DEPRESSION AND CHILD DEVELOPMENT
NB* In between the interview with an author I wanted to post something childcare related. In the works: an interview with a Nanny agency owner, what an interviewer looks for in a potential Nanny. Look out for these posts.
IF WE APPLY THE RESULTS OF THIS STUDY TO ‘NANNIES WORKING IN POVERTY’ (LOW WAGES, NO BENEFITS, NO JOB SECURITY, NO STATUS) CAN WE MAKE THE CONNECTION BETWEEN RISING DEPRESSION IN AMERICA AND EARLY CHILDHOOD EXPERIENCES IN CHILDCARE? NANNY X
THE URBAN INSTITUTE
By Tracy Vericker, Jennifer Macomber, and Olivia Golden
(EDITED BY NANNY X)
Depression in parents poses serious risks to millions of children in the United States each day, yet very often goes undetected and untreated. The risk can be very great for babies and toddlers, who are completely dependent on their parents (or Nannies) for nurturing, stimulation, and care—and for poor families (low income no status Nannies) that do not have the resources to cope with depression. But depression is treatable and opportunities to reach these families and connect them to help already exist within multiple systems. In this brief, we take a first-time national look at the characteristics, access to services, and parenting approaches for infants living in poverty whose mothers are depressed (we focus on mothers as they are often the primary caregivers). We also identify current service systems that could intervene and help depressed mothers find support.
Effects of Parental Depression
Recent estimates suggest 15 million children (or one out of five) live with an adult who had major depression in the past year (National Research Council and Institute of Medicine 2009). Depression can hurt an adult’s educational attainment, income, and employment (Coryell, Endicott, and Keller 1990; National Research Council and Institute of Medicine 2009). And depression often occurs along with substance abuse, other mental health problems, chronic medical conditions, and social disadvantage (National Research Council and Institute of Medicine 2009). We know less, however, about how depression affects parenting and, in turn, children’s development. Depression can compromise a parent’s ability to provide consistent care in a safe environment. Evidence suggests that depression can interfere with parenting, leading to poor social development and problems with physical, psychological, behavioral, and mental health in children (National Research Council and Institute of Medicine 2009).
In particular, maternal depression during infancy is a serious concern. Depression during the prenatal period is linked to complications during pregnancy or delivery and adverse pregnancy outcomes. Just as concerning, prenatal depression is associated with newborn crying, fussiness, and inconsolability, factors that in turn, may make it difficult for a parent to provide nurturing care (National Research Council and Institute of Medicine 2009). What makes the harm to children and their parents so distressing is that depression is usually treatable—and thus, the damage to children is preventable. The Institute of Medicine notes that a variety of safe and effective treatments are available for depression, including antidepressants, psychotherapies, behavioral therapies, and alternative medicines. However, the effect of these treatments has not yet been rigorously studied in vulnerable populations (National Research Council and Institute of Medicine 2009). Two recent evaluations of interventions for depressed minority and low-income mothers do offer promise that evidence-based therapies can be effective when they are culturally and linguistically appropriate (Miranda et al. 2006; Grote et al. 2009).
Seven percent of 9-month-old infants has a mother (how many have depressed Nannies?) who suffers from severe depression (figure 1). A broader look that also counts mild and moderate depression suggests that two in five 9-monthold infants (41 percent) live with a mother who suffers from some form of depression. For infants living in families with incomes below the federal poverty line, the picture is even bleaker. A striking one in nine of these infants (11 percent) lives with a mother suffering from severe depression; more than half (55 percent) of Infants of Depressed Mothers Living in Poverty: Opportunities to Identify and Serve
Observations of interactions between infants living in poverty and their mothers suggested potentially less positive interactions when the mother is severely depressed than when the mother is not depressed. These differences move in the expected direction but were not statistically significant at the 95 percent confidence level. For example, mothers’ interference with the infants’ actions was more frequently observed for infants with severely depressed mothers; correspondingly, positive observations were less frequent, including being spoken to by their mothers (spontaneously and not including scolding), and having a safe play environment. These patterns raise possible concerns that infants living with severely depressed mothers may receive less maternal stimulation and support—crucial factors in a child’s early cognitive and social development.
A basic analysis of the relationship between maternal depression and some measures of infant well-being at 9 and 24 months did not reveal notable differences for infants of depressed and non-depressed mothers, including when we looked at varying levels of severity of depression and at infants of both ages. As this was not in our original scope of work, we could not do the extensive and careful analysis of the measures and the relationships that would be needed to fully verify these findings. Hence, understanding the role of depression in a child’s outcomes, separate from the role of poverty or other factors, is an important area for future exploration.
Editor’s comment: without a thorough reform of the childcare industry (an unknown percentage of ) Nannies will continue to work unprotected and unregulated, (an unknown percentage of) parents will continue to shoulder the individual burden of screening and sourcing good childcare and (an unknown percentage of) children will continue to be serviced by an industry that operates outside of the law.
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