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Night sleep and parental bedtime practices have rarely been investigated in late talkers. This study aimed to explore: night sleep, parental bedtime practices, and their associations in late talkers as well as individual, socio-demographic, and socio-relational factors affecting them. Parents of 47 30-month-old late talkers, born low-risk preterm (n = 24) or full-term (n = 23), with an expressive vocabulary size ≤10th percentile measured by the MacArthur-Bates Communicative Development Inventory Words and Sentences, and normal cognitive abilities measured by the Bayley Scales, completed the Infant Sleep Questionnaire, the Parental Interactive Bedtime Behaviour Scale, and the Parenting Stress Index Short Form. Results showed slight settling difficulties, night wakings, and frequent co-sleeping in late talkers. Encouraging autonomy practices were frequently used by parents, rather than active physical comforting ones. Recurrent settling difficulties were reported by parents who often applied encouraging autonomy practices, whereas greater night waking problems and frequent co-sleeping were reported by parents who often left their child crying. Low-risk preterm birth and mother’s parenting stress predicted total sleep difficulties and night wakings; first-born, high maternal education level and mother’s parenting stress predicted settling difficulties; mother’s parenting stress was the only predictor for co-sleeping and leaving to cry. These findings have relevant implications for improving late talkers’ night sleep and their parents’ bedtime practices.

Previous research reported that positive parenting and parenting stress might impact children’s psychosocial adjustment. The current longitudinal study aimed at evaluating the associations over time between mothers’ positive parenting, their parenting stress, and their preschoolers’ social–emotional competence and emotional–behavioral difficulties. Participants were 53 Italian mothers, aged between 24 and 47 years (M = 35.30, SD = 5.28) at T0, and their children (females = 51%), aged between 3 and 6 years (M = 4.48, SD = 0.84) at T0. Mothers completed self-report scales at 2 time points (with a 2-year lag). An autoregressive cross-lagged model was tested that had a good fit to the data, χ2(6) = 3.37 ns, CFI = 1.00, RMSEA = 0.00. The results showed that maternal positive parenting at T0 negatively predicted maternal parenting stress at T1; maternal parenting stress at T0 negatively predicted children’s social–emotional competence at T1. Moreover, at each time point, children’s social–emotional competence was associated positively with maternal positive parenting and negatively with maternal parenting stress; children’s emotional–behavioral difficulties were positively associated with maternal parenting stress. The results confirm that interactions with mothers are fundamental for children’s psychosocial adjustment. Implications for research and practice aimed at reducing parenting stress and fostering positive parenting are discussed.

Objectives The COVID-19 pandemic resulted in a particularly adverse and stressful environment for expecting mothers, possibly enhancing feelings of anxiety and parenting stress. The present work assesses mothers' anxiety levels at delivery and parenting stress after 3 months as moderated by home-visiting sessions. Methods Women (n = 177) in their second or third trimester of pregnancy during the COVID-19 lockdown were enrolled in northern Italy and split into those who did and did not receive home visits. After 3 months, the association between anxiety at delivery and parenting stress was assessed with bivariate correlations in the whole sample and comparing the two groups. Results Higher anxiety at birth correlated with greater perceived stress after 3 months. Mothers who received at least one home-visiting session reported lower parenting stress at 3 months than counterparts who did not receive home visits. Conclusions for Practice The perinatal period is a sensitive time window for mother-infant health, especially during a critical time like the COVID-19 pandemic. We suggest that home-visiting programs could be beneficial during global healthcare emergencies to promote maternal well-being after delivery.

