Clinical,developmental and social aspects of infant crying and colic

Persistent unexplained infant crying in the first few months is a common source of distress for parents and is costly for the health services. The aim was to assess the merits of developmental and social conceptualizations of this phenomenon, compared to the clinical approach as represented by the concept of colic. From a community sample of 530 infants, 67 who met the ‘rule of threes’ definition of colic by fussing and crying for 3 or more hours per day at 4-5 weeks of age were chosen. To avoid confusion, these infants were called ‘persistent criers’. Groups of ‘evening criers’ (N = 38) and ‘moderate cries’ (N = 55) were also selected. These 160 infants were assessed by researcher measures of their consolability and by maternal diary measures of their amounts of fussing, crying and colic behaviour when 5-6 weeks old. The persistent and evening criers cried more than the moderate criers. However, irritable, ‘fussy’ behaviour was the predominant form of distress for all three groups of infants. Colic bouts–defined as ‘bouts of intense, unsoothable crying and other behaviour, perhaps due to stomach or bowel pain’–were rare even among the persistent criers and only 7% of these infants were found to be inconsolable. The results support growing evidence that normal infant developmental processes are central to this phenomenon. In addition, social interactions between infants and parents, and parental subjective variables, appear to be involved. Colic was distinguished as a rare and separate form of distress by the infants' mothers. Further evidence needs to determine whether colic is a distinct clinical phenomenon or an extreme degree of normal distress interpreted within a western cultural framework.     

Social experiences and daily routines of African American infants in different socioeconomic contexts

Sixty-two 3- to 4-month-old African American infants from lower, middle, and upper socioeconomic status (SES) backgrounds were each observed in naturalistic contexts for 12 hr. The social experiences of infants in the 3 groups were similar in many ways: Infants from all backgrounds slept and were vocalized to for similar amounts of time. However, infants in the upper SES families engaged in more self-play, vocalized less, fussed less, had fewer but longer naps, and fewer but longer bouts of social interaction than did infants in the middle- and lower SES families. Infants in the upper SES families also received more verbal affection and soothing responses to their fussing and crying than did the other infants, whereas infants in the lower SES families interacted more with extended kin than did infants in the upper SES families. These results underscore the need to study African American families in a variety of socioeconomic contexts because families in more advantaged circumstances may greatly differ from those who are more disadvantaged, especially in terms of reliance on extended kin as caregivers.     

Maternal sensitivity behavior and infant crying, fussing and contented behavior: the effects of mother's experienced social support

Maternal sensitivity behavior, mother's experienced difficulties, experienced social support, and the amount of infant's crying, fussing and contented behavior were studied when the infants were 3 and 12 months of age. Fifty-seven Finnish low-risk mothers' sensitivity behavior was assessed by the Parent-Child Early Relational Assessment method. Infant's crying behavior was assessed by the Baby's Day Record and by the Crying Patterns Questionnaire. The Social Support Questionnaires (SSQ 1 and 2) were used to evaluate mother's experienced difficulties and support. The infants of More Sensitive (MS) mothers were more contented than those with Less Sensitive (LS) mothers. The MS mothers experienced fewer difficulties with their infants and experienced more support from their best friend and their husband than LS mothers. In addition, some gender differences were found concerning infant behavior.     

The effects of contingent music and differential reinforcement on infantile colic

Infantile Colic is a behavioral syndrome characterized by paroxysms of excessive crying and increased motor activity, hypertonicity of the musculature, excessive flatus and erratic sleeping and feeding patterns. Ten to 40% of all infants are diagnosed as having Colic. The medical evidence to date does not justify any conclusions regarding the etiology or treatment of Colic. Typically, parents are advised to simply wait until Colic has run its course which is often 3-4 months. The behavioral program reported here was designed to increase behavior that competed with crying by reinforcing quiet alertness with music and parental attention. Concurrently, it attempted to inhibit excessive crying by a brief time-out procedure. A group of 8 infants diagnosed as Infant Colic were included in this study. The dependent variable, crying, was measured through direct observations based on hourly samples involving 30 observations of 2-min intervals. The independent variable consisted of a behavioral treatment package. A within-S reversal design was used to assess the functional properties of the treatment. The results show that across all 8 infants the introduction of the treatment package led to a substantial decrease in excessive crying of about 75% of the initial baseline. Further, a functional relationship was identified between the treatment and excessive crying behavior: crying decreased when the treatment was initially introduced, it resumed when the treatment was withdrawn and decreased again when the treatment was reinstated.     

