Corrected and uncorrected Bayley scores: Longitudinal developmental patterns in low and high birth weight preterm infants

In this study, we longitudinally investigated developmental changes in very low birth weight (VLBW, less than 1500 gms), in higher birth weight (HBW, 1500–2000 gms) preterm, and in full-term (FT) infants. We also investigated changes in their caretaking home environment. The subjects were 20 VLBW, 39 HBW, and 24 FT infants who participated in an intervention study. Blind independent assessments were performed at 4, 8, 12, and 16 months corrected age using the Bayley mental and motor scales, both corrected for prematurity and uncorrected, the Infant and Toddler temperament questionnaires, and the Caldwell Home Observation for Measurement of the Environment inventory (HOME). The VLBW infants obtained the lowest mental (77) and motor (77) uncorrected scores, which were significantly different from the mental and motor scores of the HBW (94 and 89, respectively) and of the FT (115 and 109, respectively) infants. Mental and motor uncorrected scores were significantly lower at 4 months than at 8, 12, and 16 months. By 12 months, the uncorrected scores of the HBW infants no longer differed from the FT ones, and by 16 months only the difference between the FT and the VLBW was significant. The corrected mental and motor scores yielded no significant group or age differences. Post hoc analysis of an interaction in the motor scores yielded significantly higher scores for the FT than for the VLBW group at the last assessment. Overall, the VLBW infants were more passive and less intense than were either HBW or FT infants. In general, the home environment of the VLBW infants was significantly less stimulating and responsive than was the home environment of the FT and HBW infants. These results are discussed in terms of vulnerability of the VLBW preterm infants to developmental deficits and the difficulties their parents experience in their caretaking role.     

Mother–infant behavioral interactions in teenage and adult mothers during the first six months postpartum: Relations with infant development

The purpose of this study was to compare adolescent mothers' (high‐risk group), at‐risk adult mothers' (moderate‐risk group), and no‐risk adult mothers' (low‐risk group) behavioral interactions at one and six months postpartum, and to examine the relationships between maternal behaviors and infant developmental scores on the Bayley scales. Results indicated that high‐risk teenage mothers and moderate‐risk adult mothers vocalized less and had lower contingency rating scores compared to low‐risk adult mothers. Also, infants in the high‐risk and moderate‐risk groups obtained lower mental scores at six months compared to the low‐risk group. Moderate stability across time was found for maternal vocalizations and infant scores on the mental scale. Maternal vocalizations and behavioral contingency rating scores at one month were associated with infants' six‐month performance on the Bayley scales. Specific intervention strategies were discussed with the aim of targeting and improving early maternal behavioral patterns in at‐risk groups. ©2003 Michigan Association for Infant Mental Health.     

Sensorimotor development in cocaine-exposed infants

This study investigated the effects of prenatal cocaine exposure on infant sensorimotor development. One hundred and sixty-seven12-month-olds (74 cocaine-exposed and 93 unexposed) were assessed using the Bayley Scales of Infant Development (BSID). Ninety-seven had previously been evaluated on the Movement Assessment of Infants and the Test of Sensory Functions in Infants at age 4 months. On the BSID, the cocaine-exposed infants performed less well on the Mental portion and were more frequently rated as behaviorally suspect. Cocaine-exposed infants also performed less well at four months on the motor and sensory measures. Early motor performance predicted 12 month BSID mental, motor and behavioral outcomes. Cocaine exposure had an effect independent from confounders on general cognitive and specific motor and behavioral outcomes.     

Infants' persistence and mothers' teaching as predictors of toddlers' cognitive development

This study examined the relative contributions of infants' persistence and mothers' teaching at 6 and 14 months to infants' cognitive development at 14 months in a sample of 65 low-income mother-infant dyads. Infants' persistence was assessed from a videotaped persistence task at 6 months and from the Behavior Record Scale of the Bayley Scales of Infant Development, 2nd ed. (BSID II) at 14 months. Mothers' teaching was assessed from a videotaped teaching interaction at 6 and 14 months using the Nursing Child Assessment Satellite Training (NCAST) teaching scale. Cognitive development at 14 months was based on the Mental Scale, BSID II. Infants' persistence at both ages and mothers' teaching at 6 months each explained unique variance in infants' cognitive status at 14 months. Persistence appears to be a stable quality that can be measured early on, and both infants' early persistence and mothers' teaching are direct pathways to cognitive status at the start of the second year.     