The goal of this study was to examine the effects of preterm birth and maternal childbirth-related posttraumatic stress and parenting stress on maternal mind-mindedness (MM). The study also investigated the effects of perceived social support on parenting stress and MM. Sixty-five preterm (N = 32) and full-term (N = 33) mother-infant dyads were observed at 6 months. Measures of maternal MM were obtained from observations of mother-infant interaction. Mothers also provided ratings of their posttraumatic stress disorder (PTSD) symptoms, parenting stress, and perceived social support via an online survey. Experiencing a preterm birth did not affect mothers' use of mental state descriptors during mother-infant interaction. Neither childbirth-related posttraumatic stress nor parenting stress directly affected maternal ability to comment on the child's mental states appropriately. However, at medium and high levels of perceived social support, a negative association between parenting stress and MM was observed. Maternal perception of being emotionally supported by significant others promoted MM in mothers showing low or mild levels of parenting stress, but not in mothers experiencing high stress in parenting their infants. Results suggest that a proclivity to MM might be affected by the interaction between parenting stress and social support, rather than by childbirth-related variables, such as prematurity.El propósito de este estudio fue examinar los efectos del nacimiento prematuro y el estrés materno postraumático relacionado con dar a luz, y el estrés de la crianza sobre la disposición de la mente (MM). El estudio también investigó los efectos que la percepción del apoyo social tiene en el estrés de la crianza y la disposición de la mente. Se observaron 65 díadas de madre-infantes prematuros (N = 32) y de gestación completa (N = 33) a los 6 meses. Las medidas de la disposición mental materna se obtuvieron de observaciones de la interacción madre-infante. Las madres también suministraron los puntajes de sus síntomas de PTSD, el estrés de la crianza y la percepción del apoyo social por medio de una encuesta electrónica. El experimentar un nacimiento prematuro no afectó el uso por parte de las madres de los factores de descripción del estado mental durante la interacción madre-infante. Ni el estrés postraumático relacionado con el dar a luz ni el estrés de la crianza directamente afectaron la habilidad materna para comentar de manera apropiada sobre los estados mentales del niño. Sin embargo, al nivel medio y alto de la percepción de apoyo social, se observó una asociación negativa entre el estrés de crianza y la disposición de la mente. La percepción materna de contar con el apoyo emocional de su pareja promovió la disposición mental de las madres que mostraban bajos o leves niveles de estrés de crianza, aunque no así en aquellas madres que experimentaban un nivel alto de estrés en la crianza de sus infantes. Los resultados sugieren que una propensión a la disposición mental pudiera ser afectada por la interacción entre el estrés de crianza y el apoyo social, en vez de las variables relacionadas con el dar a luz, tal como el nacimiento prematuro.Le but de cette étude était d'examiner les effets du stress posttraumatique lié à la naissance avant terme et à l'accouchement maternel et le stress de parentage sur l'Etat d'esprit/Orientation mentale (abrégé ici EE/OM). L’étude s'est aussi penchée sur les effets du soutien social perçu du stress de parentage et de l'EE/OM maternel. Soixante-cinq dyades mères-bébés nés avant terme (N = 32) et à plein terme (N = 33) ont été observées à 6 mois. Les mesures d'EE/FM maternel ont été obtenues d'observations de l'interaction mère-bébé. Les mères ont aussi offert des évaluations de leurs propres symptômes ESPT, du stress de parentage, et du soutien social perçu au travers d'un questionnaire en ligne. Le fait d'avoir fait l'expérience d'une naissance avant terme n'a pas affecté l'utilisation de descripteurs de santé mentale des mères durant l'interaction mère-bébé. Ni le stress posttraumatique lié à l'accouchement ni le stress de parentage n'ont affecté directement la capacité maternelle à commenter les états mentaux de l'enfant de manière appropriée. Cependant, à des niveaux moyens et élevés de soutien social perçu, une association négative entre le stress de parentage et l'EE/OM a été observée. La perception maternelle d’être soutenue émotionnellement