The association between observed non-verbal maternal responses at 12 months and later infant development at 18 months and IQ at 4 years: a longitudinal study

Background

An infant's early environment has an important influence on their development. For example, the sensitivity and warmth of a mother's responses towards her infant is associated with the infant's later socio-emotional development. However, it is less clear whether maternal responses are associated with the infant's later cognitive development.

Method

We used data from a large UK cohort study to investigate the association between non-verbal maternal responses and later infant development and IQ. Maternal responses were rated at 12 months during an observed mother–infant interaction. Infant development was assessed using the Griffiths scales at 18 months and IQ at 4 years was assessed using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). Data on the infant's developmental level at 6 months (prior to the maternal response ratings) was also available. The complete case sample comprised 732 mother–infant pairs.

Results

There was evidence for an association between positive maternal responses and infant development at 18 months. After adjusting for infant developmental level at 6 months and other confounders, we found a difference of 0.25 standard deviations (coef 2.0, 95% CI (0.8–3.2), p = 0.002) on the Griffiths scales between infant's whose mothers showed positive compared to neutral non-verbal responses at 12 months. However, an association between positive maternal responses and IQ at 4 years diminished following adjustment for maternal educational attainment.

Conclusion

The results provide evidence that positive maternal responses are associated with improved development in infants at 18 months. However, the association between maternal response and IQ at 4 years may be explained by higher educational attainment in mothers who show positive responses. Future studies are needed to explore the influence of maternal responses on different aspects of infant development as well as the role of maternal factors such as education.     

Contribution of facial and vocal cues in the still-face response of 4-month-old infants

The contribution of contingent facial and vocal information in the still-face effect was investigated. Four-month-old infants either saw and heard their mother, only saw their mother, or only heard their mother interacting with them. These interaction periods were followed by the cessation of the mother's interactive face and/or voice. Only infants who observed their mother's face become still and neutral, showed a still-face effect by decreasing their visual attention and positive affect. The findings provide further support that the mother's interactive voice does not contribute to the still-face effect. The developing sensitivity to vocal information in dyadic and triadic contexts is discussed.     

Affective facial expression in sub-clinically depressed and non-depressed mothers during contingent and non-contingent face-to-face interactions with their infants

BackgroundDepression in the postpartum period involves feelings of sadness, anxiety and irritability, and attenuated feelings of pleasure and comfort with the infant. Even mild- to- moderate symptoms of depression seem to have an impact on caregivers affective availability and contingent responsiveness. The aim of the present study was to investigate non-depressed and sub-clinically depressed mothers interest and affective expression during contingent and non-contingent face-to-face interaction with their infant.MethodsThe study utilized a double video (DV) set-up. The mother and the infant were presented with live real-time video sequences, which allowed for mutually responsive interaction between the mother and the infant (Live contingent sequences), or replay sequences where the interaction was set out of phase (Replay non-contingent sequences). The DV set-up consisted of five sequences: Live1-Replay1-Live2-Replay2-Live3. Based on their scores on the Edinburgh Postnatal Depression Scale (EPDS), the mothers were divided into a non-depressed and a sub-clinically depressed group (EPDS score ≥ 6).ResultsA three-way split-plot ANOVA showed that the sub-clinically depressed mothers displayed the same amount of positive and negative facial affect independent of the quality of the interaction with the infants. The non-depressed mothers displayed more positive facial affect during the non-contingent than the contingent interaction sequences, while there was no such effect for negative facial affect.ConclusionsThe results indicate that sub-clinically level depressive symptoms influence the mothers’ affective facial expression during early face-to-face interaction with their infants. One of the clinical implications is to consider even sub-clinical depressive symptoms as a risk factor for mother-infant relationship disturbances.     

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.     

