**4. Enhancing parenting**

poverty, showed a significant and robust association between these two variables. Neverthe‐ less, in this study the mean scores for maternal sensitivity and attachment security were significantly lower than those from the socioeconomically advantaged. One would assume then that the stressful daily life experienced by families living in poverty might negative‐ ly affect the quality of maternal sensitivity and attachment security, as well as the relation‐ ship between these two factors; for example, socioeconomic status tends to relate to knowledge about child development, as well as expectations for the infant [36]. More‐ over, the interactive pattern tends to be distinct according to socioeconomic level [29,35,39].

Mothers of higher socioeconomic status tend to talk more with their infants when trying to calm them down. Likewise, they tend to hold their children more often and express more affection towards them, compared to mothers of lower socioeconomic status [39]. In this sense, it is considered that the socioeconomic conditions of the family influence the quality of education and care the child will receive, as well as the type of resources and experiences that

Furthermore, Belsky et al. [29] found that stressors of context, namely single parenthood and marital conflict, may lead to parenting practices considered more punitive. In these situations, there were observed more behaviors of rejection and inconsistency in the care of the infant. These behaviors, in turn, would instill in children a sense of defenselessness and unpredicta‐

Since parents with higher sensitivity are better at identifying their child's needs and respond‐ ing appropriately, they are less likely to develop behaviors of neglect or maltreatment [27]. In other words, parents tend to resort to practices considered more punitive in environments marked by the presence of stressful events, which in turn can lead to a child's sense of selfdeprecation. In these cases, children tend to view themselves as little worthy of love, while others would regard them as unreliable and non-protective. As a result, their interpersonal

It is from this perspective that Belsky et al. [29] characterize the practice of infants' caregiving as arising from contextual demands. The authors explained that parents' educational strategies will be influenced by their assessment of reality. For example, if parents rated their life as difficult, violent, unstable, it is natural that they would want to educate their children in light of this reality, making them better suited to deal with these qualities. Likewise, attitudes like warmth and safety can be considered counterproductive and unhelpful to a child's develop‐ ment in an environment considered tough, hostile, and in which a person constantly needs to defend themselves. The way parents raise their children and the type of care they offer are

Nevertheless, it is necessary to emphasize that no context of development is considered better than another, but rather that they provide for distinct experiences. This is a view shared by Keller, Lohaus, Volker, Cappenberg and Chasiottis [42]. These authors postulate that care consist of a set of behaviors that have, as their main objective, to meet contextual demands. Importantly, the different educational strategies adopted in each context aim to provide the best possible development to the child, taking into account the characteristics of the environ‐

strongly influenced by their assessment of the challenges of their context [29,40].

bility, which would lead to a model of internalization considered insecure [16,15,41].

relationships would be assessed as unreliable and transient [29].

the child will have access to [40].

152 Parenting in South American and African Contexts

The development of parenting interventions improve the quality of the first emotional experiences, present in the infant-mother interactions [28], and stimulate protective factors of child and adolescent development in at-risk social contexts. Interventions aimed family caregivers are important not only to promote the healthy development of boys and girls, but also to prevent violence within the home and to help build equitable and inclusive societies, as well as to reduce abusive and neglectful parental behaviors that continue to affect many children around the world [4,5]. These elements should serve as a guide in the implementation of public and private interventions.

Bronfenbrenner, in his model of bioecological development, considers that the emotional bonding process can be facilitated through intervention programs which involve caregivers as primary intervention agents, and where strong one-on-one relationships are considered essential for the development of young children [8]. The process of emotional bonding can be understood within the Bronfenbrenner model, as a proximal process. That is, as those rela‐ tionships that occurs in the immediate surroundings of daily care.

According to the initial hypothesis proposed by Bronfenbrenner [23], the proximal processes, such as development contexts characterized by interpersonal structures, may produce two types of effects on the individual involved in this, taking into account the quality of these processes: 1) competence or ability to self-manage skillfully behavior within a domain of development; or 2) dysfunction, difficulty in maintain control over development [26]. Bron‐ fenbrenner always included within the assumptions of the theoretical model, the need of research evidence that would allow public interventions or programs to promote healthy human competency. When designing interventions for early childhood, Bronfenbrenner suggested that these should influence the microsystem, which is in everyday interactions in order to affect the core of parental relationships (i.e., the family microsystem) For Bronfen‐ brenner [23], the microsystem is "a pattern of activities, social roles and interpersonal face-toface relationships experienced by developing persons in a scenario with physical, social and symbolic individuals that invite, permit or inhibit, and that progressively engage them in more complex and active interaction within the immediate environment " (p1645). That is to say, it is within the microsystem where trigger processes occur, inhibiting or favoring human development, the proximal processes.

