Ethical,legal and societal considerations on Zika virus epidemics complications in scaling-up prevention and control strategies

Much of the fear and uncertainty around Zika epidemics stem from potential association between Zika virus (ZIKV) complications on infected pregnant women and risk of their babies being born with microcephaly and other neurological abnormalities. However, much remains unknown about its mode of transmission, diagnosis and long-term pathogenesis. Worries of these unknowns necessitate the need for effective and efficient psychosocial programs and medical-legal strategies to alleviate and mitigate ZIKV related burdens. In this light, local and global efforts in maintaining fundamental health principles of moral, medical and legal decision-making policies, and interventions to preserve and promote individual and collectiveHuman Rights, autonomy, protection of the most vulnerable, equity, dignity, integrity and beneficence that should not be confused and relegated by compassionate humanitarian assistance and support. This paper explores the potential medical and ethical-legal implications of ZIKV epidemics emergency response packages and strategies alongside optimizing reproductive and mental health policies, programs and best practice measures. Further long-term cross-borders operational research is required in elucidating Zika-related population-based epidemiology, ethical-medical and societal implications in guiding evidence-based local and global ZIKV maternal-child health complications related approaches and interventions. Core programs and interventions including future Zika safe and effective vaccines for global Zika immunization program in most vulnerable and affected countries and worldwide should be prioritized.     

Intersecting Constraints on Label Learning: Effects of Age,Label Properties,and Referential Context

ABSTRACT

This research investigates the development of constraints in word learning. Previous experiments have shown that as infants gain more knowledge of native language structure, they become more selective about the forms that they accept as labels. However, the developmental pattern exhibited depends greatly on the way that infants are introduced to the labels and tested. In a series of experiments, we examined how providing referential context in the form of familiar objects and familiar object names affects how infants learn labels that they would otherwise reject, nonspeech sounds. We found evidence of the development of intersecting constraints: Younger infants (14-month-olds) were more open to learning nonspeech tone labels than older infants (19-month-olds), and younger infants were more open to the influence of referential context. These findings suggest that infants form expectations about labels and labeling contexts as they become more sophisticated learners.     

Do early parental postnatal depression,attachment style and perceived social support affect neurodevelopmental outcomes of premature infants?

BackgroundThe birth of a premature infant is both a stressful event for both parents and associated with an increased rate of postnatal depression (PND). Additionally some mothers may have delayed feelings of attachment to their babies because of the medical procedures or possible medical complications. Social support is known as an important factor for well-being in the postnatal period. However there is scarce data about these factors for fathers. We aimed to identify the impact of parental PND, attachment style and social support on premature infant development considering the prematurity degree and risk groups.MethodsThis prospective study was conducted by including 96 infants who were born preterm. Mothers and fathers were given Edinburgh Postnatal Depression Scale (EPDS), Adult Attachment Style Scale (AASS), and Multidimensional Scale of Perceived Social Support (MSPSS) to fill out when their infants’ corrected age was 3 months. The developmental evaluation was conducted with Bayley III at the corrected 6 months and 18 months of age.ResultsPostnatal depression scores were more in mothers than fathers, the rates of secure attachment and social support were similar between mothers and fathers. Factors associated with the neurodevelopmental outcomes including prematurity degree and risk groups, EPDS, AASS and MSPSS scores were analyzed for both parents. In multivariate analysis, fathers’ depression scores were inversely associated with cognitive development (p = 0.030, R² = 0.080, B=-0.283) and mothers’ anxious/ambivalent attachment style was inversely associated with language development (p = 0.011, R² = 0.108, B=-0.329) at the age of corrected 6 months old.ConclusionsOur findings underscore that the efforts to improve developmental outcomes of premature infants should include parental well-being taking into account new fathers’ depressive symptomatology and maternal anxious/ambivalent attachment.     