Attention-getting vs. imitation effects on depressed mother-infant interactions

The effects of instructing mothers to “imitate” their infant versus “keep their infant's atten tion” were examined during mother-infant face-to-face interactions of 18 mothers reporting depressive symptoms as compared with 22 mothers who did not report such symptoms. Mothers were generally rated as showing more positive facial expressions and more game playing (particularly the depressed mothers) during the attention-getting versus the imitation sessions. The infants received more optimal physical ac tivity, and facial expression ratings during attention getting, and the infants of depressed mothers, in par ticular, showed more positive facial expressivity and more joy expressions. As might be expected for the imitation condition, mothers showed more imitative behavior, contingent responsivity, and silence during gaze aversion. Infants generally showed more disinterest and self-comfort behaviors, and the infants of depressed mothers, in particular, showed more anger expressions, fussiness, and squirming during the imitation condition. The data suggest that the attention-getting condition was the most effective “intervention” for eliciting positive behavior in the depressed mother-infant dyads.     

Fathers' versus mothers' social referencing signals in relation to infant anxiety and avoidance: a visual cliff experiment

Infants use signals from others to guide their behavior when confronted with novel situations, a process called ‘social referencing’ (SR). Via SR, signs of parental anxiety can lead to infant anxiety. Little is known about differences in the effect of paternal and maternal SR signals on child anxiety. Using a visual cliff paradigm, we studied whether SR processes between fathers and their infants differed from mothers and their infants. Eighty‐one infants aged 10–15 months were randomly assigned to conduct the visual cliff task with their father (n = 41) or mother (n = 40). The infant was placed on the shallow side of the cliff and the parent, standing at the deep side, was instructed to encourage the infant to cross. Results showed that although mothers showed more intense facial expressions of encouragement than fathers, no differences occurred in how fast, and with how much anxiety, infants crossed the cliff with fathers and mothers. However, path analyses showed that paternal, but not maternal, expressed anxiety was positively associated with infant expressed anxiety and avoidance. For infants who participated with their mother, infants' anxious temperament was negatively associated with infant avoidance of the cliff. Infant anxious temperament moderated the link between paternal expressed anxiety and infant avoidance: the higher the level of infant anxious temperament the stronger the positive association between paternal expressed anxiety and infant's avoidance of the cliff. Lastly, parental encouragement was unrelated to infant expressed anxiety and avoidance. Our results suggest that SR processes between fathers and their infants differ from those between mothers and their infants.     

The Still-Face Paradigm and bidirectionality: Associations with maternal sensitivity,self-esteem and infant emotional reactivity

The Still-Face Paradigm (SFP) is a structured stressful event within which researchers have investigated the influence of maternal psychological and behavioral characteristics on infant behavior. The present investigation contributes to this body of work by examining the joint contributions of maternal and child behavioral and affective characteristics on subsequent behaviors and affectations following the SFP. A sample of non-clinically depressed mothers and their infants (n = 31) engaged in a modified Still-Face Paradigm (SFP), followed by a period of toy play. These interactions were videotaped and behaviorally coded along the following dimensions: maternal sensitivity prior to the SFP and during toy play, infant negative emotional reactivity during the still-face, and infant resistance during the reunion phase. Additionally, mothers reported global self-esteem and this was examined as a predictor of infant behavior. Results revealed significant bidirectional influences such that maternal self-esteem predicted infant emotional reactivity, maternal sensitivity pre-SFP predicted infant resistance during the reunion phase, and infant resistance predicted subsequent levels of maternal sensitivity. Indirect effects were also examined, and provided additional support for bidirectionality in mother–infant interactions. Implications for clinical practice are discussed in light of these findings.     

Individual differences in non-clinical maternal depression impact infant affect and behavior during the still-face paradigm across the first year

Maternal depression can significantly impact mothers’ sensitivity to their infants’ needs as well as infants’ social and emotional development. The still-face paradigm (SFP) is widely used to assess infants’ understanding of the contingency between their own behavior and that of their caregivers, as well as infants’ ability to self-regulate arousal levels during sudden changes in maternal responsiveness. Infants of clinically depressed mothers display blunted levels of negative affect compared to infants of non-depressed mothers during the still-face (SF) phase. However, little is known about whether individual differences in elevated, non-clinical levels of maternal depression similarly affect mother-infant interactions. The current study examines the longitudinal effects of non-clinical maternal depression on infant and maternal behaviors during the SFP. Infants (N = 63) were assessed at 5 and 9 months and maternal depression was assessed at 5 months using the Beck Depression Inventory (BDI). Infants of mothers with elevated levels of depression displayed less negative engagement during the SF phase compared to infants of mothers with lower levels of depression. This effect was present at 5 months, but not at 9 months. Findings demonstrate that non-clinical levels of maternal depressive symptomatology can have a significant impact on infants’ affective regulation during the first half of the first year of life, but this does not necessarily have a long-lasting influence later in infancy. Interventions may want to target mothers with non-clinical depression to promote healthy infant social and emotional development.     