par leurs partenaires a promu l'EE/FM chez les mères faisant preuve de niveaux bas ou peu élevés de stress de parentage, mais pas chez les mères faisant preuve de stress élevé dans le parentage de leurs bébés. Les résultats suggèrent qu'une tendance à l'EE/OM peut être affectée par l'interaction entre le stress de parentage et le soutien social, plutôt que par des variables liées à l'accouchement, comme la prématurité.Ziel dieser Studie war es, die Effekte von Frühgeburten, geburtsbedingtem mütterlichen posttraumatischem Stress und elterlichem Stress auf mütterliche Mind-Mindedness (MM) zu untersuchen. Außerdem untersuchte die Studie den Effekt von wahrgenommener sozialer Unterstützung auf elterlichen Stress und MM. 65 Mutter-Kind Dyaden (mit N = 32 früh und N = 33 reif geborenen Säuglingen) wurden im Alter von 6 Monaten beobachtet. MM wurde anhand von Beobachtungen der Mutter-Kind-Interaktion erhoben. Über eine Online-Umfrage gaben die Mütter ein Rating ihrer PTBS-Symptome, ihres elterlichen Stresses und ihrer wahrgenommenen sozialen Unterstützung ab. Das Erleben einer Frühgeburt hatte keinen Einfluss auf die Verwendung von Beschreibungen mentaler Zustände durch die Mütter während der Mutter-Kind-Interaktion. Weder geburtsbedingter posttraumatischer Stress noch elterlicher Stress hatten einen direkten Einfluss auf die mütterliche Fähigkeit, mentale Zustände des Kindes angemessen zu kommentieren. Bei mittlerer und hoher wahrgenommener sozialer Unterstützung wurde jedoch ein negativer Zusammenhang zwischen elterlichem Stress und MM beobachtet. Wahrgenommene soziale Unterstützung förderte MM bei Müttern mit geringem oder mildem elterlichem Stress, nicht jedoch bei Müttern mit starkem elterlichem Stress. Die Ergebnisse deuten darauf hin, dass eine Tendenz zu MM eher durch die Wechselwirkung zwischen elterlichem Stress und sozialer Unterstützung als durch geburtsbezogene Variablen wie Frühgeburt beeinflusst werden könnte.早期産児と満期産児の母親におけるマインド−マインドネスと育児ストレス:母 親が認識する社会的サポートの緩和的役割 本研究の目的は、母親のマインド−マインドネス(MM)に対する早期産と母親の出 産に関連した心的外傷後ストレスと育児ストレスの影響について研究することで ある。また、育児ストレスとマインド−マインドネスに対する母親が認識する社 会的サポートの影響についても研究した。早期産(N = 32)と満期産(N = 33)の乳 児とその母親 65組を出生後6ヶ月時に観察した。母親のMMの評価は、母子相互作 用の観察から得た。母親らはまた、オンライン調査を通して、PTSD症状、育児ス トレス及び自分が認識する社会的サポートの評価を提供した。早期産の体験は、 母子相互作用中に使われる精神状態の記述子に影響を及ぼすことはなかった。出 産に関連した心的外傷後ストレス及び育児ストレスは、どちらも子どもの精神状 態を適切に表現する母親の能力に直接的に影響を及ぼすことはなかった。しかし ながら、母親が認識する社会的サポートの中及び高レベルにおいて、育児ストレ スとマインド−マインドネス間には負の相関が観察された。重要な他者に精神的 に支援されているという母親の認識は、育児ストレスが低あるいは中レベルでみ られる母親においては、マインド−マインドネスを促進していたが、育児におい て高ストレスを体験している母親ではそうなってはいなかった。結果は、マイン ド−マインドネスの傾向は、早産児といったような出産に関連する変数よりはむ しろ、育児ストレスと社会的サポート間の相互作用によって影響を受ける可能性 を示唆している。.本研究旨在探讨早产、母亲分娩相关的创伤后压力和育儿压力对母亲心智 (MM) 的影响。本研究还调查了领悟社会支持对育儿压力和心智的影响。在6个月龄时观察了65个早产 (N = 32) 和足月 (N = 33) 的母婴二人组。从母婴互动的观察中获得了对母亲MM的测量。母亲们还通过在线调查提供了他们的PTSD症状, 育儿压力和领悟社会支持的等级。经历早产并不影响母亲在母婴互动过程中使用心理状态描述词。分娩相关的创伤后压力和育儿压力都不会直接影响母亲对孩子心理状态的恰当评价。但是, 在中等和较高的领悟社会支持水平下, 观察到育儿压力和心智之间呈负相关。在那些表现出较低或中等水平育儿压力的母亲中, 得到另一半情感支持的母性知觉会提高其心智, 但在育儿过程中经历高压力的母亲则不会。研究结果表明, 心智倾向可能会受到育儿压力和社会支持之间相互作用的影响, 而不是受到与分娩相关的变量 (如早产) 的影响。.التخاطب الذهني وإجهاد الرعاية الوالدية عند أمهات الأطفال المبتسرين والرضّع كاملي المدى: الدور الملطف للدعم الاجتماعي المتصور كان الهدف من هذه الدراسة هو دراسة آثار الولادة المبتسرة والإجهاد اللاحق للولادة وإجهاد الرعاية الوالدية على التخاطب الذهني الأمومي(MM) .كما بحثت الدراسة في آثار الدعم الاجتماعي المتصور على الإجهاد الأبوي والتخاطب الذهني. تم ملاحظة 65 ثنائي من الأمهات والأطفال المبتسرين (N = 32) وكاملي المدة(N = 33) عند فترة 6 أشهر. تم الحصول على مقاييسMM الأم من ملاحظات التفاعل بين الأم والرضيع. كما قدم الأمهات تقييمات لأعراض اضطراب ما بعد الصدمة، والإجهاد الأبوي، والدعم الاجتماعي المتصور من خلال استبيان على الإنترنت. لم تؤثر تجربة الولادة المبتسرة على استخدام الأمهات لتوصيفات الحالة الذهنية أثناء التفاعل بين الأم والرضيع. لم يؤثر الإجهاد اللاحق للأمومة المرتبط بالولادة أو الإجهاد الأبوي بشكل مباشر على قدرة الأمهات على التعليق على الحالات العقلية للطفل بشكل مناسب. ومع ذلك، لوحظ وجود ارتباط سلبي بين الإجهاد الأبوي والتخاطب الذهني على المستويات المتوسطة والعالية من الدعم الاجتماعي المتصور. وقد عزز تصور الأم للدعم العاطفي من الشريك قدرة التخاطب الذهني لديها وأظهرت مستويات منخفضة أو خفيفة من إجهاد الرعاية الوالدية، ولكن لم يظهر هذا عند الأمهات اللاتي تعاني من الإجهاد العالي في الرعاية الوالدية للرضع. وتشير النتائج إلى أن الميل إلى التخاطب الذهني قد يتأثر بالتفاعل بين إجهاد الرعاية الوالدية والدعم الاجتماعي، وليس بالمتغيرات المرتبطة بالولادة، مثل الولادة المبتسرة.

