This document summarizes research on raising American-born Chinese children. It discusses common hopes parents have for their children, such as happiness and success. It also reviews prior research showing Chinese American parents value obedience and educational achievement. The document then examines cultural differences in parenting behaviors between Chinese American and European American parents, finding Chinese American parents engage in more directive communication and repetitive vocalizations. It also notes risks American-born Chinese children face, such as depression, drug/alcohol problems, and eating disorders. Overall, the document reviews cultural influences on parenting and child outcomes for American-born Chinese children.

1. Raising American Born Children:
Lessons from Research
Cindy H. Liu, Ph.D
Instructor of Psychology
McLean Hospital, Harvard Medical School

2. An introduction

3. What are your hopes for
your child?

4. ―I want my child to be
happy and successful.‖
Go to
Get into Harvard Harvard
(and make sure to and be a
graduate) dutiful
son.
Obtain financial
security (provide for the
family)
Be a
famous
NBA
player

5. “Tiger mother” Amy Chua and her teenage daughters

6. Prior Research on
Asian American Parenting
• Obedience and educational achievement
• Authoritative or authoritarian parenting
(e.g. Chao, 1994; Chen, 1998).

7. Chinese parents in the U.S. do not need to
be ―American‖ in their ways to successfully
raise a well adjusted Chinese American
child.
However it’s important to have an
awareness of how your relationship with
your child fits with their bicultural world

8. Where do your expectations
come from?
Expectations for your child
are embedded in the way
that you engage with them in
early development
Taking an observable
approach…..

9. To compare the maternal behaviors of
Chinese American and European American
infants in Face-to-Face Play
Vocalizations
Hand
Movements
Proximity Affect

10. Sample
• European American (EA) mother-infant dyads (n=39)
• Chinese American (CA) mother-infant dyads (n=38)
– 21 American born or lived in US > 10 years (CA-settled)
– 17 Immigrated to U.S. within < 10 (CA-recent)
• Maternal Age: EA (33.3 years), CA (33.7 years)
• Infant Age: 16 weeks
• Infant Gender: Equal males and females in each group

11. Behavioral Examples
European American Chinese American

12. Results
Vocalization
60
53.9% Long Syllables
50
42.2% 41.8%
Proportion of Time Vocalizating
40
36.9%
Culture x Gender 35.7%
differences 30
26.2%
20
EA: > Long Syllabic
CA recent: > Singing/Nursery 10
Rhymes
0
CA settled : > Short Syllabic Male Female Male Female Male Female
European American Chinese American - Settled Chinese American - Recent

13. Results
Vocalization
35
Singing and Nursery Rhymes
30.1%
30
Culture x Gender 25
Proportion of Time Vocalizing
differences 20
17.9%
EA: > Long Syllabic
15 14.5%
CA recent: > 10 9.1%
10.4%
Singing/Nursery
4.8%
Rhymes 5
CA settled : > Short Syllabic 0
Male Female Male Female Male Female
European American Chinese American - Settled Chinese American - Recent

14. Results
Vocalization
60
Short Syllables
51.3%
50
42.1%
Proportion of Time Vocalizating
40
Culture x Gender 33.3%
36.7% 36.2%
differences 30
EA: > Long Syllabic 20.0%
20
CA recent: > Singing/Nursery 10
Rhymes
CA settled : > Short 0
Male Female Male Female Male Female
Syllabic European American Chinese American - Settled Chinese American - Recent

15. Observed Behaviors
Hand Movements
30
Rhythmic Touching
24.7%
25
Proportion of Time Hand Movements
20
15
CA-recent: >
Rhythmic Touching 10
7.3%
8.4%
6.1%
5
3.1%
2.1%
0
Male Female Male Female Male Female
European American Chinese American - Settled Chinese American - Recent

16. Cultural Differences in Caretaking
Autonomy (Western) Relatedness (non-Western)
Physical Physical
• Greater eye contact • Closer physical proximity
• Greater physical stimulation
Verbalizations Verbalizations
• Contingent response in • Directive verbal communication
engagement (turn-taking) • Repetitive vocalizations
• Content oriented in
communications

17. Culture by Gender Effects
Cultural values of behavior may
be emphasized more with sons
than with daughters in early
infancy.
Asian American parents may exert
more control over their sons than
daughters during childhood (Chao &
Tseng, 2002)
Each culture might utilize
different parenting behaviors to
guide their sons’ development.

