Feeding and attachment in infants with and without orofacial clefts

Do the many feeding problems associated with isolated cleft palate (CP) and cleft lip and palate (CLP) adversely affect the emotional bond between mother and infant? This question was addressed by observing the feeding interactions of 126 mother-infant pairs (57 infants with CLP or CP) at 3 and 12 months of age. Infants with CLP were found to be less communicative during feeding at 3 month than comparison group infants. However, by 12 months, the CLP group had improved to a level indistinguishable from the CP and comparison groups. This change was unrelated to the timing of cleft palate surgery. Although maternal sensitivity during feeding at 3 months did not predict the attachment quality of infants with clefts, maternal sensitivity at 12 months was concurrently related to attachment. Change in maternal sensitivity between 3 and 12 months was also predictive of attachment in the cleft groups, with mothers of avoidant infants showing greater attenuation in maternal sensitivity than the mothers of secure infants.     

Father–child and mother–child interaction in families with a child feeding disorder: The role of paternal involvement

To date, research about feeding disorder (FD) has focused almost exclusively on the mother–child dyad, ignoring fathers' roles. The current study investigated father–child interactions with children having FD. The sample consisted of 67 children (1–3 years old) and their mothers and fathers. Thirty‐four children, diagnosed with a nonorganic‐based FD (FD group) and 33 children without an FD (control group) were matched for age, gender, birth order, and maternal education. Data were collected during home visits. Mothers were interviewed about their and the father's involvement in childcare. In addition, mother–child and father–child interactions were videotaped during play and feeding. Both mothers and fathers from the FD group experienced less positive parent–child interactions than did parents in the control group. Furthermore, mothers in the FD group reported greater maternal versus paternal childcare involvement than did control group mothers. Finally, FD group mothers exhibited more parental sensitivity than did fathers during feeing interactions; however, this difference was observed only when coupled with low paternal involvement. In families where fathers were highly involved, no difference was evident in paternal and maternal sensitivity. These findings highlight the importance of fathers' involvement, especially in families with children exhibiting an FD.     

The development of Japanese mother–infant feeding interactions during the weaning period

During the weaning period, infants are not skilled at self-feeding and caregivers play a prominent role in feeding. Solid feeding is therefore an inherently collaborative and interactive process between infants and caregivers. The present study examined how caregivers and infants coordinate their solid feeding interactions, based on naturalistic longitudinal observations of three Japanese mother–infant dyads. The main results were as follows. Four or five months after weaning (about 10–11 months of age), children's mouth movements and mothers’ arm movements became more synchronized, and the success or failure of coordinated feeding became independent on children's gaze behavior. During this same period, both mothers’ and children's body movements accelerated. Specifically, children's food-intake motions and mothers’ food-carrying movements became faster together, although before 10–11 months fluctuations of these motions were not as correlated. Finally, at 9–11 months of age rhythmic body movements became frequent. From the first day of weaning, all three mothers swayed their bodies rhythmically while feeding, and about 2–3 months later their children also began to sway as they ate, at first infectiously but later spontaneously. These observations indicate how specific behavioral development contributes to mother–infant coordination in feeding.     

Early tactile experience of low birth weight children: links to later mental health and social adaptation

The purpose of this study was twofold: to determine (1) the degree to which specific qualities of maternal touch may contribute to the low birth weight infant's emotional and behavioural problems as well as social adaptation, and (2) the relationship between maternal touch and a mother's other caregiving behaviour. The sample included 114 socioculturally diverse infants and their mothers who were videotaped during an infant feeding when the baby was 3 months old. This videotape was analysed to assess dimensions of mother–infant interaction, including maternal touch. Data on perinatal risk and the mother's acceptance versus rejection of the infant were also acquired. Social adaptation and emotional/behavioural problems were measured when the child was 2 years of age. Hierarchical regression analyses indicated that maternal touch accounted for 15% of the variance in the likelihood of a child having emotional/behavioural problems at age 2. Children who received more nurturing touch had significantly fewer internalizing problems (such as depression) while children receiving both more frequent touch and harsh touch had more externalizing problems (such as aggressive behaviour). Infants who were less responsive to their caregivers were especially at risk of developing aggressive/destructive behaviour as a result of frequent touch. But less responsive infants also appeared to benefit most from greater use of diverse types of maternal touch, accounting for 6% of the variance in superior adaptive behaviour at age 2. Nurturing touch was the only quality that showed even a modest relationship to other caregiving behaviour, suggesting that touch may play a distinct role in the infant's psychosocial development. Copyright © 2001 John Wiley & Sons, Ltd.     

