Early stress and social support influences on mothers' and high-risk infants' functioning in late infancy

The relationships among early stress, maternal social network supports, and mother-infant functioning during later infancy were explored in a group of 52 mothers and their high-risk premature infants. Maternal stress and support data were collected 1 month after infants were released from the hospital, and measures of parenting, mother-infant interaction, infant social and developmental competence, and infant attachment were collected at infant corrected ages of 8 and 12 months. Results indicated that stress and support from various ecological sources, including professionals, were related to parent and infant outcomes at both measurement occasions. Varying sources of support differentially predicted varying parent and infant measures where support had a stress buffering effect only under certain conditions. Professional support was found to account for significant amounts of variance in relation to some parenting factors beyond that attributable to other support sources. The results are discussed within the context of previous support findings and in relation to transactional models of high-risk infant development.     

Mother–Infant Joint Attention and Sharing: Relations to Disorganized Attachment and Maternal Disrupted Communication

The normative development of infant shared attention has been studied extensively, but few studies have examined the impact of disorganized attachment and disturbed maternal caregiving on mother–infant shared attention. The authors examined both maternal initiations of joint attention and infants’ responses to those initiations during the reunion episodes of the Strange Situation Procedure at 12 and 18 months of infant age. The mothers' initiations of joint attention and three forms of infant response, including shunning, simple joint attention, and sharing attention, were examined in relation to infant disorganized attachment and maternal disrupted communication. Mothers who were disrupted in communication with their infants at 18 months initiated fewer bids for joint attention at 12 months, and, at 18 months, mothers of infants classified disorganized initiated fewer bids. However, the infant' responses were unrelated to either the infant' or the mother' disturbed attachment. At both ages, disorganized infants and infants of disrupted mothers were as likely to respond to maternal bids as were their lower risk counterparts. Our results suggest that a disposition to share experiences with others is robust in infancy, even among infants with adverse attachment experiences, but this infant disposition may depend on adult initiation of bids to be realized.     

Predicting maternal reactivity/sensitivity: The role of infant emotionality,maternal depressiveness/anxiety,and social support

It was hypothesized that an accumulation of unfavorable conditions, i.e., high negative emotionality and low positive emotionality of the infant, maternal depression and anxiety, and lacking social and emotional support can attenuate mothers' reactivity/sensitivity. Maternal reactivity/sensitivity was observed during home visits and in the laboratory. Infant negative and positive emotionality was assessed by mother reports and behavioral observations. Maternal depressiveness/anxiety as well as social support were assessed via questionnaires. All mothers were primiparous and had healthy infants. Data collection was conducted at the infants' ages of four months (37 dyads) and eight months (33 dyads). The sample consisted of 19 male and 18 female infants (four‐months' measurement). Whereas the presence of a single risk factor was not related to maternal reactivity/sensitivity, the combination was. A decrease in maternal reactivity/sensitivity over the course of time was demonstrated for mothers who had to deal with high negative emotionality of the infant in combination with either high depressiveness/anxiety or low social support at the infants' age of four months. No significant main or interaction effects could be shown for infant positive emotionality. ©2004 Michigan Association for Infant Mental Health.     

Maternal mind-mindedness over infants’ first three months

Maternal mind-mindedness refers to mothers’ ability to reflect upon their infants’ mental states and respond appropriately. The present study assessed mind-mindedness longitudinally from the newborn period to the infant age of three months. The study is the first to assess maternal mind-mindedness in the infant’s early life prior to three months (one week, one month, two months, three months). To measure maternal mind-mindedness, mothers’ speech to their infants is coded for mental state comments about the infants’ thoughts, desires, and emotions. Appropriate mind-minded comments are judged to accurately reflect the infants’ mental states; non-attuned mind-minded comments are judged to misinterpret the infants’ mental states. Mothers’ individual stability (rank order stability) and group level continuity (mean level of stability across the infant ages) were assessed. Mothers showed modest temporal stability in both appropriate and non-attuned mind-mindedness over the infants’ first three months. The continuity of mind-mindedness showed that appropriate mind-mindedness increased over the infant ages, but non-attuned mind-mindedness showed no change. In infants’ early lives, mothers’ ability to accurately interpret their infants’ mental states is enhanced as the mother-infant relationship develops and infants become more communicative partners.     

