Predicting attachment in Portuguese infants born very or extremely preterm: Understanding the roles of infant regulatory behavior, maternal sensitivity, and risk factors

A growing body of research shows that early attachment relationships are foundational for children's later developmental and psychosocial outcomes. However, findings are mixed regarding whether preterm birth predicts later attachment, but insecurity is generally more prevalent among infants at higher medical and/or social/familial risk. This longitudinal study aimed to identify specific relational, familial/demographic, and perinatal predictors of attachment in a sample of 63 Portuguese infants born very or extremely preterm (VEPT, <32 gestational weeks) and their mothers from diverse socioeconomic backgrounds. One-third of the mothers had social/family risk factors (e.g., single parent, immigrant, unemployed, low education, and/or low income). At 3 months (corrected age), dyads were observed during social interaction in the Face-to-Face Still-Face paradigm (FFSF) and during free play. At 12 months, mother-infant dyads were observed in Ainsworth's Strange Situation. Over half (58.7%) of the infants were classified as insecurely attached. Social-Positive Oriented regulatory behavior pattern, higher maternal sensitivity, higher infant cooperation during free play, number of siblings and an absence of social/family risk factors were associated with attachment security. Perinatal variables were unrelated to attachment. Findings indicate that both relational and social contextual factors contribute to attachment in this biologically vulnerable sample.

Associations of maternal postpartum depressive and anxiety symptoms with 4-month infant and mother self- and interactive contingency of gaze, affect, and touch

Maternal depression and anxiety are associated with infant and mother self- and interactive difficulties. Although maternal depression and anxiety usually co-occur, studies taking this comorbidity into account are few. Despite some literature, we lack a detailed understanding of how maternal depressive and anxiety symptoms may be associated with patterns of mother-infant interaction. We examined associations of maternal postpartum depressive and anxiety symptoms with infant and mother self- and interactive patterns by conducting multi-level time-series models in a sample of 56 Turkish mothers and their 4-month infants. Time-series models assessed the temporal dynamics of interaction via infant and mother self- and interactive contingency. Videotaped face-to-face interaction was coded on a 1s time base for infant and mother gaze and facial affect, infant vocal affect, and mother touch. Results indicated that mothers with high depressive symptoms were vulnerable to infants looking away, reacting with negative touch; their infants remained affectively midrange, metaphorically distancing themselves from mothers' affect. Mothers with high anxiety symptoms were vulnerable to infants becoming facially dampened and mothers reacted with negative facial affect. Altered infant and mother self-contingency patterns were largely opposite for maternal depressive and anxiety symptoms. These patterns describe foundational processes by which maternal postpartum mood is transmitted to the infant and which may affect infant development.

Maternal mind-mindedness over infants' first three months

Maternal mind-mindedness refers to mothers' ability to reflect upon their infants' mental states and respond appropriately. The present study assessed mind-mindedness longitudinally from the newborn period to the infant age of three months. The study is the first to assess maternal mind-mindedness in the infant's early life prior to three months (one week, one month, two months, three months). To measure maternal mind-mindedness, mothers' speech to their infants is coded for mental state comments about the infants' thoughts, desires, and emotions. Appropriate mind-minded comments are judged to accurately reflect the infants' mental states; non-attuned mind-minded comments are judged to misinterpret the infants' mental states. Mothers' individual stability (rank order stability) and group level continuity (mean level of stability across the infant ages) were assessed. Mothers showed modest temporal stability in both appropriate and non-attuned mind-mindedness over the infants' first three months. The continuity of mind-mindedness showed that appropriate mind-mindedness increased over the infant ages, but non-attuned mind-mindedness showed no change. In infants' early lives, mothers' ability to accurately interpret their infants' mental states is enhanced as the mother-infant relationship develops and infants become more communicative partners.

