1
|
Neel ML, Jeanvoine A, Key A, Stark AR, Norton ES, Relland LM, Hay K, Maitre NL. Behavioral and neural measures of infant responsivity increase with maternal multisensory input in non-irritable infants. Brain Behav 2023; 13:e3253. [PMID: 37786238 PMCID: PMC10636412 DOI: 10.1002/brb3.3253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 10/04/2023] Open
Abstract
INTRODUCTION Parents often use sensory stimulation during early-life interactions with infants. These interactions, including gazing, rocking, or singing, scaffold child development. Previous studies have examined infant neural processing during highly controlled sensory stimulus presentation paradigms. OBJECTIVE In this study, we investigated infant behavioral and neural responsiveness during a mother-child social interaction during which the mother provided infant stimulation with a progressive increase in the number of sensory modalities. METHODS We prospectively collected and analyzed video-coded behavioral interactions and electroencephalogram (EEG) frontal asymmetry (FAS) from infants (n = 60) at 2-4 months born at ≥ 34 weeks gestation. As the number of sensory modalities progressively increased during the interaction, infant behaviors of emotional connection in facial expressiveness, sensitivity to mother, and vocal communication increased significantly. Conversely, infant FAS for the entire cohort did not change significantly. However, when we accounted for infant irritability, both video-coded behaviors and EEG FAS markers of infant responsiveness increased across the interaction in the non-irritable infants. The non-irritable infants (49%) demonstrated positive FAS, indicating readiness to engage with, rather than to withdraw from, multisensory but not unisensory interactions with their mothers. RESULTS These results suggest that multisensory input from mothers is associated with greater infant neural approach state and highlight the importance of infant behavioral state during neural measures of infant responsiveness.
Collapse
Affiliation(s)
- Mary Lauren Neel
- Department of Pediatrics & NeonatologyEmory University School of Medicine & Children's Healthcare of AtlantaAtlanta, GAUSA
| | - Arnaud Jeanvoine
- The Abigail Wexner Research Institute at Nationwide Children's HospitalColumbus, OHUSA
| | | | - Ann R. Stark
- Department of Pediatrics & NeonatologyBeth Israel Deaconess Medical Center & Harvard Medical SchoolBoston, MAUSA
| | | | - Lance M. Relland
- The Abigail Wexner Research Institute at Nationwide Children's HospitalColumbus, OHUSA
- Department of Anesthesiology & Pain MedicineNationwide Children's Hospital & The Ohio State UniversityColumbus, OHUSA
| | - Krystal Hay
- The Abigail Wexner Research Institute at Nationwide Children's HospitalColumbus, OHUSA
| | - Nathalie L. Maitre
- Department of Pediatrics & NeonatologyEmory University School of Medicine & Children's Healthcare of AtlantaAtlanta, GAUSA
| |
Collapse
|
2
|
Wang J, Shen X, Yang H, Li Z, Liang S, Wu F, Tang X, Mao X, He M, Xu F, Li X, Li C, Qian S, Zhu X, Meng F, Wu Y, Gao H, Cao J, Yin H, Wang Y, Huang Y. Early markers of neurodevelopmental disorders based on general movements for very preterm infants: study protocol for a multicentre prospective cohort study in a clinical setting in China. BMJ Open 2023; 13:e069692. [PMID: 37142311 PMCID: PMC10163464 DOI: 10.1136/bmjopen-2022-069692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
INTRODUCTION Very preterm (VPT) infants may experience varying degrees of neurodevelopmental challenges. Lack of early markers for neurodevelopmental disorders may delay referral to early interventions. The detailed General Movements Assessment (GMA) could help us to identify early markers for VPT infants at risk of atypical neurodevelopmental clinical phenotype in the very early stage of life as soon as possible. Preterm infants with high risk of atypical neurodevelopmental outcomes will have the best possible start to life if early precise intervention in critical developmental windows is allowed. METHODS AND ANALYSIS This is a nationwide, multicentric prospective cohort study that will recruit 577 infants born <32 weeks of age. This study will determine the diagnostic value of the developmental trajectory of general movements (GMs) at writhing