Bed-sharing, breastfeeding and maternal moods in Barbados

Bed-sharing among Barbadian mothers and infants was studied in relationship to maternal and infant characteristics. This prospective study followed 226 healthy, well-nourished mother–infant dyads at birth, 7 weeks, 3 months, and 6 months postpartum. At each age, approximately half of the infants shared the same beds as their mothers. Bed-sharing was associated with demographic characteristics, especially fewer home conveniences, and also maternal characteristics, including less information seeking by the mother and younger maternal age at first pregnancy. Bed-sharing was also associated with lower infant birth weights. Maternal moods were significantly correlated with bed-sharing, such that mothers who reported having more despair and anxiety were also more likely to sleep with their infants. Bed-sharing was also significantly associated with increased breastfeeding at all infant ages, but this relationship was no longer significant once the effects of maternal moods were controlled. This study emphasizes the importance of assessing maternal moods in studies evaluating the risk and benefits of bed-sharing.     

Effects of Early Parenting Interventions on Parents and Infants: A Meta-Analytic Review

This systematic review evaluates the efficacy of parenting interventions on parent, infant and parent-infant relationship outcome measures for parents of infants under 12 months old. Parent outcomes examined included competence, and confidence; baby outcomes included infant behaviours of crying, settling, and sleeping problems and parent-infant relationship outcomes included parental responsiveness. Systematic searches of five databases were carried out. In total, 36 randomised controlled trials over the past 35 years were included in the meta-analyses, with a total of 4880 participants. Interventions were carried out either during pregnancy or within the first 12 months after birth and involved teaching specific strategies and provision of information on infant development and behaviour. Mean effect sizes were obtained using a structural equation modelling (SEM) approach to meta-analysis. Heterogeneity was found on parent responsiveness and infant sleep. Potential moderator variables were assessed for these two outcomes using the SEM approach. Results showed that early parenting interventions are effective in improving parental responsiveness (d?=?0.77), and improving or preventing infant sleep problems (d?=?0.24), but not crying problems (d?=?0.27) possibly due to low power. No conclusions could be drawn in regards to parental competence or confidence. Moderator analysis showed that for interventions aimed at improving responsiveness, briefer interventions were more effective than longer ones; and studies published more recently reported smaller effects than older studies. No other moderators influenced the assessed intervention outcomes. The findings of this study provide further evidence for the positive effects of early parenting interventions for infants under 12 months of age, however future research is needed to assess intervention effects on parental competence and confidence.     

Emotional interaction in a group of preterm infants at 3 and 6 months of corrected age

Twenty preterm infants (birthweight<1500 g) and 20 healthy fullterm infants were compared with respect to emotional interaction with their mothers in a face‐to‐face situation at 3 months of age and in a feeding situation at 6 months of age (ages corrected for preterm birth). The assessed outcome was analysed with respect to infant variables (group, gender, gestational age, birthweight and neonatal risk factors) and maternal variables (age, education and parity). The outcomes at 3 and 6 months of age were also compared with findings of Griffiths’ testing at 10 months of age. At 3 months of age, the findings reveal no significant difference between the two groups with respect to emotional interaction. Maternal variables are more important for this interaction than are infant variables. The mother's level of formal education has a significant impact in both groups. In the group of fullterm infants, significantly lower scores for interaction are obtained by first‐time mothers in comparison with multi‐parae mothers. At 6 months of age, the difference between fullterm and preterm infants is significant. The preterm infants and their mothers now relate to one another more poorly than is the case for the fullterm dyads. These findings suggest that the difficulties encountered by the preterm infant emerge with time. Emotional interaction at this age and the results of Griffiths’ testing 4 months later are significantly correlated. Copyright © 1999 John Wiley & Sons, Ltd.     

