Differential associations between maternal scaffolding and toddler emotion regulation in toddlers born preterm and full term

Social cognition following preterm birth: A systematic review

Social cognitive abilities are affected by preterm birth, but pathways to, and risk factors for this outcome are not well mapped. We examined direct assessment tasks including objective coding of parent-child play to chart social development in infancy and pre-school years. A systematic search and data-extraction procedure yielded seventy-nine studies (4930 preterm and 2109 term children, aged birth - five years), for inclusion. We detected a pattern of reduced social attention in the first 12 months of life with evidence of reduced performance in social cognitive tasks later in the preschool years. However, we did not identify a consistent, distinctive preterm social phenotype in early life. Instead, the interactive behaviour of preterm infants reflects factors from outside the social cognitive domain, such as attention, language, and socioeconomic status. By combining data across samples and measures we revealed the role of domain-general skills, which may in future prove fruitful intervention targets.

Development and nationwide implementation of a postdischarge responsive parenting intervention program for very preterm born children: The TOP program

A previous randomized controlled trial has suggested the effectiveness of a Dutch postdischarge responsive parenting program for very preterm (VPT) infants, indicating that nationwide implementation was justified. This paper describes the development and nationwide implementation of the intervention, known as the TOP program, which consisted of three phases. In the preparation phase (2006-2010), a theory of change and the structure of the TOP program were developed, and funding for phase two, based on a positive Business Case, was obtained. In the pilot implementation phase (2010-2014), intervention strategies were developed for a real-world setting, capacity and adoption were increased, systematic evaluations were incorporated, and sustained funding was obtained. In the full-implementation phase (2014-2019), all Dutch Healthcare Insurers reimbursed the TOP program, enabling VPT infants to participate in the program without charge. By 2018, the number of interventionists that provided the TOP program had increased from 37 to 91, and all level III hospitals and 65% of regional hospitals in the Netherlands referred VPT infants. Currently, the program reaches 70% of the Dutch target population and parental satisfaction with the TOP program is high. After a 12-year implementation period, the TOP program forms part of routine care in the Netherlands.

Substrate-Related Factors Affecting Cellulosome-Induced Hydrolysis for Lignocellulose Valorization

Cellulosomes are an extracellular supramolecular multienzyme complex that can efficiently degrade cellulose and hemicelluloses in plant cell walls. The structural and unique subunit arrangement of cellulosomes can promote its adhesion to the insoluble substrates, thus providing individual microbial cells with a direct competence in the utilization of cellulosic biomass. Significant progress has been achieved in revealing the structures and functions of cellulosomes, but a knowledge gap still exists in understanding the interaction between cellulosome and lignocellulosic substrate for those derived from biorefinery pretreatment of agricultural crops. The cellulosomic saccharification of lignocellulose is affected by various substrate-related physical and chemical factors, including native (untreated) wood lignin content, the extent of lignin and xylan removal by pretreatment, lignin structure, substrate size, and of course substrate pore surface area or substrate accessibility to cellulose. Herein, we summarize the cellulosome structure, substrate-related factors, and regulatory mechanisms in the host cells. We discuss the latest advances in specific strategies of cellulosome-induced hydrolysis, which can function in the reaction kinetics and the overall progress of biorefineries based on lignocellulosic feedstocks.

“How Do We Solve This Task?”

Abstract. The study examines (a) whether gestational age relates to parental scaffolding (SCA), when controlling for child cognitive development, parenting stress, and socioeconomic status, and (b) how SCA links to parent–child problem-solving performance. The sample included 142 parents with a full-term or preterm 2-year-old toddler (corrected age). Parents’ SCA during one of two (randomly assigned) problem-solving tasks was rated on five scales (use of SCA means, cognitive support, metacognitive support, transfer or responsibility, contingency management). The results suggest that gestational age is positively related to parents’ transfer of responsibility and metacognitive support. The effects decrease, however, once covariates are controlled for. Regarding the problem-solving performance, direct effects were observed from parents’ cognitive and metacognitive support, transfer of responsibility, and contingency management. The data also confirm an indirect effect of parents’ use of SCA means on the problem-solving performance, partially mediated via parents’ cognitive support. Implications for the design of interventions are discussed.