and fidgety age with qualitative assessment for different atypical developmental outcomes at 2 years evaluated by the Griffiths Development Scales-Chinese. The difference in the General Movement Optimality Score (GMOS) will be used to distinguish normal (N), poor repertoire (PR) and cramped sychronised (CS) GMs. We plan to build the percentile rank of GMOS (median, 10th, 25th, 75th and 90th percentile rank) in N, PR and CS of each global GM category and analyse the relationship between GMOS in writhing movements and Motor Optimality Score (MOS) in fidgety movements based on the detailed GMA. We explore the subcategories of the GMOS list, and MOS list that may identify specific early markers that help us to identify and predict different clinical phenotypes and functional outcomes in VPT infants. ETHICS AND DISSEMINATION The central ethical approval has been confirmed from the Research Ethical Board of Children's Hospital of Fudan University (ref approval no. 2022(029)) and the local ethical approval has been also obtained by the corresponding ethics committees of the recruitment sites. Critical analysis of the study results will contribute to providing a basis for hierarchical management and precise intervention for preterm infants in very early life. TRIAL REGISTRATION NUMBER ChiCTR2200064521.
Collapse
Affiliation(s)
- Jun Wang
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Xiushu Shen
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Hong Yang
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Zhihua Li
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Shuyi Liang
- Department of Rehabilitation, Xiamen Children's Hospital, Xiamen, China
| | - Furong Wu
- Department of Rehabilitation, Xiamen Children's Hospital, Xiamen, China
| | - Xinglu Tang
- Department of Rehabilitation, Taizhou Women and Children's Hospital, Taizhou, China
| | - Xujie Mao
- Department of Neonatology, Yueqing People's Hospital, Yueqing, China
| | - Minsi He
- Department of Rehabilitation, Panyu Maternal and Child Health Hospital, Guangzhou, China
| | - Fengdan Xu
- Department of Neonatology, Dongguan Children's Hospital, Dongguan, China
| | - Xueyan Li
- Department of Rehabilitation, Dehong People's Hospital, Dehong, China
| | - Chengmei Li
- Department of Rehabilitation, Dehong People's Hospital, Dehong, China
| | | | - Xiaoyun Zhu
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Fanzhe Meng
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Yun Wu
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Herong Gao
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Jiayan Cao
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Huanhuan Yin
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Yin Wang
- Clinical Trial Unit, Children's Hospital of Fudan University, Shanghai, China
| | - Yanxiang Huang
- Shanghai Medical College of Fudan University, Shanghai, China
| |
Collapse
|
3
|
Kilbride HW, Vohr BR, McGowan EM, Peralta-Carcelen M, Stringer K, Das A, Archer SW, Hintz SR. Early neurodevelopmental follow-up in the NICHD neonatal research network: Advancing neonatal care and outcomes, opportunities for the future. Semin Perinatol 2022; 46:151642. [PMID: 35842320 PMCID: PMC11068160 DOI: 10.1016/j.semperi.2022.151642] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
At the inception of the Eunice Kennedy Shriver National Institute of Child Health and Development Neonatal Research Network (NRN), provision of care for extremely preterm (EPT) infants was considered experimental. The NRN Follow-up Study Group, initiated in 1993, developed infrastructure with certification processes and standards, allowing the NRN to assess 2-year outcomes for EPT and to provide important metrics for randomized clinical trials. This chapter will review the NRN Follow-up Study Group's contributions to understanding factors related to improved neurodevelopmental, behavioral, and social-emotional outcomes of EPT infants. We will also discuss follow up challenges, including reassessing which outcomes are most meaningful for parents and investigators. Finally, we will explore how outcome studies have informed clinical decisions and ethical considerations, given limitations of prediction of complex later childhood outcomes from early neurodevelopmental findings.