To achieve developmental impact through early interventions, Bronfenbrenner [8] emphasizes that during the first three years of life, the main objective of human development is to establish a lasting emotional relationship between parents and children, and that these relationships are built through frequent reciprocal interactions. He also points out that the impact on the development of a primary dyad increases in direct relation to the reciprocity of mutual positive feelings, a gradual shift in the balance of powers, and a progressive autonomy for the child [26]. The author said that the effect of interventions at these ages should be to strengthen the bond between parents and children, improve the motivation of parents for upbringing, and to increase the frequency, power and contingency responses of the parents to their children to get them to give mutual behavioral adaptation. Also considers that the emotional bonding process is likely to be facilitated through intervention programs. In these programs, parents must be involved as primary intervention agents, and should seek to strengthen the one-toone time spent with their child, which is essential for the development of young children [8].

for their children, such as informative videos about best practices to manage and promote

Interventions for Enhancing Parenting Quality in Early Infancy

http://dx.doi.org/10.5772/56974

155

In regards to the relationship between sensitivity and infant attachment behavior, it was found that when an intervention is highly successful in increasing sensitivity, there appears a positive parallel change in infant attachment security. It is also noted that interventions are preferable when they have a clear focus, directed exclusively on the sensitive behavior of caregivers with

On the evaluation of care behavior in caregivers of younger children, Posada, Carbonell, Alzate and Plata [57] have drawn attention to the importance of knowing not only whether scores on sensitivity or attachment security of children, evaluated with standardized instruments, are or are not similar from one culture to another, but also whether there are any contextual and cultural particularities in sensitive care quality, and above all, what these particularities are. The authors state that only using assessment tools developed with samples of white and middle-class in Western industrialized countries, fails to recognize the specific cultural manifestations of early intervention, and therefore, it is necessary to use mixed methodologies which would reveal such manifestations, especially if the results are to be useful for local intervention. However, there are several standard techniques for assessing the sensitivity of caregivers which are based on naturalistic observation and therefore are ecologically valid [23]. Among the naturalistic techniques implemented most in clinical research and early childhood are: The Home Observation for Measurement of the Environment - HOME [58], The Nursing Child Assessment Teaching Scale - NCATS [59] and the Maternal Behavior Q-Sort [7].

Taking the time to consider the ecological validity of the measurements on the quality of child care is important, since the experiences, environments and opportunities that adults provide children determine their strengths and vulnerabilities. Children that spend early childhood living in violent, emotionally or cognitively deprived situations, or who are subjected to experiences of abuse or neglect, face compromised brain development and restricted devel‐ opmental potential [60-62]. If, however, a child's world is safe, caring and full of social, emotional and cognitive opportunities, their developmental potential will unfold [9,63]. According to De Antoni and Koller [64], through the ecological approach of development, one gains a contextualized view of environmental and situational factors that may have some influence on the development. For these authors, it is necessary that the development of the person be understood from observation in the natural environment and from real situations

that affect them, their resources, and their own interpretation of reality.

**5. A home based intervention in the state of Rio Grande do Sul, Brazil**

The development of home visiting programs and parental training are based on the premise that intervention during the early years of a child's life presents a unique opportunity to promote their socio-cognitive development. From this perspective, programs whose main objective is to qualify positive parenting practices, or provide resources for parents towards the care of their children and provide richer experiences for the healthy development have

affective interaction with children, can improve a caregiver's sensitive response [56].

a modest number of sessions [44].

Some interventions based on Attachment Theory, attempting to ensure proper child develop‐ ment, aim to raise awareness of caregivers, since their ability to identify signals from young children, interpret them adequately and promptly respond to them, are factors that facilitate the establishment of an attachment relationship that is mutually satisfactory and a powerful variable to determine the safety of the child [43]. In their meta-analytic study of the effects of early interventions on sensitivity and attachment, Bakermans-Kranenburg, van Ijzendoorn and Juffer [44] found that brief interventions, focused exclusively on sensitivity as behavior, are most successful in improving caregivers' sensitivity in daily care of children, as well as infant attachment security.

Infant attachment security largely determines the quality of a child's future social relationships [10,15,16,45]. For example, it has been established that children with high levels of attachment security in early childhood, are more flexible and adaptable to changes in the environment at school age, and have more positive expectations in interactions with their peers. These children are described by others as cooperative, popular and resourceful, and are characterized as exhibiting reciprocity in social interaction, as well as verbal and behavioral fluency. Also, in interactions with adults, they are relaxed, friendly and can more easily engage in emotional intimacy [46-49]. In addition, children who show secure attachment can better regulate negative emotions and construct ways to cope with stress [50-52]. They also have a better self concept, in terms of how they see themselves and their capabilities [53,54].

The ideal duration of home intervention programs is a subject of discussion [44,55]. According with Olds [27], interventions should be initiated even during pregnancy and continue for at least the first two years of a child's life. Despite the lack of consensus on the duration of the intervention, it is unanimous that home interventions should occur on a regular time basis. The intervals between visits should be short, to allow the formation of a trustful relationship between coaches and families [27,44,55].

The most effective interventions do not always require a large number of sessions with families, and need not begin before birth or even during the first months a child's life. By contrast, in the aforementioned meta-analysis [44] researchers found that fewer sessions and intervention, beginning six months or more after birth, are the most effective. Taking into account the entire set of interventions studied, regardless of the presence or absence of multiple problems in families, such as poverty, teen pregnancy and prematurity, fewer sessions were more effective. Only cases of interventions with clinical samples (psychopathology or mental illness) showed higher levels of effectiveness, as well as interventions in which both parents participated, as compared with those in which only mothers participated. Other authors suggest that even modest interventions aimed at influencing the responsive performance of mothers in caring for their children, such as informative videos about best practices to manage and promote affective interaction with children, can improve a caregiver's sensitive response [56].