18. Parental messages are conveyed by
everyday behavior.
They are observable.

19. Are there cultural differences in how
parents observe their children?

20. San Francisco Bay Area

21. San Francisco Bay Area
• 70 Chinese mothers and
children
• Children 5-7 years old
• From churches, summer
programs
• Mothers and fathers lived
in U.S. for ~8 years
• Many of them middle to
upper middle class

22. A Simulated In Home
One-Way Mirror
• Captures mom’s expressions as she watches
child’s expressions
CHILD MOTHER
Webcam
Image of
Child
Wireless Camera

23. Video: Simultaneous
Mother and Child Expressions

24. Emotional Expressivity and
Socialization
How Emotion Inferred CA (%) EA (%)
Facial/Body Expression 32.3 87.5
Past Experience, Other 67.7 12.5
Total 100 100
How mothers inferred emotion differed by ethnicity
(Chi square (1, N)=94)=25.78, p<.001)

25. The profiles of ABC children…
• ABC children: Chinese parents and family
American school
• Constant switching in identity
• Discrimination from both cultures

26. Differing Cultural Values
Judeo-Christian and Asian or Confucian
Puritan causes: values:
• individualistic • interdependent
• self-sufficiency • discourages emotion
• self-determination displays (anger or
• independence
pride)
• self-control

27. Common Issues
At home: One mother told Wang, "When my three-year-old
daughter plays with friends at home and they fight over a
toy, I tell her, you're the host, you need to give the toy to
your guest, or you're older, you should let the younger ones
have it.
At school: "Then, at a parent-teacher conference, the teacher told me
that we needed to work on my daughter's assertiveness. At school, the
rule is: If it's your turn, you have the right to say no," she continued.

28. Common Issues
"One mother told me that her daughter is learning to
draw, and she praises her child's work when they're alone
at home together," Wang noted. "But if visitors ask how her
daughter's art lessons are going, she feels uncomfortable
bragging and answers: Oh, just so-so. She's afraid she's
confusing her daughter because the little girl asks her
later, 'Do you really think I'm good?'"

29. What is the mental health status
among ABCs?
The unfortunate reality:
There are ABCs that are suffering.

30. ABCs and Chinese immigrants do not feel perfectly fine.
High rates of
sexually
Family problems transmitted
diseases in young
adult females
―American‖ children with more
Drug and drinking
―Chinese‖ parents show higher
problems
rates of depression.
Eating disorders
Asian American women ages 15-24 have the 4% of Chinese Americans with
highest rate of suicide. mental health problems consulted
with their physician, and only 8%
consulted with a minister or
Asian American women show the highest rate priest.
of postpartum depression than any other
ethnic group (10% of population)

31. In their words…
• I mean, when I was growing up, there
wasn't even a word for depression. It was
always, you know, you're not trying hard
enough or oh, well, you think you have
problems, or just work harder in school or
pick up a new hobby, you know, practice
the piano.

32. Postpartum Depression Survey Study
• This study used the NYC PRAMS from 2004-2007, a population-
based survey data administered to postpartum women from the
five boroughs of NYC.
• The goal of PRAMS is to monitor maternal behaviors and
experiences of women before, during, and after pregnancies that
include live births. The particular dataset used for this study was
provided by the NYC Department of Health and Mental Hygiene.
• Participants
• NYC mothers, 2-4 month old infants
• Approximately 180 mothers contacted each month
• Study sample for analysis included 3,748

33. Likelihood for PPD
Model 1 Model 2 Model 3 Model 4
Race OR CI OR CI OR CI OR CI
White 1.0 1.0 1.0 1.0
Asian/Pacific Islander 4.6*** 2.6 - 8.2 4.0*** 2.2 - 7.2 2.7** 1.4 - 4.9 3.2*** 1.7 - 6.0
Hispanic 2.7*** 1.7 - 4.5 1.8* 1.0 - 3.1 1.5 0.9 - 2.7 1.5 0.9 - 2.7
Black 1.7† 1.0 - 3.0 1.2 0.6 - 2.2 0.9 0.5 - 1.8 0.9 0.4 - 1.8
Model 1: No covariates
Model 2: Controlled for maternal age, education and household income
Model 3: Controlled for infant gender, gestational diabetes, stressful events, social support, pregnancy intent, prenatal
depression dx
Model 4: discussion about depressed mood with provider
Asian/Pacific Islanders were 3.2 times more likely than Whites
to receive a PPD diagnosis even after taking into
sociodemographic information and reports of having discussed
depression with a treatment provider.

34. Risk factors for PPD differ by race
White Asian/Pacific Islander Hispanic Black
OR CI OR CI OR CI OR CI
Prenatal
Depression
Diagnosis
No 1.0 1.0 1.0 1.0
Yes 29.4*** 8.5 - 101.4 52.1*** 16.4 - 166.0 15.3*** 7.6 - 30.9 8.1*** 2.9 - 22.8
Depressed
Mood
Discussion
No 1.0 1.0 1.0 1.0
Yes 1.7 0.6 - 4.8 9.1** 2.5 - 33.4 1.3 0.7 - 2.6 5.8** 2.1 - 15.9
For all groups, having a prenatal depression diagnosis increased
rates of PPD diagnoses. Discussion about depression with
providers was associated with increased PPD diagnoses for A/PI
and African Americans.