Collapse
Affiliation(s)
- Howard W Kilbride
- Department of Pediatrics, Children's Mercy-Kansas City and the University of Missouri-Kansas City, 2401 Gillham Road, 3rd Floor Annex, Kansas City, MO.
| | - Betty R Vohr
- Department of Pediatrics, Women and Infants Hospital of Rhode Island and Brown University, Providence, RI
| | - Elisabeth M McGowan
- Department of Pediatrics, Women and Infants Hospital of Rhode Island and Brown University, Providence, RI
| | | | - Kimberlly Stringer
- Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL
| | - Abhik Das
- Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville, MD
| | - Stephanie Wilson Archer
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Susan R Hintz
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA
| |
Collapse
|
4
|
McKenzie K, Lynch E, Msall ME. Scaffolding Parenting and Health Development for Preterm Flourishing Across the Life Course. Pediatrics 2022; 149:186921. [PMID: 35503323 PMCID: PMC9847416 DOI: 10.1542/peds.2021-053509k] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 01/21/2023] Open
Abstract
Advances in obstetrics and neonatal medicine have resulted in improved survival rates for preterm infants. Remarkably, >75% extremely (<28 weeks) preterm infants who leave the NICU do not experience major neurodevelopmental disabilities, although >50% experience more minor challenges in communication, perception, cognition, attention, regulatory, and executive function that can adversely impact educational and social function resulting in physical, behavioral, and social health issues in adulthood. Even late premature (32-36 weeks) infants have more neurodevelopmental challenges than term infants. Although early intervention and educational programs can mitigate risks of prematurity for children's developmental trajectories, restrictive eligibility requirement and limitations on frequency and intensity mean that many premature infants must "fail first" to trigger services. Social challenges, including lack of family resources, unsafe neighborhoods, structural racism, and parental substance use, may compound biological vulnerabilities, yet existing services are ill-equipped to respond. An intervention system for premature infants designed according to Life Course Health Development principles would instead focus on health optimization from the start; support emerging developmental capabilities such as self-regulation and formation of reciprocal secure early relationships; be tailored to each child's unique neurodevelopmental profile and social circumstances; and be vertically, horizontally, and longitudinally integrated across levels (individual, family, community), domains (health, education), and time. Recognizing the increased demands placed on parents, it would include parental mental health supports and provision of trauma-informed care. This developmental scaffolding would incorporate parenting, health, and developmental interventions, with the aim of improved health trajectories across the whole of the life course.
Collapse
Affiliation(s)
- Kamryn McKenzie
- University of Chicago Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Chicago, Illinois
| | - Emma Lynch
- University of Chicago Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Chicago, Illinois
| | - Michael E. Msall
- Address correspondence to Address correspondence to: Michael E. Msall, MD, Section of Developmental and Behavioral Pediatrics, University of Chicago Kennedy Research Center and Comer Children's Hospital, 936 East 61 St Street, Room 207, Chicago, IL 60637. E-mail:
| |
Collapse
|
5
|
Neel ML, de Silva A, Taylor HG, Benninger K, Busch T, Hone E, Moore-Clingenpeel M, Pietruszewski L, Maitre NL. Exceeding expectations after perinatal risks for poor development: associations in term- and preterm-born preschoolers. J Perinatol 2022; 42:491-498. [PMID: 34711935 DOI: 10.1038/s41372-021-01254-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To define parenting/social characteristics associated with better-than-expected cognitive and motor outcomes in preschoolers at similar perinatal biological risk-level including various gestational ages at birth (GA) and perinatal complications. STUDY DESIGN Prospective cohort study (n = 87) of children at four years, median GA 29 weeks (IQR 26, 38). Assessments included Differential Ability Scales, Movement Assessment Battery, parenting styles, and social risk scores. Perinatal risk factors were weighted based on regression models for each outcome; individual calculated risk scores became predictors to extract standardized residuals from the mean (>1 SD above mean = better-than-expected). Mixed-effect regressions examined associations between positive adaptation and parenting/social factors. RESULT Perinatal risk scores explained 21-53% outcome variability. Children across all GA displayed positive adaptation. Children of parents with higher authoritarian scores had higher odds of better-than-expected outcomes (OR 1.17, p = 0.0002). CONCLUSION Parental structure may promote positive adaptation at preschool age in children with perinatal risk factors for poor development, including extreme prematurity.
