The Mothering The Mothering StudyStudy

Supporting Mother-Infant Supporting Mother-Infant Relationships Affected by Relationships Affected by Intimate Partner ViolenceIntimate Partner Violence

N Letourneau PhD RN

K Young MPhil

T Cluney BN Student

Child Health Intervention and Longitudinal Development (CHILD)

Studies Program

The Mothering Study

DirectorDirectorWomen in TransitionWomen in Transition

Julie GallantJulie GallantYouth in TransitionYouth in Transition

Claudette LandryClaudette LandryNB Department of HealthNB Department of Health

Sheila ProfitSheila ProfitCape Breton UniversityCape Breton University

Evelyn KennedyEvelyn KennedyCape Breton UniversityCape Breton University

Liz LautardLiz LautardLiberty Lane Inc.Liberty Lane Inc.

Christine LeBlancChristine LeBlancVON Healthy Baby & MeVON Healthy Baby & Me

Amanda LawsonAmanda LawsonMoncton HeadstartMoncton Headstart

Lyn BarrettLyn BarrettNS Transition Hose Assoc. NS Transition Hose Assoc.

Barbara ClowBarbara ClowAtlantic Centre of Excellence for Women’s Atlantic Centre of Excellence for Women’s HealthHealth

Anne DarrahAnne DarrahFredericton Early InterventionFredericton Early Intervention

Steven FletcherSteven FletcherRiver Valley HealthRiver Valley Health

Elizabeth GodboutElizabeth GodboutRiver Valley HealthRiver Valley Health

DirectorDirectorPEI Transition House Assoc.PEI Transition House Assoc.

Community Community ResearchersResearchers

The Mothering Study

Academic ResearchersAcademic Researchers NicoleNicole Letourneau Letourneau

University of New BrunswickUniversity of New Brunswick

Kimberly Critchley Kimberly Critchley University of Prince Edward IslandUniversity of Prince Edward Island

Julia CampbellJulia Campbell

University of Prince Edward IslandUniversity of Prince Edward Island Carmen GillCarmen Gill

Muriel McQueen Fergusson Center for Muriel McQueen Fergusson Center for Family ViolenceFamily Violence

Doug WillmsDoug WillmsUniversity of New BrunswickUniversity of New Brunswick

Jean HughesJean HughesDalhousie UniversityDalhousie University

Loretta SeccoLoretta SeccoCape Breton UniversityCape Breton University

Miriam StewartMiriam StewartUniversity of AlbertaUniversity of Alberta

The Mothering Study

Intimate Partner Intimate Partner ViolenceViolence

Types of Intimate PartnersTypes of Intimate Partners Categories of ViolenceCategories of Violence

• Current or former spouses Current or former spouses (including common-law (including common-law spouses)spouses)

• Dating partnersDating partners• Current or former boyfriendsCurrent or former boyfriends• Divorced spousesDivorced spouses• Separated spousesSeparated spouses

• Physical violencePhysical violence• Sexual violenceSexual violence• Threat of physical or sexual Threat of physical or sexual

violenceviolence• Psychological/emotional abuse Psychological/emotional abuse

(including coercive tactics) when (including coercive tactics) when there has also been prior there has also been prior physical or sexual violence or physical or sexual violence or prior threat of physical or sexual prior threat of physical or sexual violenceviolence

The Mothering Study

Violence and Child Violence and Child HealthHealth

Exposure to family violence is linked Exposure to family violence is linked with severe psychological and with severe psychological and behavioural effects on children in later behavioural effects on children in later lifelife

The effects of violence on children The effects of violence on children may be directly related to their lack of may be directly related to their lack of an emotionally safe and secure an emotionally safe and secure environmentenvironment

No research to date has looked at the No research to date has looked at the effects of exposure to violence on effects of exposure to violence on infants or mother-child relationshipsinfants or mother-child relationships

The Mothering Study

Pathways to ResiliencyPathways to Resiliency

The good news….The good news….