Maternal attachment representations after very preterm birth and the effect of early intervention

Objective

For very preterm infants the mother-infant relationship may be compromised. Maternal attachment representations 18 (corrected) months after very preterm birth and the effect of the post-discharge Infant Behavioral Assessment and Intervention Program (IBAIP) were studied. The IBAIP is designed to assist parents to support and enhance their infant's regulatory competence and development. The intervention consisted of 6-8 home visits during the first 8 months after birth.

Method

Seventy-eight mothers of very preterm infants (<32 weeks and/or <1500 g) were interviewed, who participated in a randomized controlled trial: 41 from the intervention group and 37 from the control group. Maternal attachment representations were assessed with the Working Model of the Child Interview (WMCI). The interviews resulted in a classification of the attachment representations into balanced or non-balanced.

Results

30% of the mothers had non-balanced attachment representations. Qualitative content analysis of the answers showed that negative feelings when first seeing their baby and negative or ambivalent feelings in the first weeks at home with their baby are related to non-balanced attachment representations. The WMCI revealed no differences between the intervention and control group.

Conclusion

Early support for mothers of very preterm born infants to develop a healthy mother-infant relationship is recommended especially for mothers who report negative first experiences.     

Parent-infant resemblance for general and specific cognitive abilities in the Colorado adoption project

Previous publications emanating from the Colorado Adoption Project have reported significant relationships between parental general cognitive ability (g) and infant Bayley MDI scores. The present study compared infant Bayley factor scores representing separable dimensions of infant cognition with parental general and specific cognitive abilities for 182 adoptive families and 164 nonadoptive families. Parent/offspring correlations between 12-month Bayley factors and parental cognitive abilities suggest only minimal relationships for both parental g and specific abilities. At 24 months, more parent/offspring resemblance was present; moreover, Bayley factors that were related to parental cognition tended to be related to parental g, not to specific abilities. The finding of significant parent/offspring relationships at 24 months between biological parents and their adopted-away infants, as well as between nonadoptive parents and their infants, suggests some genetic continuity from infancy to adulthood.     

Preventive group psychotherapy for at-risk infants and their mothers

There is increased evidence that infants who receive poor quality social stimulation from their primary caregiver are at risk for later developmental difficulties. This paper describes a preventive intervention for mother-infant dyads exhibiting impaired patterns of social interaction. An impaired relationship with the primary caregiver has been found to be associated with social and emotional deficits in early childhood as well as with significant psychopathology in adulthood. The intervention consisted of group treatment of mothers and their infants. Each group session has 4 subsections which, together, were directed towards improving the mothers' ability to relate in a stimulating and nurturant manner to their children. Types of intervention included didactic instruction, modeling, and interpretation of the infant's behavior. Qualitative data suggested that the group intervention has positive effects on the mother-infant dyads.     

Concurrent validity between instruments of assessment of motor development in infants exposed to HIV