The parents of 413 children with typical development (TD) or special educational needs (SEN) filled in an online survey to investigate the associations between the restrictions introduced to face COVID-19 and parenting stress and parental disciplinary practices. The parents of children with SEN showed a significantly higher stress level than TD children's parents. However, they showed a lower inclination to overreact. In both groups, the parents who feel less supported, feel their needs threatened, and report having a child with more difficulties were more likely to exhibit parenting stress. Data on the associations between COVID-19 restrictions and the stress perceived by parents could help to focus the attention of the public health system on their parents' needs, leading to practices aimed to prevent parenting stress and burnout.

Although preterm birth constitutes a risk factor for postpartum depressive symptomatology, perinatal depression (PND) has not been investigated extensively in fathers of very low (VLBW) and extremely low birth weight (ELBW) infants. This study explored paternal depression levels at 3, 9, and 12 months of infant corrected age, investigating also the predictive role played by the severity of prematurity, maternal and paternal PND levels, and parenting stress. We recruited 153 fathers of 33 ELBW, 42 VLBW, and 78 full-term (FT) infants, respectively. Depression was investigated by the Edinburgh Postnatal Depression Scale (EPDS) and distress by the Parenting Stress Index-Short Form-PSI-SF (Total and subscales: Parental Distress, Parent–Child Dysfunctional Interaction, and Difficult Child). ELBW fathers showed a significant decrease (improvement) in EPDS, total PSI-SF, and Parental Distress mean scores after 3 months. Paternal EPDS scores at 12 months were significantly predicted by VLBW and FT infants’ birth weight categories, fathers’ EPDS scores at 3 and 9 months, Parent–Child Dysfunctional Interaction subscale at 3 months, and Difficult Child subscale at 9 months. This study strengthens the relevance of including early routine screening and parenting support for fathers in perinatal health services, with particular attention to fathers who might be more vulnerable to mental health difficulties due to severely preterm birth.

In the last decade, the number of children and youth with special health care needs (CYSHCN) is increased as a result of the improvement of neonatal and pediatric assistance. The aim of our study was to describe the burden of care of the families caring a CYSHCN in our country, evaluating their living condition in order to explore socio-economic characteristics, health problems, needs and their adaptation processes trying to reach a balance between the needs of the disabled child and those of the other family members. We administered a questionnaire to the parents of CYSHCN during a routine clinical evaluation. From the analyses of questionnaires obtained, parents were the main caregiver of the children and 43,8% of them reported that they were not getting enough support. Burden of care fell on parents and indeed compilers reported an average level of stress of 3,2 (0-5) and more important, the main reported sources of stress were the concern about the future and health of their children. From the analyses of our population emerged unsatisfied needs of these families and their necessity to be effectively supported and integrated into the social fabric of the community. Social supporting is essential to help managing family stress and is evident the needed of these parents for interventions to directly target caregiver needs through the provision of tailored services, such as respite care opportunity, peer support, financial aid and medical home technologies to improve their quality of life.