The Mothering Study

Pathways to ResiliencyPathways to Resiliency

Some mothers that experience domestic Some mothers that experience domestic violence may be more sensitive and violence may be more sensitive and responsive to their children’s needs, responsive to their children’s needs, compensating for the negative effects of compensating for the negative effects of violence (Levendosky 2003; Wuest 2004)violence (Levendosky 2003; Wuest 2004)

Not all children are negatively Not all children are negatively affected by exposure to violenceaffected by exposure to violence

The Mothering Study

Pathways to ResiliencyPathways to Resiliency

Mothers of children exposed to Mothers of children exposed to domestic violence provide more domestic violence provide more positive forms of parenting over time positive forms of parenting over time than mothers not exposed to violencethan mothers not exposed to violence

This heightened sensitivity and This heightened sensitivity and responsiveness may be a key to the responsiveness may be a key to the successful development of some successful development of some children exposed to IPVchildren exposed to IPV

The Mothering Study

Pathways to ResiliencyPathways to Resiliency

5.50

5.75

6.00

6.25

6.50

6.75

7.00

7.25

7.50

7.75

8.00

8.25

2 3 4 5 6 7 8 9 10 11 12

Age (in years)

Par

enti

ng

Beh

avio

ur

No Violence: PositiveDiscipline

Violence: Positive Discipline

No Violence: Warm andNurturing

Violence: Warm andNurturing

No Violence: Consistent

Violence: Consistent

The Mothering Study

Policy RelevancePolicy Relevance

Policy makers internationally, Policy makers internationally, from across Canada, and within from across Canada, and within the Maritime Provinces are the Maritime Provinces are calling for increased support to calling for increased support to parents and families, especially parents and families, especially in light of early childhood needsin light of early childhood needs..

The Mothering Study

Policy RelevancePolicy Relevance WHO Report on Violence and Health National Children’s Agenda Federal/Provincial/Territorial Early Childhood Development

Agreement Family Violence Initiative, NS Our Children: Today’s Investment Tomorrow’s Promise, PEI Our Children: A Strategy for Healthy Child Development,PEI Greater Opportunities for New Brunswick Children: An Early

Childhood Development Agenda New Brunswick Minister’s Working Group on Violence Against

Women

The Mothering Study

Implications for FAS Implications for FAS Support & PreventionSupport & Prevention

Experiencing partner violence places Experiencing partner violence places women at greater risk of abusing drugs women at greater risk of abusing drugs and/or alcoholand/or alcohol

Substance abuse treatment may not be Substance abuse treatment may not be as effective if violence issues are not as effective if violence issues are not addressedaddressed Violence is often hiddenViolence is often hidden

The Mothering Study

Research QuestionsResearch Questions What is the impact of IPV on mother-infant What is the impact of IPV on mother-infant

relationships?relationships? What is the association between mother-What is the association between mother-

infant relationships and infant development infant relationships and infant development in families affected b IPV?in families affected b IPV?

What are (a) the support needs, (b) support What are (a) the support needs, (b) support resources, (c) barriers to support, and (d) resources, (c) barriers to support, and (d) preferences for support intervention to preferences for support intervention to promote mother-infant relationships affected promote mother-infant relationships affected by IPV?by IPV?

The Mothering Study

Research MethodsResearch Methods Community based, multi-site exploratory Community based, multi-site exploratory

descriptive studydescriptive study Sites in PEI, NB, and NS (Cape Breton & Sites in PEI, NB, and NS (Cape Breton &

mainland)mainland) Quantitative and qualitative data from mother Quantitative and qualitative data from mother

infant pairs previously exposed to violenceinfant pairs previously exposed to violence Qualitative data from Service ProvidersQualitative data from Service Providers

Sample sizeSample size A total of 82 mother infant pairs are A total of 82 mother infant pairs are

needed to support quantitative findingsneeded to support quantitative findings 10-20 service providers are needed in10-20 service providers are needed in

each provinceeach province

The Mothering Study

Qualitative InterviewsQualitative Interviews

Mothers will be asked to talk Mothers will be asked to talk aboutabout How they think the violence How they think the violence

affected themselves, their affected themselves, their child, and their relationship child, and their relationship with their childwith their child

What kinds of services they What kinds of services they used, and how they think used, and how they think services could be improvedservices could be improved

The Mothering Study

Qualitative InterviewsQualitative Interviews

Services Providers will be asked Services Providers will be asked aboutabout The impact of partner violence on The impact of partner violence on

mother-child relationships and child mother-child relationships and child developmentdevelopment

The support needs of women and The support needs of women and children affected by violencechildren affected by violence

Perceived feasibility of support Perceived feasibility of support interventionsinterventions

The Mothering Study

Quantitative MeasuresQuantitative Measures

Mothers will be asked to complete a number of Mothers will be asked to complete a number of assessments looking atassessments looking at Child developmentChild development Parent child relationship qualityParent child relationship quality The family environmentThe family environment Other known parenting/life stressorsOther known parenting/life stressors