Infants’ expressive behaviors to mothers and unfamiliar partners during face-to-face interactions from 4 to 10 months

Changes in the organization of infant looking, facial expressions, and vocalizations were examined over age (4, 7, and 10 months) and with different social partners. Although infants at all ages accompanied smiling with looking at both mothers and unfamiliar partners, 7- and 10-month infants accompanied vocalization with looking only when they were with mothers. Seven- and 10-month-olds vocalized with unfamiliar partners only when they were smiling at the same time. When mothers stopped talking, infants reduced smiling significantly at all ages, yet vocalized more at 10 months. In the second half of the first year, there are fundamental changes in the coordination of infant expressive behaviors that reveal a keen attunement to variations in maternal behavior and the familiarity of social partners.     

Preterm infants' affective responses in independent versus toy-centered play with their mothers

The affective behavior of medically high-risk (HR) and low-risk (LR) infants, along with a control group of full-terms (FT), was compared at 6 months of age during a 5-minute independent and a 5-minute toy-centered play session with their mothers. Because previous research has shown that joint toy play places a burden on the attentional capacities of HR infants, it was predicted that they would show less positive affect and more negative affect in toy-centered (vs. independent) play and joint attention (vs. face-to-face) interactions than would the LR or FT infants. Results showed that the HR infants displayed fewer smiles across the independent and mother toy-centered play condition and across face-to-face and joint attention interactions than LR or FT infants. The findings also indicated that the mother's presence facilitated the expression of positive affect for all three infant groups.     

Applicability and attachment findings of the Strange Situation Paradigm in infants with visual impairment

Attachment studies with diverse populations enrich the understanding of infants’ socioemotional development by documenting both universal and idiosyncratic aspects of attachment. Given the effects of attachment in children's socioemotional outcomes, such studies are necessary to investigate the impact of children's sensory impairments on attachment development. Yet, very little attachment research has focused on infants with visual impairment (VI infants), a population in which infant–caregiver emotional exchanges through visual means are reduced/absent. We investigated the applicability of the Strange Situation Paradigm (SSP), with added instructions to compensate for degraded visual input, in 20 VI infants (with no additional disabilities and who were receiving developmental counseling). In all but 1 of the SSPs coded, VI infants displayed observable attachment behavior that was classifiable. Nineteen VI infants showed attachment by 12 months of age. Across the ages tested (fractional age range = 0.9–2.33 months), most VI infants’ attachment patterns were classified as secure and organized.     

Robust patterns and individual variations: Stability and predictors of infant behavior in the still-face paradigm

In the present study we examined key issues regarding infant behavior in the still-face paradigm (SFP) in terms of individual variations, stability, and predictors. The sample consisted of 115 mothers and infants, with assessments at ages 3 and 6 months, including observations of maternal and infant behavior in the SFP, and parent reports of infant temperament. Both robust patterns and individual variations in infant SFP behaviors were found, with only a minority of infants showing the expected patterns for negative affect and gaze. Infant behavior patterns showed no stability from age 3 to 6 months, and infant gaze was related to more pronounced behavior changes across the SFP. Maternal sensitivity in the SFP baseline was related to some aspects of infant SFP behavior. Consistent with the differential susceptibility hypothesis, in infants with a more difficult temperament maternal sensitivity predicted a more pronounced expected pattern of changes in infant positive affect across the SFP, whereas this was not the case for infants with a more easy temperament.     

Maternal and infant affect at 4 months predicts performance and verbal IQ at 4 and 7 years in a diverse population

Using existing longitudinal data from 570 infants in the Maternal Lifestyle Study, we explored the predictive value of maternal and infant affect and maternal vocalizations during 2 minutes of face‐to‐face interactions at 4 months on IQ scores at 4.5 and 7 years. After controlling for demographic factors, maternal depression, and prenatal drug exposure, maternal positive affect and maternal positive vocalizations emerged as predictors of both verbal and performance IQ at 4.5 and 7 years. Although infant positive affect during the interaction with the mother was not predictive of these outcome measures, infant positive affect towards an examiner predicted verbal but not performance IQ at 4.5 years. These results suggest that maternal positive affect may index emotional engagement in interaction that facilitates both verbal and nonverbal cognitive development, while infant social positive affect is specifically related to the acquisition of verbal reasoning abilities. These findings are significant because they are based on a discrete snapshot of observable behavior in infancy (just 2 minutes of interaction), because they extend the range of maternal behaviors and characteristics known to support positive developmental outcomes, and because they are derived from high‐risk infants where prevention efforts may be beneficial. Potential mechanisms for these associations are discussed, as are the clinical implications for identifying dyads most in need of targeted interventions.     