The preterm birth of a child is a sudden event that can disturb the overall family system and its functioning. Many studies have been conducted with the aim of exploring how and the degree to which this event affects the early mother&ndash, infant dyadic relationship and maternal well-being, with often mixed findings. The present study investigates the combined effect of preterm birth and parenting stress on mind-mindedness, a parenting dimension that captures how parents represent and treat their children as separate individuals with their own mental states and activities. A hundred and ten mothers and their three-month-old infants (preterm = 54, full-term = 56) participated in the study. Mind-mindedness was assessed by coding mothers&rsquo, comments about infant&rsquo, s mental states during dyadic face-to-face interaction. Parenting stress was evaluated with the Parenting Stress Index Short Form questionnaire. Mothers of preterm infants reported similar levels of appropriate and non-attuned mind-related comments to mothers of full-term infants. The reported parenting stress levels were also comparable. Interestingly, only mothers of preterm infants who reported higher stress in parenting showed more non-attuned comments during the interaction. The results underline the need to address preterm birth as a complex event, going beyond group differences and considering its interplay with other risk or protective factors in shaping children&rsquo, s and parents&rsquo, adjustments and well-being.

International research has evidenced the psychological impact of the COVID-19 pandemic on families, and the key role played by parenting stress levels. Although significant associations with parents’ past trauma and resilience have been shown, this study aimed to explore their complex interplay on the relationship between parents’ peritraumatic distress due to COVID-19, parenting stress, and children’s psychopathological difficulties. We recruited 353 parents with children aged two to 16 years via an online survey during the Italian second wave of COVID-19. Parents’ peritraumatic distress due to COVID-19, parenting stress, past trauma and resilience, and children’s psychological difficulties were assessed through self-report and report-form questionnaires. Parents’ past traumas significantly predicted peritraumatic distress due to COVID-19 and children’s psychological difficulties. The relationship between past traumas and children’s psychological difficulties was serial mediated by parents’ peritraumatic distress and parenting stress. Direct and total effects of parent’s resilience on parent’s peritraumatic distress were not significant, but there were significant indirect effects via parenting stress and via parents’ peritraumatic distress and parenting stress, indicating inconsistent mediation. This study evidenced the key risk and protective role played by, respectively, parents’ past traumas exposure and resilience on the relationship between parents’ psychological difficulties due to COVID-19, parenting stress, and children’s psychological difficulties, with important clinical implications.

In the present study parenting stress and the broader phenotype are investigated in two highly common developmental disorders, namely Attention Deficit Hyperactivity Disorder (ADHD) and specific reading impairment (dyslexia). Within a total sample of 130 parents, 27 were parents of children with ADHD (P-ADHD), 38 were parents of children with a diagnosis of dyslexia (P-DYS) and the other 65 participants were parents of children with typical development (P-TD). A battery of cognitive tasks was administered which included verbal and non-verbal Intellectual Quotient (IQ), reading speed (passage and nonwords), verbal fluency and the Attention Network Task (ANT). Reading history, symptoms of ADHD in adults and parenting stress were measured through questionnaires. Group differences evidenced that the P-DYS group had lower scores in the reading tasks, in the verbal fluency task and in the reading history questionnaire. Conversely, the P-ADHD group had more transversal cognitive weaknesses (IQ, reading tasks, verbal fluency) and the highest scores in parenting stress and ADHD symptoms, together with poor reading history. The groups did not differ in the ANT task. Parenting stress was predicted, on the whole sample, by lower socioeconomic status (SES) and number of family members and higher ADHD symptoms. Implications for research and clinical settings are discussed. © 2019 by the author. Licensee MDPI, Basel, Switzerland.

Background: While the association between anxiety and postpartum depression is well known, few studies have investigated the relationship between these two states and parenting stress. Furthermore, a number of studies have found that postpartum depression affects mother-infant emotion regulation, but there has been only one study on anxiety and emotion regulation and no studies at all on parenting stress and emotion regulation. Therefore, the primary aim of our study is to identify, in a community sample of 71 mothers, the relationship between maternal depression, anxiety, and parenting stress. The second aim is to examine the relationship between anxiety, postpartum depression, and parenting stress and mother-infant emotion regulation assessed at 3 months. Methods: Mother-infant interaction was coded with a modified version of the Infant Caregiver and Engagement Phases (ICEP) using a microanalytic approach. The Edinburgh Postnatal Depression Scale (EPDS), State-Trait Anxiety Inventory (STAI), and Parenting Stress Index-Short Form (PSI-SF) were administered to the mothers to assess depression, anxiety, and parenting stress, respectively. Results: Analysis revealed correlations between anxiety and depression, showing that parenting stress is associated with both states. In a laboratory observation, depression was correlated with both negative maternal states and negative dyadic matches as well as infant positive/mother negative mismatches; anxiety was correlated with both negative maternal states and infant negative states as well as mismatches involving one of the partners having a negative state. Multiple regression analysis showed that anxiety is a greater predictor than depression of less adequate styles of mother-infant emotion regulation. Parenting stress was not shown to predict such regulation.