Parent-child interaction and developmental outcomes in children with typical and elevated likelihood of autism

BackgroundEarly parent-child interactions have a critical impact on the developmental outcomes of the child. It has been reported that infants with a family history of autism and their parents may engage in different patterns of behaviours during interaction compared to those without a family history of autism. This study investigated the association of parent-child interactions with child developmental outcomes of those with typical and elevated likelihood of autism.MethodThis longitudinal study investigated the relationship between global attributes of parent-child interaction and the developmental outcomes of infant siblings with elevated likelihood (EL: n = 29) or typical likelihood (TL: n = 39) of developing autism. Parent-child interactions were recorded during a session of free-play when the infants were six months of age. Developmental assessments were carried out when the children were 12 and 24 months of age.ResultsThe intensity of mutuality was significantly higher in the TL group than in the EL group, and developmental outcomes were poorer in the EL group when compared to the TL group. Positive associations between parent-child interaction scores at six months and developmental outcomes at 12 months were observed only in the TL group. However, in the EL group, higher levels of infant positive affect and attentiveness paid to the caregiver is associated with lower autism symptoms. Due to the sample size and design of the study, the findings must be viewed as indicative.ConclusionThis preliminary investigation demonstrated differences in the association between parent-child interaction quality and developmental outcomes for children with typical and elevated likelihood for autism. Future studies should combine micro-analytic and macro-analytic approaches to parent-child interaction to further examine the nature of this relationship.     

Stability of developmental status and risk of impairment at 24 and 36 months in late preterm infants

BackgroundFew studies investigated whether late preterm infants might have developmental delays in several domains in early life and how stable the lag in developmental status might be.AimWe aimed to examine the stability of potential delays across developmental domains at 24 and 36 months of age in late preterm (34°-36⁶ weeks) and term (≥37 weeks) children and whether the risk of delays remained high at 36 months.Study design, subjects, and outcome measureWe conducted a prospective cohort analysis of the children of pregnant women participating in the Vitamin Antenatal Asthma Reduction Trial (VDAART). 652 children who were prospectively followed up and had parent-completed Ages Stages Questionnaires (ASQ-3) questionnaires at both 24 and 36 months were analyzed to assess their domain-specific developmental status.Results6.61 % (42/635) of children had a late preterm birth. Developmental delays were stable between 24 and 36 months on all 5 domains for the children born preterm and on 4/5 domains for those born at term. The developmental domains with the status stability at 24 and 36 months in both late preterm and term children were the gross motor, communication, personal-social skills, and problem-solving. Late preterm children compared with term children remained at higher risk of delays at 36 months for gross motor, communication, and problem-solving skills (aOR = 4.54, 95 %CI: 1.81−10.79; aOR = 8.60, 95 %CI: 3.10−23.28 and aOR = 3.80, 95 %CI: 1.58−8.73, respectively).ConclusionLate preterm birth is associated with suboptimal development and stability in several domains at both 24 and 36 months and compared with term birth, requiring early monitoring and assessment of the developmental lag to avoid potential long-term implications.     

The associations between autistic and communication traits in parents and developmental outcomes in children at familial risk of autism at 6 and 24 months of age

BackgroundSeveral studies have explored relationships between parent broader autism phenotype and offspring communication, and have reported that autistic-like traits in parents are related to offspring communication difficulties and autism severity. However, past research has focused on studying such associations in childhood and we know very little about them in infancy. With accumulating evidence that interventions administered during infancy may be most effective in reducing ASD symptoms, it is imperative to examine whether relationships between parent autistic-like traits and child communication appear even earlier during this critical period of life.MethodThis longitudinal study collected data from infant siblings of autistic children (N = 32) and infants with no family history of autism (N = 45) to explore how autistic-like traits in parents related to child developmental outcomes during infancy.ResultsParental communication difficulties and autistic-like traits were found to be associated with a range of child behaviours in the first two years of life, including social-emotional difficulties at 6 and 24 months, lower communication and emerging cognition at 24 months, and increased autistic behaviours at 24 months.ConclusionsBased on the results, it appears that some of the difficulties seen in parents are relayed to children genetically. These findings contribute to ASD research concerning early communication development in children and heritability of ASD traits and may have important implications in monitoring child development. Furthermore, since the current study found a significant association between autistic traits in parents and child social-emotional behaviour as early as 6 months of age, it provides evidence of the value of assessing interventions that target infancy.     