Maternal sensitivity,infant temperament,and the development of early feeding problems

Early feeding problems, assessed in maternal reports about general problems and refusal behaviors, were investigated in a normal sample (n = 115) at the ages of 10 months and 2 years. In a longitudinal design, stability of feeding problems was studied. A model for development of nonorganic failure to thrive proposed by Chatoor (1989: Chatoor & Egan, 1983) was used as a guide in selection of potential antecedents to early feeding problems. The predictive value of parent-rated infant temperament and directly observed maternal sensitivity for explaining variance in feeding problems was explored. The results showed moderate stability for feeding problems. Feeding problems at both ages were predicted by interactions between infant temperament and maternal sensitivity. At 10 months feeding problems were marginally associated with an interaction between sensitivity and infant manageability (degree of negative emotionality); less sensitive mothers with less manageable infants reported more refusal behaviors. At the age of 2 years irregular infants were reported to have more problems if their mothers were less sensitive to their signals. The results are discussed in relation to studies of more severe feeding problems in infancy, and the Chatoor model was found to contribute to an understanding of the development of everyday infant feeding problems in a normal sample. © 1997 Michigan Association for Infant Mental Health     

Gestural development,dual-directional signaling,and the transition to words

This paper describes the emergence and development of three object-related gestures: pointing, extending objects, and open-handed reaching, in four first-born infants from 9 to 18 months during natural interactions with their mothers. It examines the changing characteristics of the gestures and the acquisition of conventional words in accompaniment. Furthermore, it investigates the role that the capacity for dual-directional signaling, sending simultaneously two coordinated but divergently directed nonverbal signals of gesture and gaze, may play in this transition. Analysis revealed that dual-directional signaling appeared concurrently across gestures. In addition, dual-directional signaling was employed in a socially adjusted manner, more with pointing, especially spontaneous pointing when the mothers' attention could not be assumed. Verbal accompaniments appeared with gestures only when the children had mastered dual-directional signaling. Then words emerged approximately simultaneously with more than one kind of gesture.     

Reliability and validity of mothers' developmental estimates for children between 4 and 41 months

The feasibility of mothers estimating their own children's development is explored in this paper. Construction, reliability and validity of a mothers' developmental inventory for children from 4 months to 41 months is described. The inventory consists of six subtests: Gross Motor, Fine Motor, Language Expression, Language Comprehension, Personal-Social Competence and Self Help. A preliminary version of the inventory was item analyzed on a sample of 105 mothers of 4 to 37 months old children. This reduced the inventory to 164 items with satisfactory reliability and age discrimination on half-year intervals. The list was cross-validated on a sample of 275 mothers, for which medians of alpha coefficients for the six subtests ranged from 0.69 to 0.96, with most (26 out of 36) coefficients being 0.77 or higher. Again, the age discrimination was satisfactory, although floor effects appeared on four subtests for children younger than 12 months and ceiling effects on two subtests for children older than 24 months.     

Courtesy stigma in mothers of children with Attention-Deficit/Hyperactivity Disorder: a preliminary investigation

Mothers of children with Attention-Deficit/Hyperactivity Disorder face an increased risk for depression, anxiety, and social isolation. In addition to stress due to children's behavior, mothers of children with ADHD may also feel stigmatized by their children's diagnosis. Fifty-one mothers participated in a study to assess attitudes toward ADHD. Although mothers of children with ADHD expected that parents of children without ADHD would hold harsh views of the disorder, this was not generally the case. This difference between perception and the actual self-reported views of mothers of children without ADHD supports the idea that mothers feel stigmatized but suggests that increased awareness might help mothers of children with ADHD feel less isolated.     

Parent-child physical play: The effects of sex and age of children and parents

Physical play is an important vehicle for differential socialization of boys and girls into appropriate sex roles. The aim of the study was to examine developmental changes in patterns of parent-child physical play as a function of the sex of parent and child. Three hundred ninety families with a total of 746 children ranging in age from under 1 year to 10 years were contacted by telephone and questioned about the frequency of physical-play interactions with their children. The results indicated that the strongest variable affecting the frequency of physical play was the age of the child. This developmental effect was curvilinear, with comparatively low levels prior to age one, a peak in the early childhood years, and the decline thereafter. Fathers tended to engage in more physical play than mothers. Effects of child sex were less evident, but tended to indicate that girls participated more often in nonstrenuous physical games with their parents, such as pattycake and being bounced on the parent's knee, while boys participated more often in activities such as wrestling and ball playing. There was a modest but significant tendency for older parents to engage less often in physical play with their children at each age level. The implications of parent-child physical play for sex role typing were noted.     