Influences of infants' and mothers' contingent vocal responsiveness on young infants' vocal social bids in the Still Face Task

Infants' social bids in the still face phase of the Still Face Task demonstrate their emerging sense of self agency as these behaviors happen in the absence of the partner's social overtures. The study examined the role of infants' contingent responsiveness to their mothers in social interactions on their social bidding to the mother when she becomes unresponsive. Social bids are non-distress vocalizations or smiles while looking at the unresponsive partner. Infants and their mothers longitudinally engaged in the Still Face Task when infants were one, two, and three months. At two months, infant non-distress vocalizations and smiles and contingent vocal and smiling responsiveness increased in the initial interactive phase and vocal and smile social bids increased in the still face phase. Infant contingent vocal responsiveness predicted infant vocal social bids but infant contingent smiling responsiveness did not predict infant smile social bids. Infant contingent vocal responsiveness was a stronger predictor than infant non-distress vocalizations per se of infant vocal social bids at two and three months. However, maternal contingent vocal responsiveness was the primary predictor of infant vocal social bids at these ages. Maternal contingent responsiveness to infant behavior allows infants to sense their agency in affecting their mothers' behavior. Yet infants are active participants, becoming contingently responsive to their mothers, which facilitates their awareness that they are effective agents in instigating social interaction, as demonstrated by social bids.

Intersubjectivity and the Emergence of Words

Intersubjectivity refers to two non-verbal intersubjective relations infants experience during their first year that are precursors to the emergence of words. Trevarthen, a pioneer in the study of intersubjectivity, referred to those relations as primary and secondary intersubjectivity. The former, a dyadic coordination between the infant and her caregiver, begins at birth. The latter, a triadic coordination that develops around 9 months, allows the infant and a caregiver to share attention to particular features of the environment. Secondary intersubjectivity is crucial for an infant’s ability to begin to produce words, at around 12 months. Much research on the social and cognitive origins of language has focused on secondary intersubjectivity. That is unfortunate because it neglects the fact that secondary intersubjectivity and the emergence of words are built on a foundation of primary intersubjectivity. It also ignores the evolutionary origins of intersubjectivity and its uniquely human status. That unique status explains why only humans learn words. This article seeks to address these issues by relating the literature on primary intersubjectivity, particularly research on bi-directional and contingent communication between infants and mothers, to joint attention and ultimately to words. In that context, we also discuss Hrdy’s hypothesis about the influence of alloparents on the evolution of intersubjectivity.

Infant behavioural effects of smartphone interrupted parent-infant interaction

Infants are vulnerable to changes in the dyadic synchrony with their caregivers, as demonstrated in numerous experiments employing the still-face paradigm. The sudden lack of attunement causes infant stress reactions and the still-face literature have suggested potential long-term costs of this in terms of development of social, emotional and cognitive skills. Acknowledging the rapid technological development accompanied by altered practices in the parent-infant interaction, the current study investigates infant behavioural reactions in a similar experimental paradigm, manipulating parental responsiveness and sensitivity in a slightly different manner. In the current study, the parent interrupts the ongoing interaction, simulating occupation with a smartphone, rather than making a 'still-face'. In a cross-sectional design, infants of six, nine and twelve months display increased levels of protest behaviour in response to the interrupted interaction with their parent, together with lowered levels of positive engagement and social monitoring, suggesting similar behavioural responses as the still-face effect. Implications for infant social and emotional development, as well as for mindful tech habits are discussed.

Associations between infant-mother physiological synchrony and 4- and 6-month-old infants' emotion regulation

In this study we assessed whether physiological synchrony between infants and mothers contributes to infants' emotion regulation following a mild social stressor. Infants between 4 and 6 months of age and their mothers were tested in the face-to-face-still-face paradigm and were assessed for behavioral and physiological self-regulation during and following the stressor. Physiological synchrony was calculated from a continuous measure of respiratory sinus arrhythmia (RSA) enabling us to cross-correlate the infants' and mothers' RSA responses. Without considering physiological synchrony, the evidence suggested that infants' distress followed the prototypical pattern of increasing during the Still Face episode and then decreasing during the reunion episode. Once physiological synchrony was added to the model, we observed that infants' emotion regulation improved if mother-infant synchrony was positive, but not if it was negative. This result was qualified further by whether or not infants suppressed their RSA response during the Still Face episode. In sum, these findings highlight how individual differences in infants' physiological responses contribute significantly to their self-regulation abilities.