Training of parental scaffolding in high-socio-economic status families: How do parents of full- and preterm-born toddlers benefit?

BACKGROUND

Preterm children have an increased risk regarding self-regulation development. Given the strong link between parenting behaviour (i.e., scaffolding and sensitivity) and children's self-regulation, parental training presents a promising way to counteract the negative consequences of preterm birth.

AIMS

We explored the effectiveness of parental training by comparing a basic scaffolding training and a combined scaffolding/sensitivity training to an active treatment-control group (stress management). Basic and combined treatments should increase parents' domain-specific self-efficacy (DSSE) and beliefs on parental co-regulation and the promotion of learning (BCL) more than the control treatment should. No such differences were expected for parents' domain-general self-efficacy (DGSE). We examined whether parents of preterm and full-term children benefitted equally from training conditions.

SAMPLE(S)

A total of 87 parents of full-term and 35 parents of preterm toddlers (24-36 months of age, corrected for prematurity) participated.

METHODS

Based on a quasi-experimental pre-test-post-test follow-up design, parents were randomly assigned to treatments. A multimethod approach was applied, including self-report, parent-child interactions, and standardized behavioural tasks. The presented study is limited to questionnaire data on parents' DGSE, DSSE, and BCL.

RESULTS

An overall increase resulted from pre- to post-test and/or follow-up. Parents' BCL changed significantly stronger in the combined training than in the control group. Parents of preterm and full-term children benefitted equally from basic and combined training.

CONCLUSIONS

The combined training enhanced BCL among parents of full-term and preterm children the most. If such training also yields improvement on the behavioural level, this finding will advance preterm aftercare.

Maternal intelligence quotient (IQ) predicts IQ and language in very preterm children at age 5 years

BACKGROUND

Sociodemographic factors are linked to cognitive outcomes in children born very preterm (VPT; ≤30 weeks gestation). The influence of maternal intellectual ability, a heritable trait, is unknown. Also undetermined is the extent to which associations between maternal and child intellectual ability vary according to parenting behaviors that target cognitive stimulation in the home.

METHODS

At age 5 years, 84 VPT and 38 demographically matched full-term (FT) children underwent neurodevelopmental assessment. Children's intellectual ability was assessed using The Wechsler Preschool Primary Scale of Intelligence-III, and language was assessed with the Clinical Evaluation of Language Fundamentals Preschool-2. The Wechsler Test of Adult Reading estimated maternal intellectual ability. The StimQ-Preschool questionnaire provided a measure of cognitive stimulation in the home. Linear mixed-effects models examined independent effects and interactions between maternal intellectual ability and cognitive stimulation on children's outcomes.

RESULTS

After covariate adjustment, maternal intellectual ability was associated with child intellectual (p < .001) and language (p = .002) abilities. Stronger associations were observed in FT mother-child dyads (B = .63, p = .04) than VPT dyads (B = .42, p = .01). Mothers of VPT children reported lower levels of Parental Involvement in Developmental Advance (p = .007) and Parental Verbal Responsiveness (p = .04). Group differences in Parental Involvement in Developmental Advance, but not Parental Verbal Responsivity, persisted after adjusting for social background (p = .03). There was no evidence of an interaction between maternal intellectual ability and Parental Involvement in Developmental Advance (p = .34). Instead, maternal intellectual ability (p < .001) and Parental Involvement in Developmental Advance (p = .05) independently predicted VPT children's outcomes.

CONCLUSIONS

Maternal intellectual ability is an important trait linked to VPT and FT children's intellectual and language outcomes. Prematurity increases variation in the heritability of intellectual ability and shifts children from the expected range based on maternal ability. Parental involvement in activities that help children master new skills may promote cognitive development in VPT children born to mothers of lower intellectual ability.