BackgroundExposure to HIV during pregnancy is a risks to development. Exposed child should have assessed its development since birth. Alberta Infant Motor Scale is a tool which assess gross motor skills, with easy application and low cost. Up to now, this scale had not proven its validity for the population exposed to HIV. It’s necessary to compare its with a gold standard tool, Bayley scale, which assess gross and fine motor skills, has a high cost and longer application time required. Studies compare results of Alberta with Bayley’s total motor score (gross + fine). However, it’s also necessary to compare Alberta’s result with only Bayley’s gross motor result, because it’s what both evaluate in common.Aimsto verify the concurrent validity of AIMS in infants exposed to HIV; to verify the correlation of AIMS and BSITD III for this population and to compare if these coefficients differ in the central age groups and extremities of the AIMS.Methods82 infants exposed to HIV evaluated in 1st, 2nd, 3rd, 4th, 8th, 12th, 15th, 16th, 17th and 18th months, with Alberta Infant Motor Scale and Bayley Scale (motor subscale). For analysis of concurrent validity, results of raw scores of the scales were compared with the correlation analysis. First analysis: Alberta’s score with Bayley’s total (gross + fine) motor score. Second analysis: Alberta’s score with Bayley’s gross motor score.ResultsIn the first correlation analysis, results were: r = 0.62 in 1 st month, r = 0.64 in 2nd month, r = 0.08 in 3rd month, r = 0.45 in 4th month; r = 0.62 in 8th month, r = 0.60 in the 12th month. In the second correlation analysis, results were: r = 0.69 in 1 st month; r = 0.58 in 2nd month; r = 0.25 in 3rd month; r = 0.45 in the 4th month; r = 0.77 in 8th month; r = 0.73 in 12th month. Analyzes of the 15th, 16th, 17th and 18th months couldn’t be performed because at these ages all the children had already reached the maximum score in the AIMS. Results were significant and indicate correlation between scales. Found results agree with other studies that found high correlations between the scales in premature and risk groups. However, these studies compare results of gross motor skills assessments with gross and fine motor skills assessments. Our results show that correlation only between the gross motor skills have higher coefficient values, and we believe this is the best way to compare the scales, with what both assessed in common.ConclusionsAlberta scale has correlation with Bayley scale in assessing of children exposed to HIV, and can be a substitute to Bayley in assessing of these children. Results are stronger when comparing only what both scales assess in common.     

War trauma and infant motor,cognitive, and socioemotional development: Maternal mental health and dyadic interaction as explanatory processes

BackgroundTaking care of infants in conditions of war is highly demanding and a few studies reveal the negative impact of war trauma on maternal and infant well-being. Yet, little is known regarding the influence of trauma on infant development and the potential explanatory mechanisms. First, the present study examines how mothers’ prenatal exposure to traumatic war events is associated with infant cognitive, motor, and socioemotional development. Second, it analyses the mediating roles of maternal postpartum mental health problems, quality of dyadic mother-infant interaction, and earlier infant development (at six months) in the association between prenatal traumatic war events and infants’ developmental skills at 18 months.MethodThis prospective three-wave study involved 502 Palestinian pregnant females in their first trimester during the 2014 Gaza War and participated at delivery (T1) and when the child was six (T2;N = 392) and eighteen (T3; N = 386) months of age. Mothers reported their exposure to traumatic war events (human and material losses, horrors, and threat to life) at T1 and T2, and researchers photo-documented the extent of destruction at T1. Mothers reported infants’ language, fine- and gross-motor, and socioemotional skills at T2 and researchers tested infants’ motor, cognitive-language and socioemotional skills using the Bayley Scales of Infant development (BSID-II) at T3. Mothers reported their mental health problems (symptoms of post-traumatic stress disorder [PTSD], depression and somatization) at T2 and T3 as well as dyadic interaction quality (the emotional availability self-report, [EA-SR] brief) at T2.ResultsFirst, the structural equation model (SEM) on direct effects indicated, in contrast to our hypotheses, that maternal prenatal exposure to traumatic war events did not associate with infants’ developmental skills at T2 and predicted higher level of developmental skills at T3. Second, as hypothesized, we found two negative underlying mechanisms (paths) between high exposure and low levels of motor, cognitive-language, and socioemotional skills at T3: (1) through increased maternal mental health problems at T2, which then were associated with problems at T3, and (2) through increased maternal mental health problems at T2, which then were associated with a low quality of mother-infant-interaction and low level of infant developmental skills at T2.ConclusionImproving maternal mental health and encouraging close and positive dyadic interaction can be critical for infant sensorimotor, cognitive, and socioemotional development in war conditions.     

The efficacy of massage on short and long term outcomes in preterm infants

Purpose

Premature infants lack the tactile stimulation they would have otherwise experienced in the womb. Infant massage is a developmentally supportive intervention that has been documented for several decades to have a positive effect on both full term and preterm infants. The purpose of this study was to assess the short and long term benefits of massage on stable preterm infants.

