Levels of change in parent–infant psychotherapy

This paper offers a way of thinking about the process of parent–infant psychotherapy. I start by outlining some ideas as to what can go awry in troubled parent–infant relationships, and then a way of working with parents with pre-verbal babies. I suggest a model for understanding three interlaced levels at which change might occur if a psychodynamic, systemically sensitive, therapeutic intervention is offered. I describe a particularly challenging clinical case in which a mother and I also worked with video material of her and her son.     

Infant-led innovations in a mother-baby therapy group

A mother-baby therapy group for mothers and infants in their first year who are experiencing difficulties is described. In a literature review no comparable group where the infants are seen as members in their own right has been found. Themes in the mothers' material are outlined, followed by the infants' evolving interactive and internal processes. Some therapeutic factors, in particular interactions between the infants and interventions on the part of the therapists, are then illustrated with clinical material. Some infant-led innovations are described, such as the way the infants' activity is used as a basis for making ‘group as a whole’ interpretations, and in particular how the therapists' actions towards the infants have come to be viewed as a non-verbal form of interpretation. The role of attuned play in direct work with infants is discussed further.     

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.     

Uncovering and managing unconscious ways of ‘looking’: A case study of researching educational care

Abstract

In this paper the author argues for the importance of those working as counsellors with children and adolescents to have specialist training. She outlines the need for many more properly trained counsellors to be available to children, and emphasizes the need for them to have detailed knowledge of children's emotional development. The argument is throughout illustrated with clinical examples. She draws attention to the differences between working with children and adolescents as opposed to adults, with an exploration of the special skills that need to be developed if working with younger clients. Reference is made to the differences in the contract and the thinking about the family. She explores the importance of including in a specialist training infant observation and the consideration of group and institutional dynamics.     

All by Myself? Independence and Coordination During Distress Episodes from 14 to 24 Months Among Latino Children

Growing research suggests that socialization toward independence with a focus on ‘separate individuality’ may be a culture specific rather than universal socialization goal. Among Latino families, children of mothers high in formal schooling have shown more independent and less coordinated patterns of interaction than children of mothers low in formal schooling. This longitudinal research explored the balance between independence and coordination during mother–child interaction around distress by examining age‐related changes and within‐group variation among Latino children. Fifty Latino dyads were videotaped during unstructured interactions in their homes at 14 and 24 months of age. Episodes of distress were identified and then classified according to individual contributions and coordination (e.g. [child] independent, mother‐led, coordinated). Coordinated and independent resolutions were the most frequent type at both ages. To examine the balance between these for each child, a proportion of episodes resolved in each type was calculated. Children in both groups (high maternal schooling, low maternal schooling) increased in coordination, but only children with higher maternal schooling also increased in independent resolutions. Copyright © 2012 John Wiley & Sons, Ltd.     

Social pretence with mothers and peers at 15 months

Previous research has shown that adults scaffold and direct early infant social pretend play making it difficult to establish infants' own contribution to pretence. To examine infants' social pretence abilities the present study compared infants' social pretend play in interactions with adults and same-age peers, who have similar socio-cognitive competence. Forty-five 15-month-old infants were observed during free-play interactions with their mother and two same-age, same-gender peers. The frequency and duration of parallel and coordinated social pretence were coded during both interactions. Results showed that while infants played pretence with both social partners, they engaged in more and longer coordinated social pretence with their mothers than with peers. Thus, although competent social partners play an important role in scaffolding complex pretence, infants' own socio-cognitive abilities contribute to the development of social pretence and enable them to pretend play with different partners regardless of their competencies.     

Parent Grief 1–13 Months After Death in Neonatal and Pediatric Intensive Care Units

Objective. Describe changes in mothers’ and fathers’ grief from 1 to 13 months after infant or child neonatal or pediatric intensive care unit death and identify factors related to their grief.

Methods. Mothers (n = 130) and fathers (n = 52) of 140 children (newborn–18 years) completed the Hogan Grief Reaction Checklist at 1, 3, 6, and 13 months postdeath.

Results. Grief decreased from 3 to 13 months for mothers and from 3 to 6 months for fathers. Grief was more intense for mothers of deceased adolescents and mothers whose children were declared brain dead.

Conclusion. Mothers’ and fathers’ grief intensity may not coincide, resulting in different needs during the 13 months after infant or child death.     

人类基本数学能力的进化证据

数学能力是人类重要的高级认知能力。人类的基本数学能力从进化上而言是一种适应性的表现,对个体的生存和繁衍有重要的意义。近年来比较心理学研究发现,成年人、婴儿的基本数学能力的行为表现和脑神经机制与其它物种相似,分子遗传学研究表明基本数学能力具有一定的遗传性。这些发现有助于人们更深刻地理解基本数学能力的本质及发生发展机制。     

婴儿期外显问题行为的发生与表现及成因分析

外显问题行为是指一组表现在外的、反映了儿童对外部环境消极反应的行为。研究表明婴儿最早于8个月时便已出现外显问题行为,且婴儿期这类行为主要表现为愤怒/发脾气、不顺从/反抗、攻击、破坏性、过度活跃、注意力不集中等,其成因可从早期经验因素、遗传与环境的交互作用等方面解释。此外,外显问题行为的干预研究可从差别易感性理论入手,从而为特定气质类型以及携带可塑性基因的婴儿提高了外显问题行为的干预效果。本文在梳理上述研究的基础上,对该领域研究的局限性进行了小结并对未来研究的方向进行了展望。     

The mother’s mental representation of her infant

Abstract

The mother’s intrapsychic mental representation of her infant begins before pregnancy and is modified during pregnancy and thereafter. Parents have conscious expectations and unconscious fantasies about their infant, which are all too often not consistent with reality. Early intervention in infant–parent disturbances is important for repair of the relationship and prevention of later pathogenic development. A clinical example of a mother’s unconscious ambivalent mental representations of her infant is presented.