to analyses, we examined correlations between variables of interest and demographic variables (i.e., child sex, child ethnicity, language during interaction, maternal education, maternal age). There were no significant correlations between any demographic variables and variables of interest in the models, and the groups (i.e., IBP and standard care) did not differ on any demographic characteristics. Therefore, we did not include any demographic variables in the models. Descriptive statistics and bivariate associations for the key variables are shown in Table 3. Figure 2 depicts the means of the total frequency of parent emotion talk at each assessment for both the intervention and standard care group.

Table 3.

Descriptive statistics and bivariate associations for key and demographic variables

	1. Emotion talk composite (pre)	2. Emotion talk composite (post)	3. Emotion talk composite (follow- up)	4. Behaviorally- based parenting (pre)	5. Behaviorally- based parenting (post)
1. Emotion talk composite (pre)
2. Emotion talk composite (post)	− 0.09
3. Emotion talk composite (follow-up)	− 0.15	0.73*
4. Behaviorally-based parenting (pre)	0.03	0.07	− 0.09
5. Behaviorally-based parenting (post)	0.01	0.65*	0.74*	0.09
Child sex (male)	0.19	− 0.21	− 0.23	0.52
Child ethnicity (Hispanic)	− 0.34	0.12	0.12	− 0.09	0.02
Mother age	− 0.01	− 0.06	0.05	− 0.05	0.04
Mother English speaking	− 0.09	0.02	0.08	0.01	− 0.06
High school or less	− 0.09	− 0.12	− 0.12	0.04	0.13
N	56	48	42	58	47
M (SD)	0.27 (0.56)	1.29 (2.84)	1.17 (2.78)	4.189 (3.95)	4.5 (9.45)
Min	0	0	0	0	0
Max	4	12	15	18	43

Emotion talk composite reflects the total frequency of simple affect production, elaboration/explanation/inferences production, and empathy statements/sounds

^*p < 0.001

Fig. 2.

Differences in parent emotion talk between intervention and standard care groups

Total, Direct, and Indirect Effects of the IBP

To ensure that results were not a result of overall increases in speech, we conducted all analyses using the total frequency of maternal words at the outcome as a covariate. To address the aims of the study, these analyses examined the direct effects of the IBP on parent emotion talk (Fig. 1a), as well as the direct and indirect effects of the IBP on parent emotion talk with behaviorally-based parenting skills as a mediator (Fig. 1b). As described in Table 4, in the direct effects model, the IBP was positively related to parent emotion talk at post-intervention but not at 3-month follow-up.

Table 4.

Summary of results of the direct and indirect effects

	Direct effect model		Indirect effect model
	b(SE)	B	b(SE)	B
Effects on emotion talk composite (post)
Intervention	2.31 (0.77) **	0.41
Total words	0.01 (0.01)	0.21
Emotion talk composite (pre)	− 0.59 (0.51)	− 0.16
Effects on emotion talk composite (follow-up)
Intervention	0.98 (0.73)	0.18	− 0.93(0.69)	− 0.17
Total words	0.01 (0.01)	0.45	0.01 (0.01)	0.14
Emotion talk composite (pre)	− 0.73 (0.47)	− 0.20	− 0.57 (0.38)	− 0.16
Parenting skills (post)			0.21 (0.05) ***	0.73
Effects on parenting skills (post)
Intervention			11.26 (2.25) ***	0.59
Parenting skills (pre)			0.10 (0.28)	0.04
Model fit
RMSEA	0		0.04
CFI	1.0		0.99
SRMR	0.05		0.05

Emotion talk composite reflects the total frequency of simple affect production, elaboration/explanation/inferences production, and empathy statements/sounds. Parenting skills = positive behaviorally-based parenting skills

CFI Comparative Fit Index (adjusted for auxiliary variable), RMSEA root mean square of approximation, SRMR standardized root mean square residual

^*p < .05.

^**p < .01.

^***p < .001

In the indirect effect model, there was no direct effect of the IBP on parent emotion talk at 3-month follow-up (i.e., c’ path). However, there were both total and indirect effects of the IBP. See Table 4 for a summary of direct and indirect effects. Consistent with our hypothesis, behaviorally-based parenting skills acted as the mechanism between the IBP and parent emotion talk. The total effect of the IBP on emotion talk at the 3-month follow-up was significant (b = 1.71, 95% CI [0.10, 3.50]). Specifically, the IBP positively predicted behaviorally-based parenting skills at post (i.e., a path) and behaviorally-based parenting skills positively predicted parent emotion talk at the 3-month follow-up (i.e., b path). The total indirect effect of the IBP on parent emotion talk at 3-month follow-up through behaviorally-based parenting skills was significant (b = 2.67, 95% CI [0.57, 5.47]), suggesting that the intervention led to increases in behaviorally-based parenting skills, which subsequently led to increase in parent emotion-talk.

Discussion

The current study examined the effect of the IBP, a behavioral parenting intervention for infants, on parent emotion talk. Despite the influence of parenting behavior on early emotion development [40, 41], empirical work has not examined the effect of standard parenting interventions on parent emotion socialization in infancy. Findings from the current study demonstrated that the IBP significantly predicted higher levels of parent emotion talk at the post-intervention assessment. These findings suggest that components of behavioral parenting interventions may lead to broader effects on parent emotion talk, which is not directly targeted by the IBP. Our study is the first to examine the effect of a behavioral parenting intervention on parent emotion talk in infancy, and it is particularly noteworthy to observe these effects during a critical time point (i.e., transition from infancy to toddlerhood) for emotion development [5].