Mothers’ feelings about infants’ negative emotions and mother-infant interactions among the Gamo of Southern Ethiopia

Parents’ exposure to stressful ecosocial situations, like inadequate resources, is linked to parents’ perceptions of infants’ fussing and crying and less sensitive caregiving. However, studies supporting these findings predominantly come from Western contexts of parenting and infant care. Ecosocial situations may have different effects on parenting and infants in distinct cultural contexts. In this study, the link between Gamo mothers’ expressions of stress about their infants’ negative emotional displays (N = 29 mothers and infants) and mother-infant interactions was investigated. Mothers who expressed stress in response to their infants’ negative emotions demonstrated fewer interactions overall with their infants compared to mothers who did not express stress. Regression analyses showed that mothers who did not express stress had infants that fussed and cried more in their presence than infants of mothers who did not express stress, albeit insignificant. These results are discussed in the context of Gamo infancy in Southern Ethiopia.     

Screaming, yelling, whining, and crying: categorical and intensity differences in vocal expressions of anger and sadness in children's tantrums

Young children's temper tantrums offer a unique window into the expression and regulation of strong emotions. Previous work, largely based on parental report, suggests that two emotions, anger and sadness, have different behavioral manifestations and different time courses within tantrums. Individual motor and vocal behaviors, reported by parents, have been interpreted as representing different levels of intensity within each emotion category. The present study used high-fidelity audio recordings to capture the acoustic features of children's vocalizations during tantrums. Results indicated that perceptually categorized screaming, yelling, crying, whining, and fussing each have distinct acoustic features. Screaming and yelling form a group with similar acoustic features while crying, whining, and fussing form a second acoustically related group. Within these groups, screaming may reflect a higher intensity of anger than yelling while fussing, whining, and crying may reflect an increasing intensity of sadness.     

Changing patterns of infant behavior and mother–infant interaction: Intra- and interindividual variability

Mother–infant dyads were observed weekly at their homes for a 15-month period. In this way longitudinal data about the infants’ crying, fretting/fussing, smiling and different types of physical contact with the mother were collected. The subject of this study concerns the variability and stability in macroscopic patterns of associations between these behaviors. Different types of associations were found between the behaviors, and most of them changed considerably as the infant developed. Individual differences in the nature of the associations and in the changes they underwent over time predominated, but in a limited number of cases the infants shared the same developmental trajectories of behavioral associations. The results show how the use of intensive time series designs can be advantageous in clarifying issues of long-term variability and stability in human behavior. They also support the notion of changing patterns of behavior being a normal feature of early development.     

Intraindividual variability in infant behavior.

Longitudinal observational data of infant crying, fretting/fussing, and smiling and the time spent in physical contact with the mother were used in a study on behavioral variability. The infants were followed weekly for a 15-month period. Evidence was found of an important intraindividual variability in the studied behaviors, specifically between the ages of 0 and 5 months, 5 and 10 months, but not between 10 and 15 months. Results are discussed and analyzed in the light of earlier literature. The possible functions and the factors underlying variability in development as well as its methodological implications are discussed.     

Early behaviour and its relation to behaviour at 3 years

In 34 healthy 1-month-old infants sleep, waking, crying and conditioning were analysed in detail. Intellectual functioning and coping with an unfamiliar situation were assessed at the age of 3 years. Likewise, the social environment including mother-infant interaction was considered. The majority of sleep and waking parameters assessed during the first month did not correlate with outcome data at 3 years. Rather, it was those concerning conditioning at 1 month that significantly correlated with coping in an unfamiliar situation at 3 years, a finding in accordance with neurophysiological concepts concerning stimulus sensitivity. More sensitive infants at 1 month had problems in coping with an unfamiliar situation at 3 years. In the light of these results we suggest that factors related to central nervous system processes play a role in coping with unfamiliar situations.     