Collapse
Affiliation(s)
- Mary Lauren Neel
- Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA. .,Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Aryanne de Silva
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - H Gerry Taylor
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA.,Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Kristen Benninger
- Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Tyler Busch
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, USA
| | - Emily Hone
- Biostatistics Core, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Melissa Moore-Clingenpeel
- Biostatistics Core, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Lindsay Pietruszewski
- Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Nathalie L Maitre
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA, USA
| |
Collapse
|
6
|
Vanes LD, Hadaya L, Kanel D, Falconer S, Ball G, Batalle D, Counsell SJ, Edwards AD, Nosarti C. Associations Between Neonatal Brain Structure, the Home Environment, and Childhood Outcomes Following Very Preterm Birth. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:146-155. [PMID: 34471914 PMCID: PMC8367847 DOI: 10.1016/j.bpsgos.2021.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/16/2021] [Accepted: 05/06/2021] [Indexed: 12/31/2022] Open
Abstract
Background Very preterm birth is associated with an increased risk of childhood psychopathology and cognitive deficits. However, the extent to which these developmental problems associated with preterm birth are amenable to environmental factors or determined by neurobiology at birth remains unclear. Methods We derived neonatal brain structural covariance networks using non-negative matrix factorization in 384 very preterm infants (median gestational age [range], 30.29 [23.57–32.86] weeks) who underwent magnetic resonance imaging at term-equivalent age (median postmenstrual age, 42.57 [37.86–44.86] weeks). Principal component analysis was performed on 32 behavioral and cognitive measures assessed at preschool age (n = 206; median age, 4.65 [4.19–7.17] years) to identify components of childhood psychopathology and cognition. The Cognitively Stimulating Parenting Scale assessed the level of cognitively stimulating experiences available to the child at home. Results Cognitively stimulating parenting was associated with reduced expression of a component reflecting developmental psychopathology and executive dysfunction consistent with the preterm phenotype (inattention-hyperactivity, autism spectrum behaviors, and lower executive function scores). In contrast, a component reflecting better general cognitive abilities was associated with larger neonatal gray matter volume in regions centered on key nodes of the salience network, but not with cognitively stimulating parenting. Conclusions Our results suggest that while neonatal brain structure likely influences cognitive abilities in very preterm children, the severity of behavioral symptoms that are typically observed in these children is sensitive to a cognitively stimulating home environment. Very preterm children may derive meaningful mental health benefits from access to cognitively stimulating experiences during childhood.
Collapse
Affiliation(s)
- Lucy D. Vanes
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Address correspondence to Lucy D. Vanes, Ph.D.
| | - Laila Hadaya
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Dana Kanel
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Shona Falconer
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Gareth Ball
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Developmental Imaging, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Dafnis Batalle
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Serena J. Counsell
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - A. David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| |
Collapse
|
7
|
Oosterom L, Bogičević L, Verhoeven M, van Baar AL. Parenting Behavior at 18 Months Predicts Internalizing and Externalizing Problems at 6 Years in Moderately Preterm and Full Term Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228679. [PMID: 33238382 PMCID: PMC7700126 DOI: 10.3390/ijerph17228679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/14/2020] [Accepted: 11/20/2020] [Indexed: 11/24/2022]
Abstract
Moderately preterm born children (MPT) are at increased risk for behavior problems compared to full term born (FT) children. MPT children may receive less optimal parenting, and in response, may develop behavior problems. Our aims were to examine whether parenting behavior and mother–child interaction quality mediate the association between birth status and child behavior problems. Participants were 120 MPT children and 100 FT children. At 18 months of age, mothers reported on their parenting behavior (support and structure), and mother–child interaction (sensitivity and limit-setting) was observed. At 6 years of age, mothers reported on children’s behavior problems. Using structural equation modeling, birth status was found to predict attention problems, but not internalizing and externalizing problems. Mothers of MPT children set less appropriate limits than mothers of FT children at 18 months of age. More maternal structure at 18 months predicted fewer internalizing and externalizing problems, but not attention problems, at 6 years. These associations between parenting behavior, mother–child interaction quality, and child behavior problems were similar for MPT and FT children. Our findings indicate that maternal structure in toddlerhood is an important predictor of later internalizing and externalizing problems for both MPT and FT children.
