This research explored and compared patterns of adjustment in siblings exposed to intimate partner violence. The quality of family relationships were investigated as potential mechanisms that accounted for heterogeneity in these patterns. Participants included 47 sibling pairs and their mothers recruited from the community. Mothers and children reported on child adjustment measures and the quality of family relationships. Five cluster patterns were identified for both younger and older siblings, replicating three identified in previous research: primarily internalizing symptoms, a combination of internalizing and externalizing symptoms, and an asymptomatic cluster. There was little overlap in cluster membership within families; most siblings differed in terms of their pattern of adjustment. The quality of family relationships varied significantly across clusters. Overall, asymptomatic siblings reported the most positive family relationships. Maternal warmth differed across clusters for both older and younger siblings, while maternal hostility varied across clusters for older but not younger siblings. The quality of sibling relationships also differed across clusters for older but not younger siblings. These findings underscore the importance of examining differential sibling experiences within violent families, and demonstrate the significance of family relationships as a mediating mechanism influencing heterogeneous child adjustment.

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The aims of this study were: (1) to characterise changes in the frequency and kind of social rules used in mother-child and sibling relationships over a 14-month period; (2) to assess the degree to which conflict functioned as a forum for social rules; and (3) to describe the nature of the association between references to social rules and the quality of family relationships. Naturalistic home observations of 47 families were conducted when focal younger siblings were 33 and 47 months of age. Family conversations were coded for a variety of rules. Over time, mothers referred to rules less frequently per hour, whereas elder siblings referred to rules more frequently per hour. Proportionately, mothers employed rules relatively more often than children; however, conventional rules were utilised by mothers more than moral rules. As hypothesised, moral rules were more symmetrical in sibling relationships and more complementary in mother-child dyads. Mothers mentioned social rules more often during conflicts, whereas siblings did not. Finally, moral rules mentioned by both younger and elder siblings were associated with less harmonious sibling relationships. Results were discussed with regard to theories of moral socialisation and the nature of family relationships.

The preventive role of anticipatory guidance in pediatric practice has gained increasing importance over the last two decades, resulting in the development of competing models of practice-based care. Our goal was to systematically evaluate and summarize the literature pertaining to the Healthy Steps Program for Young Children, a widely cited and utilized preventive model of care and anticipatory guidance, Medline and the bibliographies of review articles for relevant studies were searched using the keywords: Healthy Steps, preventive care, pediatric practice and others. Other sources included references of retrieved publications, review articles, and books; government documents; and Internet sources. Relevant sources were selected on the basis of their empirical evaluation of some component of care (e.g., child outcomes, parent outcomes, quality of care). From 21 identified articles, 13 met the inclusion criteria of empirical evaluation. These evaluations were summarized and compared. Results indicated that the Healthy Steps program has been rigorously evaluated and shown to be effective in preventing negative child and parent outcomes and enhancing positive outcomes. Despite limited information concerning cost effectiveness, the Healthy Steps Program provides clear benefit through early screening, family-centered care, and evidence-based anticipatory guidance. It is recommended that the Healthy Steps program be more widely disseminated to relevant stakeholders, and further enhanced by improved linguistic and cultural sensitivity and long term evaluation of cost effectiveness.

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