Adding odor: Less distress and enhanced attention for 6-month-olds

The effect of odor on cognitive and emotional processes has been studied in adults and children, but less so in infants. In this study twenty-seven six-month-olds were presented with a video while in either an odor (pine or baby-powder) or a no odor control condition. The video was a 92-s audiovisual presentation of a woman expressing happiness and sadness, with the order of emotion counterbalanced. Infant attention (looking time) and emotional expression (smiling, crying, mouthing) were coded. Infants looked longer in the presence of odor and expressed less crying and mouthing but more smiling behavior. Presence of odor markedly reduced infant emotional distress and increased attention, suggesting that the olfactory sensory system provides cues to infants that support mood regulation and maintain attention. These results have implications for optimizing infant environments for emotional health and cognitive development.     

Emergence of amae crying in early infancy as a possible social communication tool between infants and mothers

Amae is defined as “wishing to be loved (Scheidlinger (1999). The Journal of the American Academy of Psychoanalysis, 27(1), p. 91)”. Amae crying is known as crying of infants when seeking intimate emotional communication with caregivers. The objective of this study was to delineate when and how amae crying emerges in early infancy. Crying episodes of four infants were observed bimonthly, in the natural context of their homes, from birth to 6 months of age, for approximately 60 min per session. Crying episodes (total = 275) as determined by two coders were analyzed with respect to several behavioral measures. Results indicated that amae crying emerged at the age of 2 months, and consistently accounted for 30–40% of the total crying episodes after the ages of 3 months. Amae crying could be accurately identified when infants were not in acute discomfort and had already got the attention of their mothers. At such times, infants did not shed tears, cried with a fussy voice, and frequently looked at their mothers. Mothers responded to amae crying more promptly than they did to other types of crying behaviors. It is concluded that 3 months of age, when infants probably begin to use crying as a social communication tool is a major turning point for crying behavior from the perspective of its biological and social roles. It is suggested that amae crying might play an important role in strengthening and encouraging mother–infant interactions.     

Predicting adult responses to infant distress: Adult characteristics associated with perceptions,emotional reactions,and timing of intervention

This study examined adult characteristics associated with different responses to infant distress. One hundred eighty‐eight parents viewed four 20‐second segments of videotape in which a 4‐week‐old infant was either (a) fussing mildly, (b) fussing vigorously, (c) crying, or (d) crying vigorously. Participants rated their emotional reactions and perception of cry characteristics following each segment. Participants then viewed a 4‐minute videotape depicting the same infant progressing from calm to vigorous crying, and indicated when they would intervene to pick up the infant. Relatively high levels of empathy and extraversion and low levels of conscientiousness were associated with more sensitive responses to infant distress. Infant‐rearing attitudes had a strong impact on response patterns as well, suggesting that education may be an effective means of increasing parental sensitivity. ©2003 Michigan Association for Infant Mental Health.     

Preparing children for medical examinations: the importance of previous medical experience

The relationship between past medical experience and children's response to preparation for medical examinations was investigated in 79 pediatric outpatients aged 3 to 12 years. Children were randomly assigned to one of five preparation conditions prior to receiving a medical examination and a throat culture: sensory information about the exam, training in coping skills (deep breathing and positive self-talk), combined sensory information and coping skills training, attention control, and no-treatment control. The results indicated that children with previous negative medical experiences demonstrated more behavioral distress during a throat culture examination that did children with previous positive or neutral medical experiences. In addition, the attention control condition appeared to increase the distress of children with previous negative medical experiences. Amount of past exposure to the specific medical procedure was not related to observed distress. The implications of these findings for the preparation of children for medical procedures are discussed.     

阈下安全启动改善非安全依恋女性的注意加工

研究采用掩蔽启动范式，结合事件相关电位技术，考察阈下安全启动在非安全依恋女性对婴儿面孔注意加工上的改善效应。行为指标上，悲伤程度评分和反应时结果均表明了安全启动的改善作用。ERP结果上，在早期注意加工阶段，阈下安全启动比中性启动诱发了依恋焦虑和依恋回避女性对婴儿面孔表情更大的N1波幅以及更优的P2潜伏期，在晚期控制注意加工相关的P3波幅上同样发现了类似的改善效应。研究结果表明阈下安全启动能够提升非安全依恋女性对婴儿面孔的知觉敏感性，改善非安全依恋女性注意加工缺陷，且这种改善效应不仅仅作用于早期注意加工阶段而且还可以扩展到个体有意识的晚期控制加工阶段。     