35. Thus, although Asian/Pacific
Islanders were the group most likely
to benefit from information
provided by the provider, they were
the least likely to be provided
information about depressed mood

36. Do we see mood problems in
young children?
Overanxious
• I do have lots of bad dreams
• I worry that bad things are going to happen
• I get nervous when my teacher asks me a question
• I get headaches a lot
• I worry bad things are going to happen
• I do get tummy aches a lot.
• I worry a lot
• I worry if other kids will like me
Separation Anxiety
• It’s hard to say goodbye to my mom or dad
• I worry my mom or dad will go away and never come
back
• I worry about my mom or dad when I’m at school
• If my mom or dad isn’t near my bed, I’m scared to go to
sleep.
• When I’m at school I miss my mom or dad
• I get scared if my mom or dad goes somewhere without
me
• I don’t like going places without my mom or dad

37. Do we see mood problems in young
children?
Yes.
• More Chinese American boys are more anxious by 5-
to-7 years (15% vs. 2%)
• Chinese children experience more separation anxiety
(higher mean levels)

38. Being Culturally Flexible
• To succeed, children must learn to shift their behavior
and attitude depending on the situation
• Both parents and children must be aware of each
others culture
• Being rooted in your beliefs
• Demonstrating empathy

39. Thank you!
Questions?
Cindy.liu@childrens.harvard.edu

40. American born babies in China

41. What makes a good parent?
• Someone who:
– Provides food and
shelter?
– Ensures safety?
– Provides education for
their child?
– Ensures that their child
survives?
– Instills good character
and values?
– Loves?

42. Sending babies to China
• Do parents have to be
with the baby physically
to be a good parent?
• There is NO clear
answer to this.
• BUT, such a situation is
more complicated than
what parents think.

43. Parent-Baby Relationship (Attachment)
• We know that children
bond with their parents
starting from birth.
• This takes place through
physical caretaking
(being held, smelling
their mothers,
breastfeeding).
• Although babies cannot
speak or remember,
these experiences stay
with them.

44. Parent-Baby Relationship
• As babies grow, they
begin to learn who cares
for them.
• For example, they begin
to recognize who to trust
as they crawl and begin
to walk. They know who
will feed them.
• They recognize the adults
that will smile and sooth
them when they are
feeling distressed.

45. Parent-Baby Relationship
• Understanding their
caregiver requires stability.
• When the stability is taken
away, children can be
confused.
• 4-month-old babies are
even confused and
distressed when that
stability is taken away
during a normal interaction
(video example)

46. Video Clip
• Video clip of a 4 month old during the still
face paradigm

47. Sending a baby to China
• Do parents have to be with the baby
physically to be a good parent?
• Should parents send their babies to
China?
• Again, there is NO clear answer for this.
But it is complicated.

48. Reasons to send babies back
• Financial issues
• Preserving the culture
• The baby will be cared by those who have more
time to take care of them.
• Overall, it’s an advantage for the whole family.

49. What are some possible
consequences?
• Short term:
– Feelings of parental guilt
– Self or other blaming
– Depression after sending
their children back
– Relationship problems
with spouse and other
family members
– Difficulty concentrating at
work

50. Possible problems when the child
come back to the US
• Behavioral Problems
– banging their heads on walls
– refusing to speak,
– wandering aimlessly in the classroom
• Adjustment Issues
– Not wanting to call their parents by mom or
dad

51. New York Times
9/23/2009
Winnie Liu’s son Gordon, 7, with his brother Kyle, 4, had developmental problems
after living temporarily with his grandparents in China.

52. New York Times
9/23/2009
• Gordon, 3, would not look his parents in the eyes, and refused to
call them Mom and Dad. He erupted in tantrums And sometimes
cried nonstop for half an hour.
―We did not know why,‖ said his mother, Winnie Liu, recalling the
desperation that sent them to a neurologist to check Gordon for
autism, and to a hospital that referred them to Butterflies, a mental
health program for very young children on the Lower East Side of
Manhattan.
Finally they learned the reason for their child’s distress — and the
reason social service agencies that help families from China are
facing a sharp rise in such developmental problems.

53. Long Term Consequences
• Immigrant children who have been separated from their
parents are more prone to depression as well as self-
esteem and behavioral problems.
• They may have trouble attaching to their parents once
they get back to the US. Their parents may seem foreign
to them.
• Once they are older, they may resent their parents for
having sent them to China. Some children do not recover
from this and remain estranged from their parents in
adulthood.

54. Long Term Consequences
• Parents often feel guilty. Their parenting
becomes inconsistent (overly strict or indulgent).
• Some of the caregiving styles do not fit with
American expectations.
• When the child comes back their personality or
behavior may not be very adaptive at their
schools.
• They cannot get along with teachers or friends.

55. Long Term Consequences
• The child may have to adapt to new members of the
family (younger siblings) who stayed with the
parents, this may produce jealous feelings.
• Parents may feel like they cannot cope with this child’s
misbehavior
• Many instances of mental health issues in the family
have been documented, not just with the child.
• Extensive therapy may be needed

56. Gordon in Therapy
The therapist explained: ―He
was trying to find mastery over
things he had no control over.
We started introducing
scenarios to help him develop
trust in his parents’ authority
over his life.‖
Still, Gordon remains more
withdrawn than typical 7-year
A photo of Gordon with his father, Tim Fang. olds. Ms. Liu said she struggles
with guilt and regret.

57. Does the consequences on the
separation timing?
• There is not enough research for us to know
this.
• However, because the child is growing, they are
becoming more aware of their environment.
• Even if the separation is short and early in
life, some children show problems once they
reflect on their early childhood.
• They ask ―Why did this happen to me?