[26]. The author said that the effect of interventions at these ages should be to strengthen the bond between parents and children, improve the motivation of parents for upbringing, and to increase the frequency, power and contingency responses of the parents to their children to get them to give mutual behavioral adaptation. Also considers that the emotional bonding process is likely to be facilitated through intervention programs. In these programs, parents must be involved as primary intervention agents, and should seek to strengthen the one-toone time spent with their child, which is essential for the development of young children [8]. Some interventions based on Attachment Theory, attempting to ensure proper child develop‐ ment, aim to raise awareness of caregivers, since their ability to identify signals from young children, interpret them adequately and promptly respond to them, are factors that facilitate the establishment of an attachment relationship that is mutually satisfactory and a powerful variable to determine the safety of the child [43]. In their meta-analytic study of the effects of early interventions on sensitivity and attachment, Bakermans-Kranenburg, van Ijzendoorn and Juffer [44] found that brief interventions, focused exclusively on sensitivity as behavior, are most successful in improving caregivers' sensitivity in daily care of children, as well as

Infant attachment security largely determines the quality of a child's future social relationships [10,15,16,45]. For example, it has been established that children with high levels of attachment security in early childhood, are more flexible and adaptable to changes in the environment at school age, and have more positive expectations in interactions with their peers. These children are described by others as cooperative, popular and resourceful, and are characterized as exhibiting reciprocity in social interaction, as well as verbal and behavioral fluency. Also, in interactions with adults, they are relaxed, friendly and can more easily engage in emotional intimacy [46-49]. In addition, children who show secure attachment can better regulate negative emotions and construct ways to cope with stress [50-52]. They also have a better self

The ideal duration of home intervention programs is a subject of discussion [44,55]. According with Olds [27], interventions should be initiated even during pregnancy and continue for at least the first two years of a child's life. Despite the lack of consensus on the duration of the intervention, it is unanimous that home interventions should occur on a regular time basis. The intervals between visits should be short, to allow the formation of a trustful relationship

The most effective interventions do not always require a large number of sessions with families, and need not begin before birth or even during the first months a child's life. By contrast, in the aforementioned meta-analysis [44] researchers found that fewer sessions and intervention, beginning six months or more after birth, are the most effective. Taking into account the entire set of interventions studied, regardless of the presence or absence of multiple problems in families, such as poverty, teen pregnancy and prematurity, fewer sessions were more effective. Only cases of interventions with clinical samples (psychopathology or mental illness) showed higher levels of effectiveness, as well as interventions in which both parents participated, as compared with those in which only mothers participated. Other authors suggest that even modest interventions aimed at influencing the responsive performance of mothers in caring

concept, in terms of how they see themselves and their capabilities [53,54].

infant attachment security.

154 Parenting in South American and African Contexts

between coaches and families [27,44,55].

In regards to the relationship between sensitivity and infant attachment behavior, it was found that when an intervention is highly successful in increasing sensitivity, there appears a positive parallel change in infant attachment security. It is also noted that interventions are preferable when they have a clear focus, directed exclusively on the sensitive behavior of caregivers with a modest number of sessions [44].

On the evaluation of care behavior in caregivers of younger children, Posada, Carbonell, Alzate and Plata [57] have drawn attention to the importance of knowing not only whether scores on sensitivity or attachment security of children, evaluated with standardized instruments, are or are not similar from one culture to another, but also whether there are any contextual and cultural particularities in sensitive care quality, and above all, what these particularities are. The authors state that only using assessment tools developed with samples of white and middle-class in Western industrialized countries, fails to recognize the specific cultural manifestations of early intervention, and therefore, it is necessary to use mixed methodologies which would reveal such manifestations, especially if the results are to be useful for local intervention. However, there are several standard techniques for assessing the sensitivity of caregivers which are based on naturalistic observation and therefore are ecologically valid [23]. Among the naturalistic techniques implemented most in clinical research and early childhood are: The Home Observation for Measurement of the Environment - HOME [58], The Nursing Child Assessment Teaching Scale - NCATS [59] and the Maternal Behavior Q-Sort [7].

Taking the time to consider the ecological validity of the measurements on the quality of child care is important, since the experiences, environments and opportunities that adults provide children determine their strengths and vulnerabilities. Children that spend early childhood living in violent, emotionally or cognitively deprived situations, or who are subjected to experiences of abuse or neglect, face compromised brain development and restricted devel‐ opmental potential [60-62]. If, however, a child's world is safe, caring and full of social, emotional and cognitive opportunities, their developmental potential will unfold [9,63]. According to De Antoni and Koller [64], through the ecological approach of development, one gains a contextualized view of environmental and situational factors that may have some influence on the development. For these authors, it is necessary that the development of the person be understood from observation in the natural environment and from real situations that affect them, their resources, and their own interpretation of reality.