An Irish Cohort Study of Risk and Protective Factors for Infant Language Development at 9 Months

This nationally representative study of Irish infants explores whether the set of child and environmental factors established as predicting language outcomes aged 3 years would also predict language and communication development as early as age 9 months. Associations between infant and environmental characteristics and infant language outcomes at 9 months, as measured on the ASQ 10‐month communication questionnaire, were explored in a series of bivariate logistic regression models and in a fully adjusted multivariable logistic regression model. Infant gender, health, birthweight and temperament were significantly associated with passing the ASQ communication measure at 9 months. Being an only child and having some experience of relative childcare predicted positive communication outcomes. Infants of older mothers and mothers who spoke less to the child while doing other things were significantly less likely to pass. Infants of mothers with the lowest educational level were more likely than their peers to pass at 9 months. Unlike language outcomes at 3 years, low maternal education does not appear to be a risk factor for poorer outcomes at 9 months. This study adds significantly to the infant language development literature by focussing on communication outcomes in early infancy and identifying protective and risk factors at such an early stage. Copyright © 2014 John Wiley & Sons, Ltd.     

The influence of high-risk pregnancies and social support systems on maternal perceptions of the infant

This study examines the effects of high-risk pregnancies on the maternal perception of the full-term healthy infant, as well as the influence of social support systems on these effects. Thirty mothers after high-risk pregnancy and 30 mothers after low-risk pregnancy were interviewed when their infants were 3 months old. Their perceptions of own and average baby were evaluated as well as the amount and availability of and their satisfaction with social support. The obtained results confirm the hypothesis that mothers after high-risk pregnancies tend to perceive their infant as significantly more difficult than mothers after low-risk pregnancies. A main finding of this study is that high-risk pregnancy mothers perceive an average baby in a much more positive way. Social support was not found to affect significantly the maternal negative perception of the infant after a high-risk pregnancy. These findings are discussed in the context of the continuity of the process of maternal affiliation to the infant before and after delivery.     

Longitudinal Assessment of Sleep–Wake Regulation and Attachment Security with Parents

The development of sleep–wake regulation occurs within the context of the infant–parent relationship. The present study investigated (1) patterns of change in night waking across infancy and attachment to parents and (2) if dependency, a characteristic of secure subgroup B4 and insecure‐resistant infants, accounted for differences in night waking. Forty‐six families reported on the number of infant night wakings at 7, 12, and 14 months of age. Attachment was measured at 12 (infant–mother) and 14 (infant–father) months. Findings suggest that infants with a secure (including the dependent‐secure, B4) pattern of attachment with mothers decreased in the number of night wakings over time, whereas infants with an insecure‐resistant pattern of attachment with mothers continued to wake at night into the second year. Attachment dependency did not account for differences in night waking. These findings are important to understanding the mechanism(s) underlying the relation between attachment and sleep–wake regulation. Copyright © 2012 John Wiley & Sons, Ltd.     

Differences in caregiver behaviors of infants at-risk for autism and typically developing infants from 9 to 15 months of age

During an object sharing paradigm, we compared infant-caregiver interactions between two groups: i) infants at high-risk (HR) for being diagnosed with Autism Spectrum Disorder (ASD) and ii) low-risk (LR) infants, observed at 9, 12, and 15 months of age. 16 HR infants (14 infants with an older sibling diagnosed with ASD and 2 preterm infants that received a diagnosis of ASD at 2 years) and 16 LR infants (typically developing infants without older siblings diagnosed with ASD) were included in the study. At each visit, infants played with objects in the presence of their caregivers as crawlers or walkers. Previously, we found that HR infants are less likely to share their object play with caregivers at walker ages. The present study found that caregivers of HR infants used greater directive bids including being more proximal to infants and using greater verbal and non-verbal bids to sustain their infant’s attention and to ensure their compliance during the task compared to caregivers of LR infants. Our study emphasizes the bidirectional and dynamic nature of infant-caregiver interactions. Our findings have implications for caregiver training programs that teach parents appropriate strategies to promote early social communication skills in at-risk infants.     