Collapse
|
8
|
Endendijk JJ, Bos PA, Smit AK, van Baar AL. Pictures of preterm infants elicit increased affective responses and reduced reward-motivation or perspective taking in the maternal brain. Behav Brain Res 2020; 390:112677. [PMID: 32407823 DOI: 10.1016/j.bbr.2020.112677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/01/2020] [Accepted: 04/26/2020] [Indexed: 10/24/2022]
Abstract
Preterm-birth increases the risk of several physical, cognitive, neuromotor, and psychosocial problems in children, and is also related to difficulties in the parent-child relationship. Research suggests that the development of early parent-child interactions in general is affected by deviations from typical infant facial characteristics, which may also be important in the case of small, preterm born infants. Therefore, we examined mothers' (N = 22, of whom 17 had no direct experience with preterm birth) neural responses to pictures of preterm and full-term infants using functional magnetic resonance imaging (fMRI). We also explored whether neural responses to preterm and full-term infants correlated with mothers' self-reported tendencies to be nurturing and protective with children, and with mothers' ratings of affection or aversion toward pictures of preterm infants. Results revealed that, compared to pictures of full-term infants, those of preterm infants elicited more activity in specific areas of the brain (dmPFC, right insula, left caudate, hippocampi, parahippocampi, and PAG), that have previously been associated with processing of negative emotions and with empathy. In addition, less activity was seen in one area of the brain (vmPFC) known to be associated with reward-motivation or mental state understanding and perspective-taking. Higher self-reported maternal nurturance was associated with increased activity to pictures of preterm infants vs full-term infants in the caudate, which might reflect approach- or reward-related processing. To conclude, neural responses to preterm infants are related to reward-motivation, mentalizing, negative emotions, and empathy. Future studies should examine whether such neural processing of preterm infant stimuli might underlie difficulties in the parent-child relationship of parents with a preterm child.
Collapse
Affiliation(s)
- Joyce J Endendijk
- Child and Adolescent Studies, Utrecht University, Heidelberglaan 1, 3548 CS Utrecht, the Netherlands.
| | - Peter A Bos
- Institute of Education and Child Studies, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands; Department of Experimental Psychology, Utrecht University, Heidelberglaan 1, 3548 CS Utrecht, the Netherlands
| | - Anne K Smit
- Department of Child and Adolescent Psychiatry, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands
| | - Anneloes L van Baar
- Child and Adolescent Studies, Utrecht University, Heidelberglaan 1, 3548 CS Utrecht, the Netherlands
| |
Collapse
|
9
|
Abstract
OBJECTIVE This meta-analysis tested whether parents of preterm-born children differ from parents of full-term-born children regarding controlling parenting. METHODS Databases of PubMed, Scopus, Web of Science, Open Access Theses and Dissertations, and Elton B. Stephens Company were searched for cross-sectional and prospective longitudinal studies examining controlling parenting in preterm-born children. RESULTS The meta-analysis included 27 independent data sets, derived from 34 studies, with a total of 8053 participants-3265 preterm and 4788 full-term children. Parents of children born preterm were more controlling than parents of children born full-term (Hedges' g = 0.29; 95% confidence interval: 0.19-0.39; z = 5.48; p < 0.001). Heterogeneity analysis indicated significant variation in effects between studies (Q = 148.46, p < 0.001), but the effects were not moderated by gestational age, birth weight, child age, child gender, parental education, type of parenting assessment method (observational vs parental self-report), parenting dimension measured (behaviors vs attitudes), type of controlling parenting (intrusiveness vs others), study design (cross-sectional vs longitudinal), year of publication, or geographical setting of the studies (America vs Europe). CONCLUSION Findings suggest that parents of children born preterm are at higher risk for engaging in controlling parenting strategies, stressing the importance of psychosocial follow-up support for these parents.