The many faces of the Still-Face Paradigm: A review and meta-analysis

The Still-Face Paradigm (SFP) designed by Tronick, Als, Adamson, Wise, and Brazelton (Tronick, E., Als, H., Adamson, L., Wise, S., & Brazelton, T. B. (1978). Infants response to entrapment between contradictory messages in face-to-face interaction. Journal of the American Academy of Child and Adolescent Psychiatry, 17, 1–13) has been used for many different purposes in over 80 empirical studies. In the current paper, the nature and correlates of infant behavior in the SFP were examined in a systematic narrative review and a series of meta-analyses. The results of the meta-analyses confirmed the classic still-face effect of reduced positive affect and gaze, and increased negative affect, as well as a partial carry-over effect into the reunion episode consisting of lower positive and higher negative affect compared to baseline. The still-face effect is very robust as it was found regardless of most sample variations such as infant gender and risk status, and regardless of most procedural variations, such as the length of the SFP episodes and the use of intervals between episodes. The few moderator effects that were found in the meta-analyses tended to put findings from the narrative review in a new perspective. Additional meta-analyses confirmed the narrative review in finding that higher maternal sensitivity predicted more infant positive affect during the still-face. Infants’ higher positive affect and lower negative affect during the still-face were predictive of secure attachment at age 1 year. The meta-analytic results for maternal depression were equivocal. Implications for future research include a need for studies testing the role of the adults’ identity (parent versus stranger, mother versus father) to elucidate the relationship-specificity of the still-face effect. Also, the role of maternal sensitivity and temperament as potential moderators of the still-face effect need to be examined further. On a procedural level, the effects of the timing of the still-face and of the duration of the reunion on infant responses deserve future research attention.     

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

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

Using the Actor-Partner Interdependence Model to assess maternal and infant contributions to mother-infant affective exchanges during the Still-Face Paradigm

This study describes maternal and infant contributions to dyadic affective exchanges during the Still-Face Paradigm (SFP) in an understudied mostly low-income sample. One hundred eleven mothers and their 7-month-old infants were videotaped during the SFP to analyze how a social stressor affects mother-infant positive and negative affective exchanges during interaction. The SFP includes 3 episodes: baseline, maternal still-face, and reunion. Maternal and infant positive and negative affect were scored by masked reliable coders. Data were analyzed using the Actor-Partner Interdependence Model to test the hypotheses that each partner’s affectivity during the baseline episode would predict their own affectivity during the reunion episode (actor effects). We also expected that each partner’s affectivity during the baseline episode would influence the other partner’s affectivity during the reunion episodes (partner effects). After controlling for infant sex and maternal education, results provided evidence for actor effects for maternal and infant positive affect, and for partner effects for maternal baseline positive affect to infant positive affect during the reunion. One significant partner effect was observed for negative affect: Infant negativity during baseline predicted greater maternal negativity during reunion. Findings confirm that both mothers and infants contribute to dyadic affective processes during the SFP but specific findings vary depending on the affective valence in question. Clinical implications and future research are discussed.     

Perceived and observed parenting behavior in American and Italian first-time mothers across the first 3 months