Intervention effects on emotion regulation in preterm infants with very low birth weight: A randomize controlled trial

Preterm infants are at risk for emotional difficulties and behavioral problems. This study was aimed to investigate the effects of a clinic-based intervention program (CBIP) and a home-based intervention program (HBIP) compared with a usual care program (UCP) on emotion regulation to stress in preterm infants with very low birth weight (VLBW, birth weight <1500 g). A total of 178 VLBW preterm infants had been previously randomly assigned to receive one of three interventions (57 in CBIP, 63 in HBIP and 58 in UCP). The CBIP and HBIP contained identical child-, parent- and dyad-focused interventions that were provided to infants during hospitalization and were respectively delivered at clinics and at home at PMA 36-38 and 40 weeks, and 1, 2, 4, 6, 9, 12 months of corrected age. All infants were prospectively observed for behavioral reactivity and regulation in response to experimentally evoke stress evoked by a toy-behind-barrier procedure at 12, 18, and 24 months of corrected age. Their cognitive and language abilities, and mothers' responsiveness were also assessed at 12 months as potential covariates. Compared to the UCP-group infants, the HBIP-group infants exhibited shorter durations of visual orientation to a toy (adjusted difference [95% CI]=-1.60 [-3.07 to -0.13], p=0.03), and the CBIP-group infants exhibited shorter durations of avoidance (adjusted difference [95% CI]=-0.84 [-1.57 to -0.10], p=0.03) from 12 to 24 months of corrected age. The CBIP and HBIP showed no difference in the stress reactivity from the UCP, however. These results suggest that comprehensive interventions incorporating child-, parent- and dyad-focused services enhanced VLBW preterm infants' emotion regulation in response to stress at toddler age.

Effects of maternal sensitivity on low birth weight children's academic achievement: a test of differential susceptibility versus diathesis stress

BACKGROUND

Differential Susceptibility Theory (DST) postulates that some children are more affected - for better and for worse - by developmental experiences, including parenting, than others. Low birth weight (LBW, 1,500-2,499 g) may not only be a predictor for neurodevelopmental impairment but also a marker for prenatally programmed susceptibility. The aim was to test if effects of sensitive parenting on LBW and very LBW (VLBW, <1,500 g) versus normal birth weight (NBW, ≥2,500 g) children's academic achievement are best explained by a differential susceptibility versus diathesis-stress model of person-X-environment interaction.

METHODS

Nine hundred and twenty-two children ranging from 600 g to 5,140 g birth weight were studied as part of a prospective, geographically defined, longitudinal investigation of neonatal at-risk children in South Germany (Bavarian Longitudinal Study). Sensitive parenting during a structured mother-child interaction task was observed and rated at age 6 years. Academic achievement was assessed with standardized mathematic, reading, and spelling/writing tests at age 8 years.

RESULTS

Maternal sensitivity positively predicted the academic achievement of both LBW (n = 283) and VLBW (n = 202) children. Confirmatory-comparative and model-fitting analysis (testing LBW vs. NBW and VLBW vs. NBW) indicated that LBW and VLBW children were more susceptible than NBW to the adverse effects of low-sensitive, but not beneficial effects of high-sensitive parenting.

CONCLUSIONS

Findings proved more consistent with the diathesis stress than differential-susceptibility model of person-X-environment interaction: LBW and VLBW children's exposure to positive parenting predicted catch-up to their NBW peers, whereas exposure to negative parenting predicted much poorer functioning.

Relation of perinatal risk and early parenting to executive control at the transition to school

Executive control (EC) develops rapidly during the preschool years and is central to academic achievement and functional outcome. Although children with perinatal adversity are at known risk for EC impairments, little is known about the underlying nature of these impairments or the mechanisms that contribute to their development over time. Drawing on a cohort of 110 high-risk children born very preterm (VPT; < 33 weeks / < 1500 g) and 113 healthy full-term children, this study examined the implications of perinatal adversity and early parenting for children's EC as they transitioned to formal schooling. Parent supportive presence, intrusiveness, and parent-child synchrony were observed during a series of problem-solving tasks at ages 2 and 4 years. At age 6, children completed a comprehensive battery of EC tasks. Academic outcomes were assessed at age 9. The VPT group showed global EC impairments at age 6, although the unitary factor that best characterized the structure of EC was the same in both groups. High-risk dyads were characterized by more intrusive and less synchronous parent-child interactions in early childhood, which in turn predicted poorer child EC at age 6. EC partially mediated the relation of risk status to poorer academic achievement at age 9. Findings demonstrate the cumulative effects of perinatal adversity on children's EC in the crucial transition to schooling. They also highlight the importance of the parent-child relationship as a target for intervention efforts to help mitigate these effects.