Maternal limit‐setting in toddlerhood: Socialization strategies for the development of self‐regulation

Early findings from the Prohibition Coding Scheme (PCS; Houck & LeCuyer, 1995; LeCuyer‐Maus & Houck, 2002; Medvin & Spieker, 1985) revealed that maternal limit‐setting styles with toddlers were differentially related to later child social competence, self‐concept, and delay of gratification. For this study, the PCS was revised to provide more information about the specific strategies mothers used during limit‐setting in relation to those outcomes. Results from the PCS‐Revised (PCS‐R; LeCuyer & Houck, 2004) included that the more time mothers spent actively distracting their toddlers away from a prohibited object during limit‐setting, as early as 12 months, the longer their children could delay gratification at age 5 years. Mothers who spent more time sensitively following and being engaged in their toddler's own interests (other than the prohibited object), again as early as 12 months, had more socially competent children with more developed self‐concepts at age 3 years. Maternal use of reasoning statements later in toddlerhood also related to higher levels of social competence. Maternal limits and prohibitions were not related to these outcomes, and appeared to contribute to the development of self‐regulation mainly by creating the opportunity for the use of other, less directive strategies. The findings indicate that these strategies may be important to include in intervention programs for the promotion of toddler and child development of self‐regulation.     

Maternal verbal interaction in different situations with infants born prematurely or at term

The present study investigates whether maternal verbal behaviour, in terms of the use of declaratives, interrogatives and imperatives, can be accounted for by gestational age of the infant, or the situation in which mother–infant pairs were observed. Thirteen mothers and their premature and term babies were observed twice in three situations, namely playing with, feeding and changing their infants. The first observation took place at a mean gestational age of 40 weeks and the second observation took place approximately 7 weeks later. All mothers used more imperatives during play than during changing or feeding situations. Mothers used more interrogatives during play than during changing or feeding, and they used more declaratives during both changing and playing than during feeding. In contrast, gestational age influenced only the complexity of maternal interrogatives. It is concluded that situational factors are significant and hence that the mother's role has to be judged relative to the context in which mothers and infants are observed. Copyright © 1999 John Wiley & Sons, Ltd.     

Affective exchanges between young autistic children and their mothers

This study examined autistic children's social behavior, affect, and use of gaze during naturalistic interactions with their mothers. Sixteen autistic children, 30 to 70 months of age, and 16 normal children, matched on receptive language, participated. Children and their mothers were videotaped during three situations: a free-play period, a more structured period during which communicative demand was made on the child, and a face-to-face interaction. In all three situations, autistic and normal children did not differ in the frequency or duration of gaze at mother's face. In the one condition (face-to-face interaction) during which affective expressions were coded, autistic and normal children also were not found to differ significantly in the frequency or duration of smiles displayed, and neither group displayed frowns. However, autistic children were much less likely than normal children to combine their smiles with eye contact in a single act that conveyed communicative intent. Autistic and normal children were not found to differ in the percentages of smiles they displayed to social versus nonsocial events. However, when autistic children's responses to mother's smiles specifically were examined, it was found that they were much less likely to smile in response to mother's smiles than were normal children. Finally, it was found that mothers o f autistic children displayed fewer smiles and were less likely to smile in response to their children's smiles, when compared with mothers o f normal children. These findings suggest that the autistic child's unusual affective behavior may negatively affect the behavior of others.We wish to thank the children and their mothers who participated in this study, and the staff at Division TEACCH at the University of North Carolina at Chapel Hill for their help in recruiting children for the study. Harriet Reingold generously allowed us to videotape the children in her infant observation laboratory at the University of North Carolina, Chapel Hill. Cathy Lord provided videotapes of some of the autistic children and their mothers. Mary Evers assisted in data collection. Kerry Hogan assisted in the coding of data; her help is gratefully acknowledged. The study was supported by a grant from the University of North Carolina at Chapel Hill.     