Objective: In the 1st year of the post-partum period, parenting stress, mental health, and dyadic adjustment are important for the wellbeing of both parents and the child. However, there are few studies that analyze the relationship among these three dimensions. The aim of this study is to investigate the relationships between parenting stress, mental health (depressive and anxiety symptoms), and dyadic adjustment among first-time parents. Method: We studied 268 parents (134 couples) of healthy babies. At 12 months post-partum, both parents filled out, in a counterbalanced order, the Parenting Stress Index-Short Form, the Edinburgh Post-natal Depression Scale, the State-Trait Anxiety Inventory, and the Dyadic Adjustment Scale. Structural equation modeling was used to analyze the potential mediating effects of mental health on the relationship between parenting stress and dyadic adjustment. Results: Results showed the full mediation effect of mental health between parenting stress and dyadic adjustment. A multi-group analysis further found that the paths did not differ across mothers and fathers. Discussion: The results suggest that mental health is an important dimension that mediates the relationship between parenting stress and dyadic adjustment in the transition to parenthood.

In recent years, studies have shown that parents of children with Neurodevelopmental Disorders (NDDs) experience more parenting stress than parents of typically developing children, but the relation between the type of disorders and parenting stress is far from clear. The purpose of this study was to compare the parenting stress experienced by parents of 239 children with Specific Learning Disorders (SpLD), Language Disorders (LD), Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), and typical development (TD). Parents of children with NDDs experience more parenting stress than those of children who have TD. Although, parents of children with ASD or ADHD report the most high scores of parenting stress, also the parents of children with SpLD or LD report higher parental stress compared with parent of children without NDDs. Another interesting finding was that IQ level or emotional and behavioral problems are associated with the higher levels of parenting stress. This study suggest that parent, both mothers and fathers, of children with different type of NDDs should be provided with interventions and resources to empower them with the knowledge and skills to reduce their stress and to enhance their quality of life.

Background: Hypothyroidism has been associated with cognitive and motor impairments, the degree to which mild hypothyroidism, or subclinical hypothyroidism impacts mood and cognitive functions and whether these symptoms respond to treatment, remains controversial. Furthermore, hypothyroidism is associated with an increased susceptibility to depression and reductions in health-related quality of life. Objective and hypotheses: Recent longitudinal studies stressed that the follow-up of children with treated congenital hypothyroidism (CHT) should not be limited to the cognitive domain. This study attempted to evaluate the emotional–behavioural profiles in children with CHT and the parenting stress profiles. Method: Data for children and families characteristics were collected from 33 families with a CHT child (13 males, 20 females; age: 6 months–6 years) diagnosed and treated since the newborn period. We analyzed the children by the Denver intelligence test and the child behaviour checklist (CBCL). Furthermore we proposed the parenting stress index (PSI) to their parents. Results: Denver intelligence test results demonstrated that nine/33 patients were normal, 20/33 were dubious, four/33 were not estimable. However the specific neuropsychiatric evaluation and QI confirmed a reduced performance only in three. The CBCL was normal in 18/33 patients (ten females; eight males), borderline in 8/33 (five females; three males), pathological in 7/33 (five females; two males). The children younger than 2 years showed a pathological or borderline score, with the exception of two. Between these, the more frequently pathological items were somatic complaints (five pathological; four borderline), anxious/depressed (two pathological; four borderline), attention problems (one pathological; four borderline). The PSI revealed a pathological test in six/33 patients. All the items were pathological in two; however in all the six pathological patients the PSI identified a ‘difficult child’. No correlations were found between starting day of treatment and developmental outcome. Initial T4 concentration and initial T4 dose were weak predictors for developmental outcome. Conclusion: The diagnosis of a chronic disease of the son could interfere with the emotional relationship in the family.