This short-term longitudinal study investigated cross-cultural universality (similarities) and cultural specificity (differences) in American and Italian first-time mothers’ perceived parenting efficacy and observed parenting behavior in early infancy. Thirty-two mother–infant dyads from the United States (n = 16) and Italy (n = 16) participated in this study at 1 and 3 months across the first developmental transition. Maternal self-efficacy in parenting was assessed by self-reports. Mothers’ parenting behavior was observed and videotaped in a feeding situation. Both micro- (15-s time sampling) and macro-analytic (global ratings) strategies were employed to measure maternal and infant behaviors. Results revealed both cross-cultural similarities and differences in American and Italian mothers’ perceived parenting efficacy and observed parenting behavior. Both American and Italian mothers perceived themselves as becoming more efficacious in their parental role from 1 to 3 months and demonstrated significant stability in their individual differences over time. Compared to American mothers, Italian mothers displayed greater social/affective and handling/holding behavior. Whereas American mothers showed more synchronous responses to their infants when they were resting, Italian mothers spent significantly more time in synchronous dyadic social exchanges with their infants. The findings are discussed from the perspective of cultural organization of parenting, which suggests that parents structure everyday activity for their infants in accordance with cultural values and expectations.     

Coordination of Emotions in Mother–Infant Dialogues

Eleven infant–mother dyads in Crete were videod during spontaneous interactions at home, from the second to the sixth month of life. Micro‐analysis was used to investigate‘coordination'and ‘non‐matching’ of facial expressions of emotion. ‘Emotional coordination’ was evaluated with four measures: matching of facial expressions, completion when one responded to the other with ‘pleasure’ or ‘interest’, synchrony by matching frequency of change or rhythm of emotional expressions, and attunement when shifts of emotional intensity of the two partners were in the same direction.‘Emotional non‐matching'was coded when neither the infant nor the mother showed interest in interacting with the other. In emotional coordination or non‐matching between mother and infant, who performed first was also recorded. We obtained evidence of emotional matching, synchrony, and attunement. Importantly, the probability of emotional non‐matching by the infant was higher than the probability of emotional matching and completion, indicating a tendency for thoughtful attention or playful rivalry in the responses of infants, who also initiated emotional matching, completion, and non‐matching more frequently than mothers. The probability of expression of emotional matching, completion, and non‐matching changed with age. Both mothers and infants act to obtain sympathetic complementarity of feelings and co‐operative inter‐synchrony of actions. Copyright © 2016 John Wiley & Sons, Ltd.     

Infant affective responses to mother's still face at 6 months differentially predict externalizing and internalizing behaviors at 18 months

This study investigated (a) stability and change in infant affective responses to the still-face interaction, (b) whether maternal depression affected infant responses, and (c) whether responses to the still-face interaction predicted toddler problem behaviors. Infants (63 girls and 66 boys) of European American mothers (67 depressed and 62 nondepressed) were observed in the still-face interaction at 2, 4, and 6 months. Affect and gaze were coded on a 1-s time base. There were stable individual differences in gazing away and in rates of negative affect. Developmental change occurred only for gazing away, which increased. At 18 months, infants who failed to smile at 6 months in the still-face interaction showed more externalizing-type behaviors than did other toddlers. Infants who failed to cry at 6 months showed fewer internalizing-type behaviors. Mothers' current depressive symptoms and infants' earlier responses to the still-face interaction made independent, comparable contributions to problem behaviors at 18 months.     

Infants' vagal regulation in the still-face paradigm is related to dyadic coordination of mother-infant interaction

The authors investigated relations between mother-infant dyadic coordination and infants' physiological responses. Mothers (N=73) and 3-month-old male and female infants were observed in the still-face paradigm, and mothers' and infants' affective states were coded at 1-s intervals. Synchrony and levels of matching between mother-infant affective states were computed, and infants' heart rate and vagal tone were measured. Infants showed increased negative affect and heart rate and decreased vagal tone during mothers' still-face, indicating physiological regulation of distress. Infants who did not suppress vagal tone during the still-face (nonsuppressors) showed less positive affect, higher reactivity and vagal suppression in normal play and reunion episodes, and lower synchrony in normal play with mothers. The results indicate that infants' physiological regulation in social interaction differs in relation to dyadic coordination of affective behaviors.     