Effect of developmental care for very premature infants on neurodevelopmental outcome at 2 years of age

BackgroundTo determine the effect of developmental care on neurodevelopmental outcome in formerly preterm infants at a corrected age of 2 years.MethodsA prospective phase-lag study was performed at an Austrian neonatal intensive care unit (NICU). From January 2003 to December 2005 (study period of conventional care) and January 2007 to December 2009 (study period of developmental care), we enrolled all infants born in Tyrol at less than 32 weeks of gestation. During this period a total of 261 of 359 preterm infants (participation rate 72.7%) completed the follow-up visit at 2 years of age; there were 124 children in the conventional and 137 in the developmental care group. The association between developmental care and delayed motor or mental development (Bayley Scales of Infant Development II; psychomotor or mental developmental index <85) was analyzed by means of logistic regression analysis at a corrected age of 24 months.ResultsChildren in the developmental care group showed less psychomotor delay than did those in the control group (developmental care group: 16.1%, conventional care group 27.4%; adjusted odds ratio 0.37 [95% confidence interval: 0.19–0.74], P = 0.005). Not smoking in pregnancy and higher gestational age were also significant predictors for a better psychomotor outcome at 2 years of age. Regarding cognitive outcome, no significant difference was observed between these two groups.ConclusionOur data implicate that developmental care may result in an improved 2-year psychomotor outcome in formerly preterm infants.     

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 influence of parents,older siblings,and non-parental care on infant development at nine months of age

BackgroundThe majority of research examining the influence of social environment on early child development suggests benefits to two-parent households, but contradictory evidence for the effects of siblings. The aims of the present study were to examine the influence of the child's proximal social environment, and the effects of interactions between socioeconomic status and social environment on developmental outcomes.MethodsPrimary caregivers of a representative sample of 10,748 nine-month-old infants in Ireland completed the Ages and Stages Questionnaire and provided information on social environment. Adjustment was made for infant and maternal characteristics, household income, and area where the child was living at the time of the study. Further analyses tested for interactions between social environment and household income.ResultsBinary logistic regressions indicated no effects for number of parents in the household. However, the presence of siblings in the household was a consistent predictor of failing to reach milestones in communication, gross motor, problem-solving, and personal-social development. Furthermore, there was a gradient of increasing likelihood of failing in gross motor, problem-solving, and personal-social development with increasing numbers of siblings. Care by a grandparent decreased the likelihood of failing in communication and personal-social development.ConclusionsThese findings do not support the majority of research that finds positive benefits for two-parent households. Similarly, the findings suggest limited effects for non-parental care. However, the observed negative effects of siblings support both the confluence and resource dilution models of sibling effect. Examination of follow-up data may elucidate current findings.     

Cognitive development in children of adolescent mothers: The impact of socioeconomic risk and maternal sensitivity

BackgroundAdolescent motherhood is accompanied by a constellation of risk factors that translate into developmental risk for the off-spring. Socioeconomic risk that is associated with adolescent motherhood as well as maternal interactive behaviors may contribute to the impact of adolescent motherhood on children’s developmental outcome.ObjectiveTherefore, the aim of the current study was to investigate differences in children’s cognitive development between children of adolescent and adult mothers in their first two years of life and to examine whether socioeconomic risk (e.g. such as educational and financial problems) and/or maternal sensitivity mediate developmental differences between children of adolescent and adult mothers.MethodsAdolescent mothers (<21 years; N = 64) and adult mothers (>25 years; N = 34) and their infants were included in the current study. Child cognitive development and maternal sensitivity were assessed at three different time points (T1: mean child age 5.26 months; T2: mean child age 14.69 months; T3: mean child age 21.16 months).ResultsChildren of adult mothers showed better cognitive performance at T3 compared to children of adolescent mothers but not at T1 and T2. A multiple mediation model including socioeconomic risk and maternal sensitivity as serial mediators demonstrated that the effect of adolescent motherhood on cognitive development was mediated in a causal effect chain with socioeconomic risk negatively affecting maternal sensitivity and maternal sensitivity affecting children’s cognitive development.DiscussionThe present findings demonstrate that maternal interactive behaviors are not only a simple predictor of cognitive development but may also act as a mediator of the association between more distal variables such as socioeconomic risk and cognitive development in adolescent mothers. This supports the need to promote prevention and intervention programs for adolescent mothers during the early postpartum period to reduce socioeconomic problems and enhance maternal interactive behaviors.     