The Mothering Study

Quantitative MeasuresQuantitative Measures Nursing Child Assessment Teaching Scale (NCATS)Nursing Child Assessment Teaching Scale (NCATS) Ages and Stages questionnaires Ages and Stages questionnaires Centre for Epidemiological Studies Depression Scale (CESD)Centre for Epidemiological Studies Depression Scale (CESD) Social Provisions Scale (SPS)Social Provisions Scale (SPS) Family Functioning Scale (FFS)Family Functioning Scale (FFS) Difficult Life Circumstances Scale (DLC)Difficult Life Circumstances Scale (DLC) Infant Characteristics Questionnaire (ICQ)Infant Characteristics Questionnaire (ICQ) Parenting Scale Parenting Scale Motor and Social Development Scale (MSD)Motor and Social Development Scale (MSD) Demographic InformationDemographic Information

The Mothering Study

Special ConsiderationsSpecial Considerations

The Cycle of ViolenceThe Cycle of Violence Long term implications of a violent relationshipLong term implications of a violent relationship Mothers’ needs for supportMothers’ needs for support Mothers’ safety needsMothers’ safety needs TrainingTraining

The Mothering Study

Research ProgressResearch Progress

Ethical approval has been received at one of Ethical approval has been received at one of the four research sitesthe four research sites

The pilot phase of the mother interviews has The pilot phase of the mother interviews has been completed (n = 3)been completed (n = 3)

Interviewers for each province have been Interviewers for each province have been trainedtrained

The Mothering Study

Research ProgressResearch Progress

Service provider pilot interviews are beginning Service provider pilot interviews are beginning in New Brunswick in New Brunswick

Participant recruitment has begun in New Participant recruitment has begun in New Brunswick and is ongoing in Prince Edward Brunswick and is ongoing in Prince Edward IslandIsland

Data collection in all threeData collection in all threeprovinces is anticipated to provinces is anticipated to be completed by the summer be completed by the summer of 2008of 2008

The Mothering Study

Research Assistant Research Assistant TrainingTraining

Training Manual Training Manual

Training Training sessession sion hheld eld August 17, 2006August 17, 2006 Research Assistants from Research Assistants from

NS, PEI, and NB NS, PEI, and NB participated in a variety of participated in a variety of group, role-playing and group, role-playing and hands on learning activitieshands on learning activities

The Mothering Study

Research Assistant Research Assistant TrainingTraining

Training session topicsTraining session topics Research ObjectivesResearch Objectives Site ProtocolsSite Protocols Safety and Sensitivity Protocols Safety and Sensitivity Protocols Data Collection Data Collection Audio & Video Equipment UseAudio & Video Equipment Use

The Mothering Study

RecruitmentRecruitment

Service providersService providers Community Research Team Community Research Team

membersmembers Service agencies used to Service agencies used to

recruit mother-infant pairsrecruit mother-infant pairs ParticipantsParticipants

Recruitment efforts in both Recruitment efforts in both focused areas and the focused areas and the general populationgeneral population

The Mothering Study

Participant RecruitmentParticipant Recruitment

Targeted ApproachesTargeted Approaches Agencies that target violence/at-risk familiesAgencies that target violence/at-risk families

Liberty Lane Second Stage HousingLiberty Lane Second Stage Housing VON Healthy Baby and MeVON Healthy Baby and Me Chrysalis House for Youth in TransitionChrysalis House for Youth in Transition Coalition of Transition HousesCoalition of Transition Houses Center of Excellence in Women’s HealthCenter of Excellence in Women’s Health Family Violence Outreach ProgramFamily Violence Outreach Program Dept. of Health and Social ServiceDept. of Health and Social Service Other ideas?Other ideas?

The Mothering Study

Participant RecruitmentParticipant Recruitment

Universal ApproachesUniversal Approaches Public Service AnnouncementsPublic Service Announcements Paid Newspaper AdsPaid Newspaper Ads Candy CardsCandy Cards Other ideas?Other ideas?

The Mothering Study

Candy CardsCandy Cards

The Mothering Study

AcknowledgementsAcknowledgements

Canadian Institutes for Health ResearchCanadian Institutes for Health Research Muriel McQueen Fergusson Center for Muriel McQueen Fergusson Center for

Family Violence ResearchFamily Violence Research M. Merritt-Gray, J. Wuest, K. White (UNB)M. Merritt-Gray, J. Wuest, K. White (UNB)