Collapse
|
10
|
Neel ML, Slaughter JC, Stark AR, Maitre NL. Parenting style associations with sensory threshold and behaviour: a prospective cohort study in term/preterm infants. Acta Paediatr 2019; 108:1616-1623. [PMID: 30790352 DOI: 10.1111/apa.14761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 02/01/2019] [Accepted: 02/18/2019] [Indexed: 11/29/2022]
Abstract
AIM Early-life atypical sensory functioning and behavioural profiles are often associated with long-term developmental problems, especially in former preterm infants. We tested whether parenting style is associated with atypical sensory threshold or behavioural outcomes in preterm and term infants assessed during early childhood. METHODS We prospectively evaluated parenting style for a cohort of term and preterm infants who had previous assessments of sensory development and behaviour. We used standardised tools to evaluate parenting style, sensory neurological threshold at one year, and internalising and externalising behavioural tendencies at two years. Covariates included gestational age, sex and maternal education. RESULTS For the entire cohort (n = 82), children of more permissive parents were 2.7 times more likely to demonstrate abnormal sensory neurological thresholds compared to children of parents with less permissive styles (CI: 1.4-4.9). More permissive parenting scores were also associated with 2.4 times increased internalising (CI: 1.3-4.2) and 3.0 times increased externalising (CI: 1.6-5.6) tendencies. In the preterm group only, higher authoritative parenting scores were associated with fewer behavioural problems. CONCLUSION Permissive parenting is associated with worse infant sensory and behavioural outcomes. Authoritative parenting is associated with fewer behavioural problems in preterm children. Modification of parenting style may improve sensory development and behavioural outcomes.
Collapse
Affiliation(s)
- Mary Lauren Neel
- Vanderbilt University Medical Center Nashville TN USA
- Nationwide Children's Hospital The Ohio State University Columbus OH USA
| | | | - Ann R. Stark
- Vanderbilt University Medical Center Nashville TN USA
- Beth Israel Deaconess Medical Center Boston MA USA
| | - Nathalie L. Maitre
- Nationwide Children's Hospital The Ohio State University Columbus OH USA
| |
Collapse
|
11
|
Peralta-Carcelen M, Schwartz J, Carcelen AC. Behavioral and Socioemotional Development in Preterm Children. Clin Perinatol 2018; 45:529-546. [PMID: 30144853 DOI: 10.1016/j.clp.2018.05.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Prematurity is a significant risk factor for impaired neurodevelopmental outcomes. These include motor, cognitive, language, behavioral, and socioemotional competence. Long-term overall function depends on healthy socioemotional functioning. The vulnerability of the preterm brain during critical periods of development contributes to behavioral and socioemotional problems in preterm children. Attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) clinical features are more frequent in preterm children compared with their full-term counterparts; however, true rates of ASD and ADHD vary across studies. Early detection of behavioral and socioemotional problems in preterm children would enable timely early intervention to improve long-term functional outcomes.
Collapse
Affiliation(s)
- Myriam Peralta-Carcelen
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Alabama at Birmingham, Dearth Tower Suite 5602, McWane. 1600 7th Avenue South, Birmingham, AL 35233-1711, USA.
