Dissertations & Theses (Open Access)

Date of Award

Spring 5-2019

Degree Name

Doctor of Philosophy in Nursing (PhD)


Cathy L. Rozmus, PhD

Second Advisor

Nikhil S. Padhye, PhD

Third Advisor

Dorothy Mandell, PhD


Background: Disparities in early language development have been noted for children from low-income homes, which can impact their educational and health trajectory. The quantity and quality of language exposure in the home environment influences a child’s language development. Adult attachment style is a predictor of parenting behavior and could impact critical interactions between the parent and child. Evidence demonstrates that differences in adult attachment style impact program participation and outcomes in early childhood parenting programs delivered through home visitation.

Aims: The aims of this study were to 1) explore the association of adult attachment style on intervention outcome trajectories from a group based, parent-focused early language development intervention and 2) evaluate the association of adult attachment style on intervention attendance.

Methods: This exploratory study used data from a program evaluation of a group-based, parent-focused early language development intervention to examine the associations of adult attachment style on intervention attendance and parent-child interaction outcomes measured longitudinally. Parents of children (ages 0-24 months) were recruited to participate in a 13-week early language development program. A sample of program participants completed questionnaire data that included adult attachment style, depression symptoms, and sociodemographic information. Confirmatory and exploratory factor analyses were used to find three-factors of adult attachment style; relationship anxiety, discomfort with closeness, and relationships as secondary to achievements. Parent-child interaction was assessed by digital language processors recording child-directed speech and reciprocal interactions in the home environment weekly and parents reported average shared book reading weekly. Latent growth trajectories of parent-child interaction variables were identified through latent class growth analyses and regressed onto adult attachment style factors and covariates in order to determine the association of adult attachment style on the outcome trajectories. In addition, intervention attendance was regressed onto adult attachment style factors and covariates to understand the impact of adult attachment style on intervention attendance.

Results: This study found three latent growth trajectories (high, middle, and low) for child-directed speech and two latent growth trajectories (high and low) for reciprocal interaction and shared book reading. This study found that discomfort with closeness had strong odds (OR: 2.60; p < .05) of attending 10 or more intervention sessions; however, discomfort with closeness was significantly associated with lower baseline and lower growth trajectory of reciprocal interactions between the parent and child (OR: .34, p < .001).

Conclusions: Interventions supporting early language development are often targeted towards parents, as healthy development is fostered by parents’ provision of a supportive and cognitively stimulating home environment. Findings from this study suggest that adult attachment style does impact the effects of parent-focused language development programs and thus additional supportive measures may be needed for parents with insecure adult attachment styles to fully benefit from these types of programs.


Early Language Development, Adult Attachment Style, Latent Class Growth Analysis, Parent-Child Interaction, Child Development

Included in

Nursing Commons



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