Early mother-infant interaction and factors negatively affecting parenting

The social information-processing model contributes to identifying the psychological processes underlying the construct "sensitivity" in early mother-child interaction. Negative emotional states associated with inadequate self-regulation in coping with stressors affect the mother's attention skills and the processing of the baby's signals. This leads to less synchronous parental practices, particularly unsatisfactory when the baby is unhappy, or crying because the required self-regulation is not provided. This micro-social research studies the sequential profile of maternal reactions to the baby's positive/neutral vs. difficult behaviours and compares them in two groups of dyads, one with mothers who reported high levels of distress and other negative factors for parenting and another group with low levels. The unfavourable circumstances of the high stress group and their negative effects on interaction were observed in some indiscriminate maternal responses and particularly as they reacted to their baby's difficult behaviour, when the mother's regulatory role is more necessary.     

The effects of early foster care intervention on attention biases in previously institutionalized children in Romania

Children raised in institutions experience psychosocial deprivation that can negatively impact attention skills and emotion regulation, which subsequently may influence behavioral regulation and social relationships. The current study examined visual attention biases in 8‐year‐old children who were part of the Bucharest Early Intervention Project (BEIP). Relations among attention biases and concurrent social outcomes were also investigated. In early childhood, 136 children abandoned at birth or shortly thereafter into institutional care were randomized to receive a high‐quality foster care intervention or care‐as‐usual within the context of the Bucharest Early Intervention Project (BEIP). At 8 years of age, 50 care‐as‐usual, 55 foster care, and 52 community controls performed a behavioral dot‐probe task, and indices of attention biases to threat and positive stimuli were calculated. Concurrent data on social behavior were collected. Children placed into the foster care intervention had a significant attention bias toward positive stimuli, while children who received care‐as‐usual had a significant bias toward threat. Children in the foster care intervention had a significantly larger positive bias when compared to the care‐as‐usual group. A positive bias was related to more social engagement, more prosocial behavior, less externalizing disorders, and less emotionally withdrawn behavior. The magnitude of positive bias was predicted by age of placement into foster care among children with a history of institutionalization. An attention bias towards positive stimuli was associated with reduced risk for behavioral problems amongst children who experienced early psychosocial deprivation. Research assessing attention biases in children experiencing early environmental stress may refine our understanding of the mechanisms underlying risk for later psychiatric and social disorders and inform prevention efforts.     

People and objects affect the quality of vocalizations in infants with down syndrome

The vocalizations of eight infants with Down syndrome were recorded longitudinally in relation to different social and non-social contexts. The infants were observed biweekly from 8 to 24 weeks and monthly up to 40 weeks. At each visit the infants were presented with their mother, a female stranger, and a rattle puppet, each alternately active and passive. Each condition lasted 60 sec. The results showed that by 4 months of age, the infants produced different types of vocal sounds in relation to environmental contexts. They produced significantly more melodic (speechlike) sounds, vocalic (non-speechlike) sounds, and emotional (crying, laughing and fussing) sounds when facing people than objects. By 6 months of age, these utterances began to be distinguished between mother and female stranger and active and passive adults. However, within the communicative context the overall amount of vocalic (non-speechlike) sounds produced was larger than the amount of melodic (speechlike) sounds. It is suggested that this low output of melodic sounds in the overall vocal production of these infants may adversely affect the development of more appropriate vocal behaviour.     

Infant crying and maternal holding in the first 2 months of age: an Italian diary study

This study aims to confirm previous North American and North European findings about the normal developmental pattern of infant crying by studying the crying of Italian babies. A cohort of 70 healthy, full‐term Italian infants was assessed longitudinally at 2, 5 and 8 weeks of age. Mothers were asked to fill in 24‐h behaviour diaries for 3 consecutive days at each age. Results show significant differences in the amount of daily crying between 2 and 8 weeks and between 5 and 8 weeks. Different from other similar studies, no significant cry peak at 5 weeks was found in the Italian babies, but the amount of time Italian mothers spent holding their babies showed a peak at 5 weeks. Infants cried more during the evenings and mothers carried them most during this part of the day. Significant correlations between maternal holding and infant crying were found both concurrently and predictively. The amount of infant crying at 2 weeks predicted the amount of holding at 5 weeks. Results confirmed previous findings about the individual stability of daily crying in the first 8 weeks of age, but future research should take account of cultural variations in maternal holding in studying infant crying in different societies. Copyright © 2008 John Wiley & Sons, Ltd.