Communication in preterm infants: Why is it different?

The present paper selectively reviews the literature which compares full-term and preterm infants' communication with their mothers in the first year of life. The review is focused not only on what differences are found between full-term and preterm infants, but also why such differences exist. Particular emphasis is placed on the importance of interpreting the findings in the light of the developmental phase of the infants, the heterogeneity of the preterm population and the situation in which communication is studied. Most studies were not designed to consider these issues in any detail. Differences with respect to these factors can be found between studies, however, which may have contributed to the often contradictory findings. Consequently, comparisons between these studies provide clues about the effects of these factors on communicative development. The ultimate goal of this review is to point to important directions for future research on early communication in preterm infants.     

Associations between risk factors,developmental outcomes,and executive function in neonatal intensive care unit graduates at 2 years: A retrospective study

This study explores the extent to which medical and sociodemographic variables and cognitive and language skills are associated with executive function (EF) skills in neonatal intensive care unit (NICU) graduates at 24 months of adjusted age. We explored cognitive, language, and EF skills in 42 NICU graduates who participated in a NICU follow-up programme clinic. The association between risk factors and EF and the completion of the EF assessment were explored. Correlational analyses revealed that child gender was associated with EF scores. Analyses revealed cognitive skills, language skills, and multiple gestational births were associated with EF assessment completion. Our findings are among the first to examine EF skills in NICU graduates as young as 24 months of age using a multidimensional, child completed measure. Implications for NICU follow up programmes, the consideration of early interventions aimed to positively affect EF skills, and considerations for future studies are discussed.     

The risk of low risk: First time motherhood,prematurity and dyadic well-being

Premature birth has a well-documented impact on infants, mothers and their dyadic interactions. First time motherhood in the context of low risk premature birth—relatively unexplored in the literature—is a specific experience that sits at the nexus of premature infancy, motherhood and the processes that underpin dyadic connection. This qualitative study analyzed semistructured interviews with first time mothers of low risk premature babies. Findings were generated in response to research questions concerning mothers’ meaning-making, bonding and identity. Findings demonstrated that maternal meaning-making emerged from a dyadic framework. When mothers or their infants were considered outside of a dyadic context, surplus suffering inadvertently occurred. Findings have important implications for infant mental health practice in medical settings, for postnatal support in the aftermath of premature birth, and for understanding the meaning of risk.     

Early maternal stimulation and the development of cognitive competence and attention of preterm infants

The aim of the study was to investigate the relationship between several dimensions of maternal interactive behaviours, and cognitive development and attention in preterm infants. Of special interest was the question of whether high levels of maternal stimulation and activity may have negative consequences for the development of preterm infants. Sixty-six preterm infants and their mothers were followed longitudinally and videotaped in interaction situations at home, at the infant age of 6, 9 and 12 months. Mothers behaviours were scored on involvement, sensitive responsiveness, non-intrusiveness and level of activity. Moreover, infant cognitive status was assessed at 6, 12 and 24 months of age, using the Bayley Scales of Infant Development. Infant ability in problem solving and attention were assessed in two problem solving tasks at 18 and 24 months of age. The results showed that infant cognitive status at 12 and 24 months was best predicted by maternal involvement and infant responsiveness. No significant relationships were found between maternal interactive behaviours and infant ability in problem solving and attention. More importantly, there was no indication that high levels of maternal stimulation or intrusiveness may have a negative impact on later cognitive development and attention in preterm infants. © 1998 John Wiley & Sons, Ltd.     

Are Newborns Morally Different from Older Children?

Policies and position statements regarding decision-making for extremely premature babies exist in many countries and are often directive, focusing on parental choice and expected outcomes. These recommendations often state survival and handicap as reasons for optional intervention. The fact that such outcome statistics would not justify such approaches in other populations suggests that some other powerful factors are at work. The value of neonatal intensive care has been scrutinized far more than intensive care for older patients and suggests that neonatal care is held to a higher standard of justification. The relative value placed on the life of newborns, in particular the preterm, is less than expected by any objective medical data or any prevailing moral frameworks about the value of individual lives. Why do we feel less obligated to treat the premature baby? Do we put newborns in a special and lesser moral category? We explore this question from a legal and ethical perspective and offer several hypotheses pertaining to personhood, reproductive choices, “precious children,” and probable evolutionary and anthropological factors.     

Maternal expectations about infant development of pre‐term and full‐term infants: a cross‐national comparison

In three European regions (The Netherlands, Northern Italy and Southern Italy) we investigated whether mothers of healthy pre‐term infants (n=92) adjust their expectations for the timing of developmental milestones in the first years of life as compared to mothers of full‐term infants (n=140). We examined whether these adjustments could be seen as reflecting a pessimistic view, as would be predicted from the ‘prematurity stereotype’ perspective. Partial corrections for prematurity were regularly made, but no indications were found for an overly pessimistic view. Moreover, the differences between the regions in the anticipated timing of mastery of milestones were larger than the effects of prematurity. Copyright © 2006 John Wiley & Sons, Ltd.     

The use of the mental development index of the Bayley scale to diagnose language delay in 2-year-old high-risk infants

To determine if a detailed analysis of the language items of the Bayley Scales of Infant Development (BSID) would be useful in detecting language delay, the Bayley Mental Development Index (MDI) and Reynell Developmental Language Scales (RDLS-R) were administered to 137 low-birthweight infants at 2 years of age. In spite of scores in the normal range on the BSID, many of these children had significantly delayed language. However, the children with delayed language could be detected on the basis of detailed analysis of certain language items of the MDI, indicating that these items are more useful than the total MDI score.     

Infant crying,risk status and social support in families of preterm and term infants

Infant crying influences the caregiver and the broader caregiving environment. In this study, cry acoustics were recorded and acoustically analyzed from a sample of fullterm and preterm infants at 40 weeks gestational age, along with the medical risk and socioeconomic status (SES) of the family. Following factor analysis of the cry acoustics, cry factors, along with medical risk and SES were used to predict patterns of social support in the informal (family, friends) and formal (health care providers) social support networks at 44 weeks gestational age. One cry factor, temporal patterning, indicative of the influence of respiratory factors on the infant's cry, predicted a significant amount of variance in the amount of support from the informal network, beyond that predicted from medical risk and SES. Medical risk alone predicted the amount of contact with the formal network, and SES predicted satisfaction with help from the formal network. There were different patterns of relationship between cry acoustics and social support for families with term and preterm infants, indicating that caregivers may interpret and respond to different information in the acoustics of their infants' cries. These findings have implications for understanding how infant crying and behavior influence the caregiving environment and for the clinical management of early cry problems in families with infants differing in risk status. © 1998 John Wiley & Sons, Ltd.