| | - Justin Schwartz
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Alabama at Birmingham, Dearth Tower Suite 5602, McWane. 1600 7th Avenue South, Birmingham, AL 35233-1711, USA
| | - Andrea C Carcelen
- International Health Department, John Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room 5517, Baltimore, MD, USA
| |
Collapse
|
12
|
Neel MLM, Stark AR, Maitre NL. Parenting style impacts cognitive and behavioural outcomes of former preterm infants: A systematic review. Child Care Health Dev 2018; 44:507-515. [PMID: 29575031 PMCID: PMC6005730 DOI: 10.1111/cch.12561] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 01/12/2018] [Accepted: 01/30/2018] [Indexed: 11/30/2022]
Abstract
We sought to evaluate published evidence in aggregate regarding the impact of parenting style on the cognitive and behavioural outcomes of former preterm infants. We searched 5 databases using germane MeSH terms. Parenting style was defined as any descriptor of parenting using ≥2 dimensions on published parenting axes. We evaluated studies for quality of evidence and strength of recommendations using standardized tools and categorized summative recommendations by parenting axis and child outcome. Twenty-seven articles met our inclusion criteria. Parental responsivity is the only parenting axis strongly associated with both improved child cognition and behaviour. Parental demandingness is associated only with improved child cognition, and parental warmth and rejection are associated only with child behaviour. Parental coercion is not associated with subsequent child outcomes. Parental responsivity may be essential in optimizing neurodevelopment in former preterm infants. More targeted studies are needed to inform this relationship and identify opportunities for intervention.
Collapse
Affiliation(s)
- Mary Lauren M. Neel
- Neonatal-Perinatal Medicine, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Vanderbilt University Medical Center, , 615-322-3476
| | - Ann R. Stark
- Department of Pediatrics; Fellowship Program Director, Neonatal-Perinatal Medicine, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Vanderbilt University Medical Center, , 615-322-3475
| | - Nathalie L. Maitre
- Department of Pediatrics; Principal Investigator, Center for Perinatal Research; Director, NICU Follow-Up Programs, Nationwide Children’s Hospital and the Ohio State University, , 614-722-4559
| |
Collapse
|
13
|
Zmyj N, Witt S, Weitkämper A, Neumann H, Lücke T. Social Cognition in Children Born Preterm: A Perspective on Future Research Directions. Front Psychol 2017; 8:455. [PMID: 28611695 PMCID: PMC5447081 DOI: 10.3389/fpsyg.2017.00455] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 03/13/2017] [Indexed: 11/13/2022] Open
Abstract
Preterm birth is a major risk factor for children’s development. It affects children’s cognitive and intellectual development and is related to impairments in IQ, executive functions, and well-being, with these problems persisting into adulthood. While preterm children’s intellectual and cognitive development has been studied in detail, their social development and social-cognitive competencies have received less attention. Namely, preterm children show problems in interactions with others. These interaction problems are present in relationships with parents, teachers, and peers. Parents’ behavior has been identified as a possible mediator of children’s social behavior. Maternal sensitivity and responsiveness as well as absence of mental disorders foster children’s social development. In this article, we will report on the social side of impairments that preterm children face. The review of the literature revealed that preterm infants’ joint attention abilities are impaired: They are less likely to initiate joint attention with others and to respond to others’ efforts to engage in joint attention. These deficits in joint attention might contribute to later impairments in social cognition, which in turn might affect social interaction skills. Based on these three domains (i.e., problems in social interaction, parental behavior, and impairments in joint attention), we suggest that preterm children’s social cognitive abilities should be investigated more intensively.
