Dr Jennifer St George

Background: Support from fathers to their partners is important to reduce distress in mothers during the perinatal period when conditions such as depression and anxiety can be common. The SMS4dads digital platform delivers text messages to fathers but has not previously addressed specific messages to fathers with partners who are experiencing perinatal depression and/or anxiety (PNDA). Aim: To develop messages, in collaboration with experienced parents and clinicians, that are suitable for fathers whose partner is experiencing PNDA. Methods: Messages designed to enhance the quality of partner support for mothers experiencing PNDA were drafted by the SMS4dads team based on suggestions from mothers with lived experience of PNDA. Mothers and fathers with lived experience and expert clinicians rated the messages for importance and understanding. Clinicians additionally rated clinical relevance. Open response comments from parents and clinicians were collated for each message. Re-drafted messages were screened again and checked for literacy level. Results: Forty-one draft messages received a total of 170 ratings from 24 parents and 164 ratings from 32 clinicians. Over three quarters of parents and clinicians agreed or strongly agreed that messages were understandable (parents 85.6%; clinicians 77.4%), important (parents 86.3%; clinicians 86.6%), and 85.5% of clinicians rated the messages as clinically relevant. Comments from clinicians (n = 99) and parents (n = 46) were reviewed and guided message development. Thirty re-drafted messages were screened and 16 edited based on a second round of ratings and comments from parents and clinicians. Conclusion: Messages for fathers whose partners are experiencing depression and anxiety can be developed and evaluated in collaboration with lived experience of parents and clinicians.

Most studies interested in understanding the role of parents in children's school adjustment have focused on mothers. Given the importance of father-child play during the preschool period, this study explores the possible links of father-child rough-and-tumble play and also father's involvement in child schooling with two dimensions of school adjustment: social adaptation and academic achievement. Observational data was collected from father-child rough-and-tumble play sessions filmed in family homes when children were average age of 4 years. Fathers completed the Family Involvement Questionnaire on parent involvement in child schooling, and teachers completed the Social Behaviour Questionnaire and the Teacher Report form to assess social adaptation, and the Teacher Rating Scale to assess academic achievement when children (40 boys; 32 girls) were average age of 8 years. Boys demonstrated more externalising behaviours at school when during rough-and-tumble play fathers let them direct the play. Boys were more prosocial at school when their fathers were more involved in school-based activities, while girls demonstrated more internalising behaviours at school when their fathers were less involved in home-based learning activities. Moreover, boys performed less well academically when fathers demonstrated more negative reactions than boys, the dyad demonstrated more upset terminations, and boys demonstrated more fear and less anger during rough-and-tumble play. Girls performed less well academically when during rough-and-tumble play fathers made more rules and fewer positive reactions towards them. Neither boys' nor girls' academic achievement was related to any type of fathers' school involvement. The study fills a gap in understanding the ways in which father involvement influences children's school adjustment according to the children's sex.

Play fighting and chasing in human children¿often referred to as rough-and-tumble play, or RTP or R&T¿is a common form of play, and one that has the most obvious correspondence to play in many (especially mammalian) non-human species. Unlike object, pretend and sociodramatic play, generally encouraged by teachers and parents, play fighting is viewed in a much more ambivalent way. The role it has in development, and whether this should be viewed in a positive or negative light, continues to be debated. Here we review what insights may be gained from research on play fighting in non-human species, main developmental trends in humans, definitional and measurement issues, cultural variations, and empirical data on the correlates found with behaviors of adaptive significance. We conclude with some reflections on theoretical issues and future research priorities. A consistent theme from work with non-human species, parent¿child RTP, and peer-peer RTP, is that RTP experience is important for emotional control and the learning of restraint in what may be competitive or conflictual situations.

Background: Approximately 1 in 10 fathers of infants experience symptoms of common mental health disorders, prompting calls for paternal postpartum screening. However, numerous obstacles exist to screening implementation. The aim of this study was to provide preliminary evidence for an alternative approach that starts with asking fathers about their sleep. Methods: Using self-reported father data at 0 to 36 months postpartum (N=1204) from four Australian cohort studies, we assessed associations between responses to various single-item questions about sleep (good to poor), and scores on validated measures of mental health (depression, anxiety and stress). We conducted regressions, unadjusted and adjusted for father age, child age, household income, education, first or later child, and marital status, to test associations between sleep and each indicator of mental health. We then meta-analyzed effects and assessed interactions between sleep and each of the covariates. Results: Consistent associations between fathers' subjective poor sleep and depression, anxiety and stress were replicated across the four cohorts despite heterogeneity in the sleep questions. At the meta-analytic level, effects ranged from weak to moderate (0.25 to 0.37) and were robust to all adjustments. Interactions were only detected between family income and poor sleep, such that the association was stronger for high income fathers. Limitations: This study does not address the sensitivity or specificity of single-item sleep questions for assessing paternal mental health risk. Conclusions: A low-cost, non-stigmatizing single question to postpartum fathers about their sleep may present a gateway opportunity to enquiring about mental health.