Beneficial effects of a music listening intervention on neural speech processing in 0–28-month-old children at risk for dyslexia

Familial risk for developmental dyslexia can compromise auditory and speech processing and subsequent language and literacy development. According to the phonological deficit theory, supporting phonological development during the sensitive infancy period could prevent or ameliorate future dyslexic symptoms. Music is an established method for supporting auditory and speech processing and even language and literacy, but no previous studies have investigated its benefits for infants at risk for developmental language and reading disorders. We pseudo-randomized N∼150 infants at risk for dyslexia to vocal or instrumental music listening interventions at 0–6 months, or to a no-intervention control group. Music listening was used as an easy-to-administer, cost-effective intervention in early infancy. Mismatch responses (MMRs) elicited by speech-sound changes were recorded with electroencephalogram (EEG) before (at birth) and after (at 6 months) the intervention and at a 28 months follow-up. We expected particularly the vocal intervention to promote phonological development, evidenced by enhanced speech-sound MMRs and their fast maturation. We found enhanced positive MMR amplitudes in the vocal music listening intervention group after but not prior to the intervention. Other music activities reported by parents did not differ between the three groups, indicating that the group effects were attributable to the intervention. The results speak for the use of vocal music in early infancy to support speech processing and subsequent language development in infants at developmental risk.

Research Highlights

• Dyslexia-risk infants were pseudo-randomly assigned to a vocal or instrumental music listening intervention at home from birth to 6 months of age.
• Neural mismatch responses (MMRs) to speech-sound changes were enhanced in the vocal music intervention group after but not prior to the intervention.
• Even passive vocal music listening in early infancy can support phonological development known to be deficient in dyslexia-risk.

     

SES differences in language processing skill and vocabulary are evident at 18 months

This research revealed both similarities and striking differences in early language proficiency among infants from a broad range of advantaged and disadvantaged families. English‐learning infants (n = 48) were followed longitudinally from 18 to 24 months, using real‐time measures of spoken language processing. The first goal was to track developmental changes in processing efficiency in relation to vocabulary learning in this diverse sample. The second goal was to examine differences in these crucial aspects of early language development in relation to family socioeconomic status (SES). The most important findings were that significant disparities in vocabulary and language processing efficiency were already evident at 18 months between infants from higher‐ and lower‐SES families, and by 24 months there was a 6‐month gap between SES groups in processing skills critical to language development.     

Dichotomous perception of animal categories in infancy

ABSTRACT

Although there is a wealth of knowledge on categorization early in life, there are still many unanswered questions about the nature of category representation in infancy. For example, it is unclear whether infants are sensitive to boundaries between complex categories, such as types of animals, or whether young infants exhibit such sensitivity without explicit experience in the lab. Using a morphing technique, we linearly altered the category composition of images and measured 6.5-month-olds’ attention to pairs of animal faces that either did or did not cross the categorical boundary, with the stimuli in each pair being equally dissimilar from one another across the two types of image pairs. Results indicated that infants dichotomize the continua between cats and dogs and between cows and otters, but only when the images are presented in their canonical, upright orientations. These findings demonstrate a propensity to dichotomize early in life that could have implications for social categorizations, such as race and gender.     

Psychological Predictors of Health Anxiety in Response to the Zika Virus

The threat of a United States (U.S.) Zika virus pandemic during 2015–2016 was associated with public anxiety. Such threats represent opportunities to examine hypotheses about health anxiety. The present study investigated psychological predictors of Zika-related anxiety during the 2015–2016 outbreak. U.S. adults (N?=?216) completed a battery of measures assessing Zika-related anxiety as well as psychological variables hypothesized to predict anxious responding to the threat of a domestic Zika outbreak. Contrary to hypotheses, regression analyses indicated that only contamination severity overestimates and greater Zika knowledge significantly predicted Zika-related anxiety. Study limitations and clinical implications are discussed.     

