Parental stress and parent-rated child behavior in relation to otitis media in the first three years of life

Objective. As part of a long-term study of possible effects of early-life o titis media on speech, language, cognitive, and psychosocial development, w e tested relationships between parents' ratings of parent-child stress at a ges 1, 2, and 3 years, and of their children's behavior problems at ages 2 and 3 years, and the children's cumulative duration of middle-ear effusion (MEE) in their first 3 years of life. Methods. We enrolled healthy infants by age 2 months who presented for prim ary care at 1 of 2 urban hospitals or 1 of 2 small-town/rural and 4 suburba n private pediatric practices. We obtained standardized baseline measures o f parental stress; we intensively monitored the children's middle-ear statu s by pneumatic otoscopy, supplemented by tympanometry, throughout their fir st 3 years of life; we monitored the validity of the otoscopic observations on an ongoing basis; and we treated children for otitis media according to specified guidelines. We obtained parent ratings of parental stress using the Parenting Stress Index/Short Form when the children reached ages 1, 2, and 3 years, and parent ratings of children's behavior using the Child Beha vior Checklist when the children reached ages 2 and 3 years. Results. In 2278 children we found no substantial relationships between par ents' ratings of parent-child stress when the children reached ages 1, 2, a nd 3 years, or of their children's behavior problems at ages 2 and 3 years, and the cumulative duration of the children's MEE during antecedent period s. On the other hand, ratings both of parent-child stress and of behavior p roblems were consistently highest among the most socioeconomically disadvan taged children and lowest among the most socioeconomically advantaged child ren. Ratings also tended to be highest among children whose parents' baseli ne stress scores were highest. Conclusions. Parent-child stress and children's behavior problems in the fi rst 3 years of life, as rated by parents, bear little or no relationship to the children's previous cumulative duration of MEE.