Maternal Responsiveness,Intrusiveness, and Negativity During Play with Infants: Contextual Associations and Infant Cognitive Status in A Low‐Income Sample

Maternal parenting behaviors during a mother–infant play interaction were examined in a sample of 160 low‐income mothers and their 15‐month‐old infants. Maternal responsive/didactic, intrusive, and negative behaviors were coded from videotapes and examined in relation to mothers’ age, marital status, stressful life events, and depressive symptoms, and infants’ cognitive scores at 15 and 25 months. Younger maternal age and increases in stressful life events were associated with increases in mothers’ negative behaviors whereas being married was positively associated with mothers’ responsive/didactic behaviors and inversely associated with their negative and intrusive behaviors. Mothers’ depressive symptoms were inversely associated with both responsive/didactic and intrusive behaviors and predicted lower cognitive scores in infants at 15 months, but not 25 months. Maternal responsive/didactic behaviors predicted infant cognitive scores at both ages after controlling for maternal characteristics and other parenting behaviors. Intrusiveness moderated associations between both responsive/didactic and negative parenting behaviors and infant 25‐month cognition. Maternal age, marital status, psychological resources, and contextual sources of stress play a central role in the quality of parenting among low‐income mothers, and positive mother–infant interactions are strong predictors of infants’ early cognitive status.     

The association between prenatal exposure to cigarettes and infant and maternal negative affect

This study examined the association between prenatal exposure to cigarettes and infant and maternal negative affect. Participants were 115 mother-infant dyads (69 prenatally exposed to cigarettes and 46 nonexposed). Infant and maternal negative affect were both assessed during the neonatal period (2-4 weeks of age) and again at 7 months of infant age. Results indicated that only prenatal exposure to cigarettes predicted infant negative affect. Infants who were prenatally exposed to more cigarettes had higher levels of negative affect at both time points. Furthermore, regression analyses indicated that both infant and maternal negative affect during the neonatal period predicted maternal negative affect at 7 months of age. These results highlight the importance of considering the reciprocal relationship between infant and maternal behavior when examining developmental outcomes among infants prenatally exposed to cigarettes.     

A randomized controlled trial of mother–infant psychoanalytic treatment: I. Outcomes on self‐report questionnaires and external ratings

Mother–infant relationship disturbances occur in three domains: maternal distress, infant functional problems, and relationship difficulties. They constitute common clinical problems. In Sweden, they are usually handled by nurses as part of public Child Health Centre care. Severe cases are referred to child psychiatry services. This randomized controlled trial compared two groups of mother–infant dyads in a Stockholm sample. One received only Child Health Centre care (the “CHCC” group) while the other received mother–infant psychoanalytic treatment plus CHCC (the “MIP” group). Eighty dyads of mothers and infants under 1½ years of age where the mothers had serious concerns about themselves in their role as mothers, their infants' well‐being, or the mother–baby relationship were randomly selected for either the MIP or the CHCC group. The primary outcomes were mother‐reported depression, mother‐reported infant functional problems, and interviewer‐based relationship assessments, all at 6 months after joining the project. Secondary outcomes were mother‐reported stress and general psychic distress, externally rated video‐recorded interactions, and the consumption of healthcare at the CHC, again all after 6 months. Intent‐to‐treat analyses of Treatment × Time effects significantly favored MIP treatment for maternal depression, mother–infant relationships, and maternal sensitivity. Effects were nearly significant on maternal stress, but nonsignificant on mother‐reported infant functional problems, general psychic distress, maternal interactive structuring and nonintrusiveness, infant responsiveness and involvement, and healthcare consumption. MIP treatment improved mother–infant relationships and maternal sensitivity and depression, all of which are known to influence child development. If effects persist and are reproduced, MIP treatment holds promise for more widespread use.