Precursors to aggression are evident by 6 months of age

We tested the hypothesis that developmental precursors to aggression are apparent in infancy. Up to three informants rated 301 firstborn infants for early signs of anger, hitting and biting; 279 (93%) were assessed again as toddlers. Informants' ratings were validated by direct observation at both ages. The precursor behaviours were significantly associated with known risk factors for high levels of aggressiveness. Individual differences were stable from early infancy to the third year and predicted broader conduct problems. These findings suggest that some individuals set forth on the trajectory to high levels of aggression by 6 months of age. The findings have implications for developmental studies of aggression, clinical prevention and intervention strategies, and theoretical considerations regarding the detection of precursors in different domains of development.     

Conflicting Social Cues: Fourteen- and 24-Month-Old Infants' Reliance on Gaze and Pointing Cues in Word Learning

Language acquisition is a process embedded in social routines. Despite considerable attention in research to its social nature, little is known about developmental differences in the relative priority of certain social cues over others during early word learning. Employing an eye-tracking paradigm, we presented 14-month-old infants, 24-month-old infants, and adults with movies in which an actor repeatedly gazed at one and pointed to the other of two objects while presenting them with a novel word. The results show that the 14-month-old infants pay more attention to a model's eye gaze when learning to map a novel word to a referent, whereas 24-month-old infants and adults rely more on pointing cues. Our results provide evidence for a developmental change in the relative priority of pointing versus eye-gazing cues in language acquisition.     

Interindividual differences in neonatal sociality and emotionality predict juvenile social status in rhesus monkeys

In humans, socioeconomic status (SES) has profound outcomes on socio‐emotional development and health. However, while much is known about the consequences of SES, little research has examined the predictors of SES due to the longitudinal nature of such studies. We sought to explore whether interindividual differences in neonatal sociality, temperament, and early social experiences predicted juvenile social status in rhesus monkeys (Macaca mulatta), as a proxy for SES in humans. We performed neonatal imitation tests in infants’ first week of life and emotional reactivity assessments at 2 and 4 weeks of age. We examined whether these traits, as well as the rearing environment in the first 8 months of life (with the mother or with same‐aged peers only) and maternal social status predicted juvenile (2–3 years old) social status following the formation of peer social groups at 8 months. We found that infants who exhibited higher rates of neonatal imitation and newborn emotional reactivity achieved higher social status as juveniles, as did infants who were reared with their mothers, compared to infants reared with peers. Maternal social status was only associated with juvenile status for infant dyads reared in the same maternal group, indicating that relative social relationships were transferred through social experience. These results suggest that neonatal imitation and emotional reactivity may reflect ingrained predispositions toward sociality that predict later outcomes, and that nonnormative social experiences can alter socio‐developmental trajectories. Our results indicate that neonatal characteristics and early social experiences predict later social outcomes in adolescence, including gradients of social stratification.     

Temperament and early stuttering intervention: Two perspectives

PurposeTo discuss clinical applications of research findings about temperament and early stuttering.MethodA “1000-bytes” format (Onslow & Millard, 2012) was used to provide readers with contemporaneous observation of a “conversation” between the authors. The conversation is proceeded by a prologue and followed by concluding statements from each author.ResultsOne author contended that comprehensive, multidimensional assessment of temperament domains is essential during clinical management of early stuttering, and the results of that assessment are best incorporated into a multifactorial treatment approach. The other author contested that view, arguing that such an approach is not empirically justifiable at present.ConclusionsThe authors agree about the salience of research on temperament and early stuttering but have different perspectives about the topic when applied to providing health care for early stuttering.     

Patterns of maternal responding in postpartum mothers with schizophrenia

Little is known about how schizophrenia might affect how a mother responds to her infant, such as whether responding is reduced or impaired. The aim was to identify, from brief videotaped interactions, whether the responses of mothers with schizophrenia were fewer, less positive, more negative, and more ‘abnormal’ than mothers with affective disorder, and whether their infants (mean age: 15 weeks) lacked activity or initiation to which mothers could respond. Mothers with schizophrenia (N = 14) were as responsive as mothers with affective disorder (N = 31), but they showed markedly low positive responsiveness. Only the schizophrenia group exhibited non-responses as a result of being psychologically withdrawn from the interaction, and abnormal behaviors. Inconsistent to our hypothesis, infants in both groups showed similar levels of activity, initiative and negativity. The findings highlight the need for further research to examine the contribution of maternal response impairments to the developmental vulnerability of this genetically high-risk group.