ATTACHMENT IN INFANTS WITH CLEFT LIP AND/OR PALATE: MARGINAL SECURITY AND ITS CHANGES OVER TIME

This study examines the attachment quality and how this changed over time among infants who had cleft lip and palate (CLP), by conducting a prospective longitudinal study addressing the effects of this type of perinatal event on the parent–infant relationship and the emotional development of the infants. At 12 months of age, the Strange Situation Paradigm (SSP; M. Ainsworth, M.C. Blehar, E. Waters, & T. Wall, 1978) was administered to a sample of 38 CLP infants (born between 2003 and 2010) and 17 healthy controls. At 4 years of age, the Attachment Story Completion Task (ASCT; I. Bretherton, D. Ridgeway, & J. Cassidy, 1990) was administered to 32 individuals from the CLP sample and 14 from the control group. As reported in the literature, CLP infants display secure attachment behaviors as frequently as do control infants (55%). However, a more detailed analysis of the attachment scales revealed that CLP infants show more avoidance and less proximity seeking. In addition, a closer examination of the subcategories of attachment styles revealed that most CLP infants (71%) displayed distal attachment strategies such as the B1/B2 or A1/A2 subcategories. At 4 years old, CLP infants clearly displayed more deactivation and less security than did the control sample. Moreover, when detailing the evolution of attachment individually, almost 60% of the CLP children showing distal strategies at 12 months became deactivated or disorganized when they reached 4 years. Indeed, subtle differences in attachment behaviors at 12 months old—which can be considered marginally secure at that age—may reveal attachment vulnerabilities, which seem to be more apparent over the course of development.     

Interactions between mothers and infants showing food refusal

This study examined the interactional patterns of mothers and their infants who showed food refusal (N = 24) and of mothers and infants in a control group (N = 24) during feeding and play. The observations revealed significant group differences in both infant and maternal behavior. Infants in the case group rejected food more often and showed less clear communication signals than control infants, and mothers of case infants were less sensitive, less cooperative, and had more verbal teaching/control behavior than the control group. These differences pertained to both feeding and play situations. The findings have implications for the development of appropriate and efficient intervention strategies for infants showing food refusal.     

Gender Differences in Emotional Closeness Between Preschool Children and Their Mothers

The emotional closeness between mothers andtheir children was examined to determine if motherdaughter pairs exhibit closer emotional relationshipsthan mother son pairs. Forty-one mother childpredominantly Caucasian dyads were videotaped during asemistructured play setting. The children were 4 (10males and 10 females) and 5 years of age (10 males and11 females). Emotional closeness was defined as physical proximity, mutual eye contact, and global levelof enjoyment. Results demonstrated that compared toboys, girls were physically closer to their mothers,engaged in more mutual eye contact with their mothers, and were rated higher on global enjoyment.Results are consistent with Chodorow's theory thatgender identity development is related to the emotionalrelationships that develop between children and their mothers.     

Developmental patterns in the infants and young children of mentally ill mothers

The development of children (ages 2 to 49 months) of mentally ill mothers was compared with that of children of matched “well” mothers. The children of mentally ill mothers scored lower on measures of intelligence and had a less adaptive coping style in the testing situation. The children of “well” mothers were more socially competent; that is, they sought the attention of adults more often, responded more to social initiatives, displayed more positive affect, and sent clearer signals. Clinical data on the children of mentally ill mothers complemented the research data, indicating that these children displayed problems in the areas of interpersonal relationships, verbal-conceptual functioning, attentional skills, and mood and affect.     

The effects of early relational antecedents and other factors on the parental sensitivity of mothers and fathers

This study examines the effect of early relational antecedents (ERA, i.e. the quality of parenting parents recalled receiving as children), parenting stress, marital stress, socio‐economic factors and children's characteristics (gender and disability condition) on the parental sensitivity of mothers and fathers. The sample consisted of 116 mothers and 84 fathers of 117 eighteen month old children drawn from a larger longitudinal study on the adaptation of parents to a child with a disability. Thirty‐four children were diagnosed with Down syndrome (DS), 51 with a cleft lip and/or palate (CLP), and 32 were non‐disabled children. Multiple regression analyses reveal that mothers' sensitivity is best predicted by her level of education and family income, whereas fathers' sensitivity is best predicted by their ERA, marital stress, family income and the child's disability condition. Mothers with more education and a greater family income displayed a greater sensitivity to their children, as did fathers who perceive less marital stress, those with a greater family income and those who perceived their parents as less controlling. Also, fathers of children with DS displayed less sensitivity for their children than fathers of children with CLP or fathers of non‐disabled children. These results concord with many studies about the importance of socio‐economic factors, ERA, marital stress, parent's gender and children's factors in the understanding of parental sensitivity. Copyright © 2003 John Wiley & Sons, Ltd.     