Methods

A quasi experimental design was used, 66 infants were recruited from two university hospitals with tertiary level NICUs; 32 infants received the massage therapy by their mothers. Data collection by a researcher blind to the infants’ group assignments included weight at discharge, pain responses on the PIPP scale at discharge, length of stay in hospital, neuro-developmental outcome (Bayley scores) and breastfeeding duration at 12 months corrected age.

Results

Infants who were massaged had significantly lower scores on the PIPP after a heel-stick compared to before the massage and had lower PIPP scores at discharge compared to the control group. Massaged infants had higher cognitive scores at 12 months corrected age. Weight gain, length of stay, breastfeeding duration and motor scores did not differ between groups.

Conclusion

Stable preterm infants benefit from massage therapy given by their mothers and may be a culturally acceptable form of intervention to improve the outcomes of preterm infants.     

Targeting adolescent mothers with depressive symptoms for early intervention

Infants of mothers with depressive symptoms show developmental delays if symptoms persist over the first 6 months of the infant's life, thus highlighting the importance of identifying those mothers for early intervention. In Study 1, mothers with depressive symptoms (n = 160) and mothers without depressive symptoms (n = 100) and their infants were monitored to identify variables from the first 3 months that predict which mothers would still be symptomatic at 6 months. A "dysregulation" profile was noted for the infants of depressed mothers, including lower Brazelton scores, more indeterminate sleep, and elevated norepinephrine, epinephrine, and dopamine levels at the neonatal period, and greater right frontal EEG activation, lower vagal tone, and negative interactions at the 3- and 6-month periods. A group of maternal variables from the neonatal and 3-month assessments accounted for 51% of the variance in the mothers' continuing depressive symptoms. These variables included greater right frontal EEG activation, lower vagal tone, and less positive interactions at 3 months, and elevated norepinephrine, serotonin, and cortisol levels at the neonatal stage. In Study 2, a similar sample of mothers with depressive symptoms (n = 160) and without depressive symptoms (n = 100) was recruited and followed to 3 months. Those symptomatic mothers who had values above (or below) the median (depending on the negative direction) on the predictor variables identified in Study 1 (taken from the first 3 months) were then randomly assigned to an intervention or a control group at 3 months. These groups were then compared with each other, as well as with the group without depressive symptoms, at 6 and 12 months. The intervention, conducted from 3 to 6 months, consisted of free day care for the infants and a rehab program (social, educational, and vocational) plus several mood induction interventions for the mothers, including relaxation therapy, music mood induction, massage therapy, and mother-infant interaction coaching. Although the mothers who received the intervention continued to have more depressive symptoms than did the nondepressed mothers, their interactions significantly improved and their biochemical values and vagal tone normalized. Their infants also showed more positive interations, better growth, fewer pediatric complications, and normalized biochemical values, and by 12 months their mental and motor scores were better than those of the infants in the control group.     

Home‐based intervention after discharge for Latino families of low‐birth‐weight infants

A home‐based intervention designed for impoverished Latino families of low‐birth‐weight infants was implemented, and the efficacy assessed for infants and mothers. Specially trained public health nurses visited the participants' homes for 4 months for the “short” and 12 months for the “extended” intervention groups. Mothers received support and training in infant care. A third group did not receive the intervention. Assessments were at 4‐ to 6‐month intervals from 1 to 24 months. Although the extended visitation group showed no benefits from the intervention, the short visitation group had higher scores on maternal confidence at one month, and on the Bayley Mental Scores at four months than the group receiving no intervention and extended intervention. The nonvisitation group scored significantly higher than both intervention groups on the HOME scores and on the Mother–Infant Interaction and Feeding scores at three different assessment periods. These data suggest that for poor Latino families home intervention is not beneficial across the board. Instead, efforts should be made to identify families that could benefit from intervention and to tailor the program to the specific needs of Latino families. © 2000 Michigan Association for Infant Mental Health.     