Collapse
Affiliation(s)
- Norbert Zmyj
- Institute of Psychology, TU Dortmund UniversityDortmund, Germany
| | - Sarah Witt
- Institute of Psychology, TU Dortmund UniversityDortmund, Germany
| | - Almut Weitkämper
- Department of Neuropediatrics, University Children's Hospital, Ruhr-Universität BochumBochum, Germany
| | - Helmut Neumann
- Department of Neuropediatrics, University Children's Hospital, Ruhr-Universität BochumBochum, Germany
| | - Thomas Lücke
- Department of Neuropediatrics, University Children's Hospital, Ruhr-Universität BochumBochum, Germany
| |
Collapse
|
14
|
Neri E, Agostini F, Baldoni F, Facondini E, Biasini A, Monti F. Preterm infant development, maternal distress and sensitivity: The influence of severity of birth weight. Early Hum Dev 2017; 106-107:19-24. [PMID: 28189798 DOI: 10.1016/j.earlhumdev.2017.01.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 12/04/2016] [Accepted: 01/31/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the influence of the severity of prematurity based on birth weight on maternal distress and sensitivity and on infant development. METHODS Sixty-eight mothers and their preterm babies (30 babies classified into Extremely-Low-Birth Weight-ELBW and 38 into Very-Low-Birth Weight-VLBW) were assessed at 9months of infant corrected age, using: Griffiths Scales for infant development, CARE-Index for maternal sensitivity during 5-minute of mother-infant interaction, and Parenting Stress Index-Short Form (PSI-SF) for maternal distress. Sixty-six healthy full-term infants (FT) and their mothers were assessed with the same procedure. RESULTS ELBW, VLBW and FT groups showed similar levels at CARE-Index and PSI-SF. Nevertheless, considering infant development as outcome, a significant interaction between birth weight and maternal distress emerged, with higher Hearing & Language mean quotients in association with Non-Distressed mothers, but only in VLBW infants, compared to FT ones. Also the interaction between birth weight and maternal sensitivity influenced infant development: higher quotients (Eye-hand coordination, Hearing & Language, Locomotor) were significantly associated with sensitive mothers but only in ELBW infants. CONCLUSION The severity of prematurity, in interaction with the degree of maternal distress and sensitivity, influenced the level of infant development. PRACTICAL IMPLICATIONS Taken together, these results suggest the relevance of considering severity of prematurity and maternal variables in order to implement appropriate interventions for supporting parenting role after a preterm birth and promoting an adequate infant development.
Collapse
Affiliation(s)
- Erica Neri
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy.
| | - Francesca Agostini
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| | - Franco Baldoni
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| | - Elisa Facondini
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| | - Augusto Biasini
- Pediatric and Neonatal Intensive Care Unit, Bufalini Hospital, Viale Ghirotti 286, 47521 Cesena, Italy
| | - Fiorella Monti
- Department of Psychology, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| |
Collapse
|
15
|
van de Weijer-Bergsma E, Wijnroks L, van Haastert IC, Boom J, Jongmans MJ. Does the development of executive functioning in infants born preterm benefit from maternal directiveness? Early Hum Dev 2016; 103:155-160. [PMID: 27689894 DOI: 10.1016/j.earlhumdev.2016.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 09/12/2016] [Accepted: 09/17/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Problems in early development of executive functioning may underlie the vulnerability and individual variability of infants born preterm for behavioral and learning problems. Parenting behaviors may aggravate or temper this increased risk for dysfunction. This study assessed how maternal parenting behaviors predict individual differences in early development of executive functioning in infants born preterm, and whether this varies with infant temperament, i.e., self-regulation. METHODS Participants were 76 infants born preterm (≤36weeks' gestation and <2500g birth weight) and their mothers. Maternal sensitive responsiveness and directiveness were observed during a mother-infant interaction situation at 7, 10 and 14months corrected age. At the same ages, executive functioning was measured using the A-not-B task. An infant self-regulation questionnaire (IBQ-R) was completed by mothers at 7months. RESULTS After controlling for perinatal risk factors, Multivariate Latent Growth Modeling showed that consistently higher levels of maternal directiveness predicted a stronger increase in A-not-B performance, which did not vary with infant self-regulation. No relationship between maternal sensitive responsiveness and development in A-not-B performance in infants born preterm was found. CONCLUSIONS These results suggest that preterm infants' early executive functioning development in the first year of life may benefit from a more and consistent directive approach by their mothers. These findings have important implications for early intervention programs aimed at facilitating preterm infants' development.
Collapse
Affiliation(s)
- Eva van de Weijer-Bergsma
- Utrecht University, Faculty of Social and Behavioral Sciences, Department of Pedagogical and Educational Sciences, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands.
| | - Lex Wijnroks
- Utrecht University, Faculty of Social and Behavioral Sciences, Department of Pedagogical and Educational Sciences, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
| | - Ingrid C van Haastert
- Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Jan Boom
- Utrecht University, Faculty of Social and Behavioral Sciences, Department of Developmental Psychology, Utrecht, The Netherlands
| | - Marian J Jongmans
- Utrecht University, Faculty of Social and Behavioral Sciences, Department of Pedagogical and Educational Sciences, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
| |
Collapse
|