However, the effect of the IBP on parent emotion talk was not maintained at the 3-month follow-up. Therefore, the intervention led to more immediate changes in parent emotion talk. The findings at follow-up may suggest the need to target parent emotion talk as a supplement to behavioral parenting interventions to maintain its effect on parent emotion talk. Adding intervention components to target parent emotion talk would be consistent with work by Luby et al. [23] and Chronis-Tuscano et al. [42] who have adapted PCIT to include emotion coaching elements with preschoolers and older children. It is possible that a stepped cared model would be best, where only some mothers would need additional intervention components to result in changes in emotion socialization practices. Given the relatively small sample size, we were unable to examine individual differences in parent emotion-talk, and future research should examine which mothers would be most likely to benefit from additional services. Nonetheless, it is difficult to understand the lack of significant effects at follow-up without understanding the mechanism by which the intervention led to changes in parent emotion talk.

Given the direct effect of the IBP on parent emotion talk at post-intervention, as well as the goal of improving parent-infant interactions via parenting skills, we tested the indirect effect of positive behaviorally-based parenting skills on the relation between the IBP and parent emotion talk. The current findings support our hypothesis that levels of behaviorally-based parenting do skills at post-intervention act as a mechanism of change on the relation between the IBP and parent emotion talk at the 3-month follow-up. Therefore, although there was no direct effect of the IBP on parent emotion talk at follow-up, the significant indirect effect suggests that the IBP led to improvements in parent emotion talk through changes in behaviorally-based parenting skills. These findings suggest that positive parenting skills are aligned with emotion socialization, which has been shown to improve emotion regulation and emotion understanding in children [43, 44]. The mechanism by which parent emotion talk develops also suggests a potential path by which we could target and emphasize intervention targets to improve child emotional development including emotion regulation.

While the current study is the first to our knowledge to examine the effect of a behavioral parenting intervention for infants on parent emotion talk, there were some limitations that should be noted. First, the sample for the current study was largely homogeneous in terms of ethnicity and race. Our findings expand knowledge of the impact of a parenting intervention on parent emotion talk in a sample of infants from mostly underrepresented ethnic and racial minority backgrounds (94.8% minority status), but results may differ in a more ethnically and racially diverse sample. While our sample had limited variability in ethnicity, we did find significant correlations between ethnicity and total frequency of parent emotion talk. Given the scope of this study and limitations of the sample (i.e., small sample size, homogenous ethnicity), we did not further examine this relation but encourage future researchers to explore the role of ethnicity and culture on parent emotion talk. Second, while all caregivers were invited to participate in the intervention, only mothers enrolled in the study as primary caregivers. Given the role that other caregivers, such as fathers, have been shown to have on infant emotion development [45], future studies should examine the impact of parenting interventions on other caregivers’ parent emotion talk.

Third, while we measured one type of emotion socialization (i.e., emotion talk), we did not measure other components of emotion socialization, such as teaching and reacting to an infant’s emotions. These components of emotion socialization, such as emotion reaction, may differentially impact infant emotion development [44]. Furthermore, the parent-infant play task used was not intended to elicit parent emotion talk and therefore may not have fully captured the extent to which parents may have used emotion talk with their infant throughout other interactions. Future studies should examine the effect of behavioral parenting interventions on parent emotion talk across other interactions previously examined in emotion talk research, such as book reading [14]. Additionally, we utilized observational coding systems to measure behaviorally-based parenting skills and parent emotion talk. While observational coding systems can provide an objective assessment of parenting behavior, multi-method assessments including behavioral and self-report measures (e.g., Self- Expressiveness in Family Questionnaire) provide a more comprehensive evaluation of parenting behaviors [46]. It is also important to note that the sample size in the current study was relatively small and may have reduced the power to detect effects.

Despite these limitations, the current study demonstrated an effect of a brief, home-based behavioral parenting intervention with infants on parent emotion socialization. It is particularly noteworthy that this intervention that did not target parent emotion-socialization skills but had a significant effect on parent emotion talk. Overall, these preliminary findings suggest promise in improving components of parent emotion socialization in mothers of infants through behaviorally-based parenting skills. Replicating and expanding these findings to understand the effects on infant and child outcomes (e.g., internalizing and externalizing behaviors, emotion regulation) is an important next step for future research.

Summary

This study aimed to examine the effect of an early intervention program for mothers of infants, based on PCIT, on parent emotion talk and the mediating role of parenting skills. We hypothesized that (1) parents who received the early intervention program would use more emotion talk at post assessment and 3-month follow-up assessments than parents assigned to standard care, and that (2) behaviorally-based parenting skills mediate the effect of the early intervention on parent emotion talk. Parent-infant dyads (n = 58) were recruited from a primary care clinic and randomly assigned to receive an early intervention program or standard care. Families completed a baseline, post, and 3-month follow-up assessment where they were observed in a brief parent–child interaction in their homes. The parent–child interaction was coded for parent emotion talk and behaviorally based parenting skills. Results showed that the early intervention program was associated with increases in parent emotion talk at the post-assessment but not the 3-month follow-up. The results also revealed that behaviorally-based parenting skills played a mediating role between the early intervention program and parent emotion talk. Findings from the present study suggest the possibility of targeting parent emotion socialization skills as early as infancy.