The development of 3- to 9-month-old infants in two cultural contexts: Bayley longitudinal results for Cameroonian and German infants

Based on the Bayley Scales of Infant Development III, this study provides the results of a longitudinal study on the development of Cameroonian Nso farmer and German middle-class infants. Complete longitudinal data were available for 253 infants (69 from Cameroon and 184 from Germany) with Bayley assessments at 3, 6 and 9 months. The results show large differences between Cameroonian Nso and German infants with regard to gross motor and language development. The developmental sequence within each Bayley scale is more in line with the original Bayley sequence for German than for Cameroonian Nso infants as is indicated by Goodman scalogram analyses. Path analyses show some basic similarities between the developmental paths across ages for Cameroonian Nso and German infants, but more interconnections between the scales in the German sample. The results underline the need to adjust developmental scales to the cultural background of the infants to be tested.     

The Effect of Research with Teenage Mothers on the Development of Their Infants1

Mother-infant interaction of 14 teenage mothers and 12 women 20 years or older was observed and recorded in the laboratory or the home when the infants were 16, 20, 24, and 52 weeks of age. In order to assess the possible effect of the research intervention on the maternal behavior and on the infants' development, a control group of teenage mothers and their infants was seen only at the end of the study when the infant was 52 weeks old. At 12 months the Home Observation Measure of the Environment Inventory (HOME) was administered and infants were assessed with the Bayley Scales of Infant Development (motor and mental scales) and the Ainsworth Strange Situation procedure. On all measures the observation groups scored significantly higher than the control group. The significant aspects of the research intervention are discussed.     

Maternal risk factors as predictors of developmental outcome in early childhood

This paper describes the rationale, procedures, and initial validation of an instrument which assesses distal environmental factors thought to negatively influence maternal caregiving ability. A sample of 36 lower class, single, black mothers (ranging in age from 14 to 19 years) of first born, full-term infants were included in an educational intervention program carried out during infants' first 12 months of life. The development of the maternal risk score (MRS) instrument was centered around four areas: maturity of mother, degree of planning of the mother, family support system and level of poverty. Initial, Year 1, Year 2, and Year 3 MRS scores were compared with infant development at one and two years as measured by the Bayley Scales, and at three years with the McCarthy Scales, using Pearson product-moment correlations. The initial MRS correlated negatively with the Bayley Mental Development Index (MDI) at Year 1 and also at Year 2 (N=−.38 and −.40 respectively, both significant at p<.05). The MRS for Year 1 showed significant negative correlations with the two Bayley MDIs: two and three year MRS scores were significantly related to three year McCarthy test scores. This screening instrument, which assesses qualitative aspects of the caretaking environment, appears to be a promising approach for identifying lower class mothers of infants who might be at risk for developmental disabilities.     

Neurodevelopmental outcomes of Ugandan infants with HIV infection: an application of growth curve analysis.

Neurodevelopmental outcomes of human immunodeficiency virus Type 1 (HIV-1)-infected infants of non-drug-using mothers were assessed in a controlled, prospective study from birth to 24 months with 3 groups: 61 infants of HIV-infected mothers, 234 uninfected infants of HIV-infected mothers (seroreverters), and 115 uninfected infants of uninfected mothers. Compared with seroreverters and uninfected infants, HIV-infected infants demonstrated lower mental and motor development on the Bayley Scales and greater deceleration in their rate of motor development. HIV-infected infants with abnormal neurologic exams had lower motor and mental test scores and lower rates of motor Bayley Scales scores than their HIV-infected counterparts with normal neurologic exams. Contrary to prediction, no group differences in mean performance or growth rates were found on visual information processing on the Fagan Test of Infant Intelligence.     

Rapid eye movement (REM) in premature neonates and developmental outcome at 6 months

Different aspects of early sleep organization have been associated with subsequent development in premature infants. The aim of the present study was to assess the relations between rapid eye movement (REM) activity in premature neonates and infants' developmental outcomes at 6 months. Participants were 81 premature infants (47 males). Sleep-wake states and REM were observed across 4 consecutive evening hours (7-11 PM) in 10-s frames when infants were between 32 and 36 weeks post-menstrual age. Developmental outcome was assessed at 6 months with the mental development index (MDI) of the Bayley II. Infants with low-REM activity spent more time in less growth-promoting states, including crying and unfocused alert states in the neonatal period and had lower MDI scores at 6 months corrected age compared to infants with high-REM. Differences between the high- and low-REM groups were independent of neonatal medical risk. Low-REM activity may serve as an indicator of developmental risk among premature neonates.     