Fathers of children on the autism spectrum are often in need of support due to high levels of parenting stress and the complexity associated with raising these children. While the importance of the fathering role as both parent and partner is well recognized, the recruitment of fathers into support programs is often resource intensive and generally fails to achieve desired levels of enrollment and retention. Text2dads explored paternal engagement with a program providing text-based information and support to smartphones of Australian fathers (N = 184) raising children on the autism spectrum. The evaluation is scaffolded by Piotrowska et al.'s CAPE model of engagement¿Connection, Attendance, Participation and Enactment. Analysis demonstrated high rates of connection and participation when compared to other father-focused interventions. Evidence from response rates, comments and surveys demonstrate that fathers actively participated in the project while also reporting that they applied information gained from Text2dads in their parenting behavior. Advances in mobile communication have created opportunities to engage with fathers using alternative modes of intervention. The present study demonstrates support for the acceptability of this cost effective and highly scalable program.

Although both fathers and mothers speak differently in infant-directed speech (IDS) compared to adult-directed speech (ADS), the acoustic characteristics of present-day paternal IDS are still insufficiently understood. To extend this understanding, 11 fathers and 17 mothers in The Netherlands were recorded interacting with their infant (260¿476¿days old; for IDS) and with an adult experimenter (for ADS). Both fathers and mothers were found to raise their average pitch, expand their pitch variability within utterance, and increase their pitch variability across utterances in IDS. Moreover, fathers increased their pitch variability within and across utterances more than mothers. The IDS produced by present-day Dutch-speaking fathers is thus acoustically highly dynamic, in line with fathers' energetic interaction style.

There is increasing recognition of the issues facing men in the perinatal period. Vulnerability factors and issues in the partner relationship contribute to mental health risk and can impact the quality of the father¿infant relationship. Yet, there is limited understanding of fathers' help-seeking when they or their partner are experiencing mental health issues in the context of caring for a new baby. The present study examines fathers' contacts with the Perinatal Anxiety and Depression Australia (PANDA) National Helpline. The study reviewed contacts from fathers and their identified needs for assistance, relationship issues, and support needs; 70% of male callers (N = 129) reported concerns about the mother's mental health, and 57% were concerned about relationship breakdown. Significant numbers of men raised issues about their own mental health (43%) and many were concerned about the impact of maternal mental state on the relationship with the infant. When compared to community data, there were elevated rates of concerns about depression and anxiety. Men also described difficulties with the fathering role and with regulating their own feelings of guilt and frustration. These findings highlight the needs of men for support when a mother experiences perinatal problems and also the risk for distress in fathers.

Background: Fathers are increasingly acknowledged as active participants in rearing young children, yet few observational measures recognize gender-differentiated parenting and can be used by practitioners and researchers to assess and improve fathers' parenting capacity in playful settings, in order to inform program effectiveness. Two potential measures are the Rough-and-Tumble Play Quality Scale (RTPQ), which is based on evolutionary and attachment theory and assesses rough-and-tumble play behaviors related to social-emotional competencies. The second is Dads' Parenting Interaction with Children: Checklist of Observations Linked to Outcomes (PICCOLO-D), which is grounded in a systemic approach linking parenting behaviors to child outcomes. Objective: The aim of this study was to compare the two observational measures for suitability of assessment of fathers' parenting capacity with diverse low-income families. Method: A correlational longitudinal design was used to examine naturalistic rough-and-tumble play extant video observations of 25 fathers and their 2- to 4-year-old children independently coded with each measure, with child prekindergarten and fifth grade outcomes. Results: Convergent validity showed strong association between the two measures. No associations were found with family characteristics. Both measures predicted child prekindergarten attention regulation and aggression (inversely). PICCOLO-D predicted prekindergarten language and cognition, and language/literacy in fifth grade. Conclusions: The similarities and subtle differences between the measures confirm the distinctive theoretical approaches underpinning each measure, and suggest both are suitable tools for practitioners and researchers. PICCOLO-D may be useful for multiple type of play, while the RTPQ may be more relevant to specific qualities of paternal physical play interaction.

Objective: This paper will describe the development of a programme of SMS messages including parenting information and support to be sent to the mobile phones of mothers with severe mental illness (SMI) and their partners from early pregnancy to 24 weeks post birth. Method: Text messages (total 176) designed and tested for fathers (SMS4Dads) addressing father-infant attachment, co-parenting and self-care (including Mood Tracker texts asking fathers to rate their mood) were adapted by an expert advisory group of clinicians with experience across perinatal mental health services. Messages were rated on importance, clarity, acceptability (separately for mothers and fathers) and being consistent with current evidence. Additional messages were developed specifically for this population and all messages were tested for literacy level. The SMS4dads 'Mood Tracker' was redesigned to address common stress-inducing parenting issues such as infant crying, lack of sleep, and self-doubt about capacity to parent with an escalation process in cases of significant distress. Results: Separate protocol tested text-message banks for mothers (141 messages), and fathers (141 messages) were developed. Fourteen Mood Tracker topics were developed with two levels of distress escalation linked to local mental health services. Discussion: The need for accurate descriptions of health interventions processes is widely recognised, particularly in the case of digital mental health. This study provides a detailed description of the adaptive design by clinicians and researchers of brief text messages suitable for mothers with severe mental illness and their partners.