Cognitive biases in processing infant emotion by women with depression,anxiety and post-traumatic stress disorder in pregnancy or after birth: A systematic review

Perinatal psychological problems such as post-natal depression are associated with poor mother–baby interaction, but the reason for this is not clear. One explanation is that mothers with negative mood have biased processing of infant emotion. This review aimed to synthesise research on processing of infant emotion by pregnant or post-natal women with anxiety, depression or post-traumatic stress disorder (PTSD). Systematic searches were carried out on 11 electronic databases using terms related to negative affect, childbirth and perception of emotion. Fourteen studies were identified which looked at the effect of depression, anxiety and PTSD on interpretation of infant emotional expressions (k = 10), or reaction times when asked to ignore emotional expressions (k = 4). Results suggest mothers with depression and anxiety are more likely to identify negative emotions (i.e., sadness) and less accurate at identifying positive emotions (i.e., happiness) in infant faces. Additionally, women with depression may disengage faster from positive and negative infant emotional expressions. Very few studies examined PTSD (k = 2), but results suggest biases towards specific infant emotions may be influenced by characteristics of the traumatic event. The implications of this research for mother–infant interaction are explored.     

Intentions make a difference: infant responses to still-face and modified still-face conditions

In two studies, 3-, 6- and 9-month-old infants interacted with their mothers during natural, still-face, and modified still-face (i.e., mothers wearing a mask, or drinking from bottle) conditions. Infants were also presented with matching doll conditions to control for the possibility that their responses might be due to changes in superficial perceptual features. Regardless of age, infants displayed negative affect to the still-face, but, in contrast to recent reports, not to the modified still-face conditions. However, whereas infants' positive affect also depended on their mothers' communicative intentions, these responses changed with cognitive maturation. As expected, infant responses to their mothers were significantly different from those to the doll. The implications of these findings for theories of communication are discussed.     

Two-month-olds' attention and affective response to maternal still face: a comparison between term and preterm infants in Taiwan

Maternal still face is a robust experimental procedure designed to examine infants’ sensitivity to social contingency and reactivity to its violation. To extend earlier research on the still-face effect on term infants in Western cultures, the present study compared Taiwanese term and preterm infants’ attention and affective response to and recovery from a modified maternal still-face procedure that used an additional still-face reengagement sequence at 2 months of age (corrected age for preterm infants). Infants’ gaze and facial affect were coded from videos. Results showed that preterm infants were as sensitive as term infants to the interruption to social contingency. Both groups of infants reacted with decreased gaze and positive affect across episodes, together with a decreased latency to gaze aversion and an increased latency to positive affect. Both term and preterm infants also demonstrated a W-shaped pattern of decline-followed-by-recovery in their latency to negative affect. However, compared to term infants, preterm infants became distressed faster and stayed in a negative affective state longer after the first exposure to maternal still face. Effects of prematurity on infant attention and affect regulation were discussed. Implications of preterm infants’ heightened affective negativity to mild stress for intervention studies were also addressed.     

Acquisition of social referencing via discrimination training in infants

This experiment investigated social referencing as a form of discriminative learning in which maternal facial expressions signaled the consequences of the infant's behavior in an ambiguous context. Eleven 4- and 5-month-old infants and their mothers participated in a discrimination-training procedure using an ABAB design. Different consequences followed infants' reaching toward an unfamiliar object depending on the particular maternal facial expression. During the training phases, a joyful facial expression signaled positive reinforcement for the infant reaching for an ambiguous object, whereas a fearful expression signaled aversive stimulation for the same response. Baseline and extinction conditions were implemented as controls. Mothers' expressions acquired control over infants' approach behavior for all participants. All participants ceased to show discriminated responding during the extinction phase. The results suggest that 4- and 5-month-old infants can learn social referencing via discrimination training.     

Audio-visual integration of emotional cues in song

We examined whether facial expressions of performers influence the emotional connotations of sung materials, and whether attention is implicated in audio-visual integration of affective cues. In Experiment 1, participants judged the emotional valence of audio-visual presentations of sung intervals. Performances were edited such that auditory and visual information conveyed congruent or incongruent affective connotations. In the single-task condition, participants judged the emotional connotation of sung intervals. In the dual-task condition, participants judged the emotional connotation of intervals while performing a secondary task. Judgements were influenced by melodic cues and facial expressions and the effects were undiminished by the secondary task. Experiment 2 involved identical conditions but participants were instructed to base judgements on auditory information alone. Again, facial expressions influenced judgements and the effect was undiminished by the secondary task. The results suggest that visual aspects of music performance are automatically and preattentively registered and integrated with auditory cues.