Mother–infant interaction improves with a developmental intervention for mother–preterm infant dyads

While premature infants have a high need for positive interactions, both infants and their mothers are challenged by the infant‘s biological immaturity. This randomized clinical trial of 198 premature infants born at 29–34 weeks gestation and their mothers examined the impact of the H-HOPE (Hospital to Home: Optimizing the Infant's Environment) intervention on mother–premature infant interaction patterns at 6-weeks corrected age (CA). Mothers had at least 2 social environmental risk factors such as minority status or less than high school education. Mother–infant dyads were randomly assigned to the H-HOPE intervention group or an attention control group. H-HOPE is an integrated intervention that included (1) twice-daily infant stimulation using the ATVV (auditory, tactile, visual, and vestibular-rocking stimulation) and (2) four maternal participatory guidance sessions plus two telephone calls by a nurse-community advocate team. Mother–infant interaction was assessed at 6-weeks CA using the Nursing Child Assessment Satellite Training–Feeding Scale (NCAST, 76 items) and the Dyadic Mutuality Code (DMC, 6-item contingency scale during a 5-min play session). NCAST and DMC scores for the Control and H-HOPE groups were compared using t-tests, chi-square tests and multivariable analysis. Compared with the Control group (n = 76), the H-HOPE group (n = 66) had higher overall NCAST scores and higher maternal Social-Emotional Growth Fostering Subscale scores. The H-HOPE group also had significantly higher scores for the overall infant subscale and the Infant Clarity of Cues Subscale (p < 0.05). H-HOPE dyads were also more likely to have high responsiveness during play as measured by the DMC (67.6% versus 58.1% of controls). After adjustment for significant maternal and infant characteristics, H-HOPE dyads had marginally higher scores during feeding on overall mother–infant interaction (β = 2.03, p = 0.06) and significantly higher scores on the infant subscale (β = 0.75, p = 0.05) when compared to controls. In the adjusted analysis, H-HOPE dyads had increased odds of high versus low mutual responsiveness during play (OR = 2.37, 95% CI = 0.97, 5.80). Intervening with both mother and infant is a promising approach to help premature infants achieve the social interaction patterns essential for optimal development.     

Early home intervention and socio-emotional development of preterm infants

In the present study, the effects of developmental intervention and parent-infant interaction intervention on the social competence and emotional development of preterm infants were assessed. The results suggest that early home intervention focused on the infant's development facilitates social competence and adaptation, whereas intervention focused on the parent-infant interaction resulted in greater emotional security on the part of the infant. Social competence during the second year of life was predicted by social competence at 8 months and emotional security at 12 and 16 months. These findings have implications for early identification of infants at risk of later socio-emotional difficulties and intervention with dysfunctional mother-infant dyads.     

Cognitive and motor development in children with vertically transmitted HIV infection

This study was designed to examine mental and motor development in infants with vertically transmitted human immunodeficiency virus (HIV) infection. Early neurodevelopment was examined in 25 young children with HIV infection acquired through vertical transmission. Compared with 25 children born to HIV-positive mothers but not infected with the virus, and after controlling for developmental risk factors, the HIV-infected group showed impairments in mental and motor development. Mental and motor development were assessed using the Bayley Scales of Infant Development. On the mental scale (MDI), the HIV-infected infants obtained significantly lower scores than the uninfected infants. On the performace scale (PDI), the HIV-infected infants obtained significantly lower standard scores than the uninfected infants. CT scan results were available for 20 of the HIV-infected children. CT abnormalities were associated with developmental delays, particularly for motor development. The results point to the importance of early abnormalities in myelination and of subcortical lesions of cognitive and motor development.