Abstract: Parent-child play directly influences child development. One aspect of parent-child play that is gaining interest is a form of physical play, 'rough-and-tumble play' (RTP), or roughhousing. RTP is most often played by fathers and has been shown to have positive benefits for children. However, little is known about parents' perceptions of this type of play, although beliefs and values about learning through play shape parents' interactions with their children. In this study, we investigated parents' beliefs and knowledge about father¿child RTP. A qualitative design was used to create a conceptual description of parents' views, and 52 (31% male) Australian parents participated in semi-structured interviews supported by a video stimulus of father¿child RTP. Three conceptual themes characterized parents' perspectives on RTP: Strength Challenge describes the physicality and inter-personal challenge of the game; Dynamic Bonding describes how parents view RTP as fostering close father-child relationships, confidence and a playful state of mind; the final theme, Context and Caveats, integrates the contended and contingent aspects of RTP perceived to influence the short and long-term effects of this play. The study provides insight into how parents perceive the broad function of parent-child RTP and fathers' role within this play.

Paternal perinatal depression and anxiety is a common, though under-recognized mental health condition experienced by men during their transition to fatherhood. An opportunity to screen for paternal mental health issues occurs when parents present for assistance with the care of their baby at early parenting services (EPSs). There are 10 EPSs located across Australia that provide specialist, multidisciplinary interventions to support parents experiencing complex parenting difficulties. Using structured telephone interviews, this qualitative study explored the views of 18 professional staff from nine EPSs regarding screening, referral processes and acceptability of screening fathers for mental health issues. A thematic analysis revealed that most EPSs screened fathers for depression. Participants agreed screening was important and that routine approaches to screening would help normalize the process for both men and services. Despite this, no uniform, comprehensive approach to identifying the mental health needs of fathers was found. EPSs provide a unique opportunity to address the mental health needs of fathers. Results from this study point to the need for a national approach to the development of father-specific screening guidelines for EPSs to improve family well-being, in parallel to those informing the Australian National Perinatal Mental Health Initiative for mothers.

The coparenting relationship has been linked to parenting stress, parenting self-efficacy and many other concerns associated with the development of children with ASD. Parents of children with ASD (N = 22) were interviewed to explore three domains of their coparenting relationship; (1) adaptation to the emergence of their child's autism, (2) parenting their child with ASD, (3) expectations for their child's developmental outcomes. The concept of coparenting competence, developed during analysis, describes collective perceptions of parenting efficacy. Parents linked perceptions of coparenting competence to their, ability to cope with diagnosis and parenting, motivation to do what they could for their child, and hopes for their child's development. The concept of coparenting competence could play an important role in future research and intervention.

Unintentional injury is an important cause of infant and child hospitalisation and parents play a key role in reducing children's risk-taking behaviour. Studies show that maternal and paternal parenting and supervision of children differ, but there is little research showing how fathers' parenting may influence children's tendency to engage in risk-taking behaviour. Recent theoretical developments suggest that father's parenting may be particularly effective in encouraging safe risk taking. In this study, we examine how well parenting practices typically undertaken by fathers predict rates of children's injury risk at three years. Questionnaire data were collected from 46 fathers. Results show that both duration of rough-and-tumble play and fathers' encouragement of perseverance predicted lower rates of injury behaviours, while their stimulation of risk taking predicted higher rates of injury behaviours. The results are discussed in the light of developmentally appropriate risk taking and fathering.

The present-day involvement of men in many facets of childrearing stands in contrast to previous eras when men accepted that the major task of fathering was to provide a secure income to support the family. This imperative often required long hours away from the family. However, when men whose contact with children has been limited due to work and cultural constraints retire, their newly acquired lifestyle may bring fresh opportunities for involvement with grandchildren. An important question therefore concerns the impact of caring for young children on men's perceptions of their role as grandfathers. This interview study explores the experiences of 19 Australian grandfathers. The analysis found themes that relate to relationships and change, as well as themes concerning core beliefs and existential questions. The findings demonstrate the potential for insight into family relationships and personal growth in older age when studying the topic of grandparenting and caring from the male perspective. © 2014, Baywood Publishing Co., Inc.

Energetic, competitive, body-contact play (rough and tumble play (RTP)) is commonly observed among young children and is reported as an important feature of father-child relationships. Animal studies have demonstrated positive developmental effects of peer-peer play-wrestling, influencing cognitive and social outcomes. The purpose of this paper is to discuss the nature of RTP between father and child and its relationship to child development and to describe a theoretically informed measure of the quality of father-child RTP. © 2013 Copyright Taylor and Francis Group, LLC.