Maternal anxiety and toddler depressive/anxiety behaviors: The direct and moderating role of children's focused attention

Attention mechanisms have a pertinent role in shaping developmental pathways to anxiety and depressive disorders. The current study examined the direct and interactive associations between maternal anxiety symptoms, children's focused attention, and children’s anxiety and depression behaviors in early toddlerhood. Participants were 150 mother-child dyads (50 % female) that were assessed at two time points. At 12 months of child age, mothers reported about their anxiety symptoms and children's focused attention. Children's focused attention was also observed and rated from an individual play task. At 18 months of age, mothers reported about children's anxiety and depression behaviors. Focused attention predicted child anxiety and depressive behaviors, with different patterns of associations between observed and reported measures of attention. There was also a significant interaction between maternal anxiety symptoms and observed children's focused attention. A positive association between maternal anxiety symptoms and child anxiety and depression symptoms was evident only for children with above-average levels of observed focused attention during play. Results suggest that different aspects of focused attention play a role in maternal reported anxiety and depression behaviors in early development and may modulate the intergenerational transmission of anxiety.     

Maternal attitudes and attachment styles in mothers of obese children

This study evaluated categories of attachment style and the maternal attitude toward educational role in a sample of 30 mothers of obese children and a control group of 80 mothers of children of normal weight. All mothers completed the 1994 Attachment Style Questionnaire and the 1958 Parental Attitude Research Instrument. 30 mothers (M age 37.4 yr., range 31 to 54 years; M yr. of education 11.6, range 5 to 18 years) of obese children (range 30 to 60% above normal weight) and a control group of 80 mothers (M age 37.1 yr., range 29 to 52 years; M yr. of schooling 11.4, range 5 to 18 years) of children with normal weight were contacted at the primary school attended by their children and joined the project voluntarily. Age and number of years of education were not significantly different between the two groups of women. There was a significant prevalence of the Insecure Attachment Style in the group of mothers with obese children (66.6%) as compared to the control group of mothers of children of normal weight (38.5%) and significantly higher scores on 6 subscales of the Parental Attitude Research Instrument of Obese compared to Nonobese children. These data indicate that obese children's mothers tend to make the family their exclusive centre of interest. They also tend to dedicate themselves to their children with possessiveness and hyperprotection. They seem to have an insistent requirement of idealisation of their own role as parent and reward expectations that confirm the efficiency of the care they provide their children. Consequently, these findings suggest that in addition to dietetic treatment, it may be important to include a psychological intervention, which involves the mother and aims to modify the relational dynamics between the mother and her obese child.     

Infant physiological regulation and maternal risks as predictors of dyadic interaction trajectories in families with a preterm infant

This longitudinal study examined predictors of rates of growth in dyadic interaction quality in children born preterm who did not experience significant neurological findings during neonatal intensive care unit (NICU) hospitalization. Multiple methods were used to collect data from 120 preterm infants (48% girls, 52% boys) and their mothers. Infant heart rate variability (HRV), gestational age, neonatal health, feeding route, and maternal socioeconomic (SES) risks were assessed at NICU discharge (mean of 36 weeks postconception). Mother-child interactions were observed at 4, 9, 16, and 24 months postterm and analyzed with hierarchical linear modeling. On average, children's quality of play, interest, and attention increased over time while their dysregulation and irritability decreased, whereas average maternal positive affect and involvement declined in quality (ps < .05), although there was individual variation in rates of change. Mothers of infants with higher postfeeding HRV (i.e., vagal regulation) exhibited less decrease in positive affect and involvement between 4 months and 24 months, compared with mothers of infants with lower HRV (p < .05). Although infants with higher postfeeding HRV showed less positive affect and communication at 4 months, they exhibited significantly greater increases in positive affect and social competence and decreases in dysregulation and irritability between 4 months and 24 months, compared with infants with lower HRV (ps < .05). Dyads experiencing more SES risks showed less optimal interactions at 4 months; this difference remained as children grew older (ps < .05). Results have implications for our understanding of social development in preterm infants.