An interactionist perspective on the development of coordinated social attention

Infants' ability to coordinate their attention with other people develops profoundly across the first year of life. Mainly based on experimental research focusing on infants' behavior under highly controlled conditions, developmental milestones were identified and explained in the past by prominent theories in terms of the onset of specific cognitive skills. In contrast to this approach, recent longitudinal research challenges this perspective with findings suggesting that social attention develops continuously with a gradual refinement of skills. Informed by these findings, we argue for an interactionist and dynamical systems view that bases observable advances in infant social attention skills on increasingly fine-tuned mutual adjustments in the caregiver-infant dyad, resulting in gradually improving mutual prediction. We present evidence for this view from recent studies leveraging new technologies which afford the opportunity to dynamically track social interactions in real-time. These new technically-sophisticated studies offer unprecedented insights into the dynamic processes of infant-caregiver social attention. It is now possible to track in much greater detail fluctuations over time with regard to object-directed attention as well as social attention and how these processes relate to one another. Encouraged by these initial results and new insights from this interactionist developmental social neuroscience approach, we conclude with a "call to action" in which we advocate for more ecologically valid paradigms for studying social attention as a dynamic and bi-directional process.

Mapping the Specific Pathways to Early-Onset Mental Health Disorders: The "Watch Me Grow for REAL" Study Protocol

BACKGROUND

From birth, the human propensity to selectively attend and respond to critical super-stimuli forms the basis of future socio-emotional development and health. In particular, the first super-stimuli to preferentially engage and elicit responses in the healthy newborn are the physical touch, voice and face/eyes of caregivers. From this grows selective attention and responsiveness to emotional expression, scaffolding the development of empathy, social cognition, and other higher human capacities. In this paper, the protocol for a longitudinal, prospective birth-cohort study is presented. The major aim of this study is to map the emergence of individual differences and disturbances in the system of social-Responsiveness, Emotional Attention, and Learning (REAL) through the first 3 years of life to predict the specific emergence of the major childhood mental health problems, as well as social adjustment and impairment more generally. A further aim of this study is to examine how the REAL variables interact with the quality of environment/caregiver interactions.

METHODS/DESIGN

A prospective, longitudinal birth-cohort study will be conducted. Data will be collected from four assessments and mothers' electronic medical records.

DISCUSSION

This study will be the first to test a clear developmental map of both the unique and specific causes of childhood psychopathology and will identify more precise early intervention targets for children with complex comorbid conditions.

Temporal Coordination in Mother-Infant Vocal Interaction: A Cross-Cultural Comparison

Temporal coordination of vocal exchanges between mothers and their infants emerges from a developmental process that relies on the ability of communication partners to co-coordinate and predict each other's turns. Consequently, the partners engage in communicative niche construction that forms a foundation for language in human infancy. While robust universals in vocal turn-taking have been found, differences in the timing of maternal and infant vocalizations have also been reported across cultures. In this study, we examine the temporal structure of vocal interactions in 38 mother-infant dyads in the first two years across two cultures-American and Lebanese-by studying observed and randomized distributions of vocalizations, focusing on both gaps and overlaps in naturalistic 10-min vocal interactions. We conducted a series of simulations using Kolmogorov-Smirnov (K-S) tests to examine whether the observed responsivity patterns differed from randomly generated simulations of responsivity patterns in both Arabic and English for mothers responding to infants and for infants responding to mothers. Results revealed that both mothers and infants engaged in conversational alternation, with mothers acting similarly across cultures. By contrast, significant differences were observed in the timing of infant responses to maternal utterances, with the Lebanese infants' tendency to cluster their responses in the first half-second after the offset of the Lebanese mothers' utterances to a greater extent than their American counterparts. We speculate that the results may be due to potential phonotactic differences between Arabic and English and/or to differing child-rearing practices across Lebanese and American cultures. The findings may have implications for early identification of developmental disorders such as autism spectrum disorders within and across cultures.

The effect of mother-infant skin-to-skin contact on Ghanaian infants' response to the Still Face Task: Comparison between Ghanaian and Canadian mother-infant dyads

The effect of mother-infant skin-to-skin contact on Ghanaian infants' developing social expectations for maternal behavior was investigated. Infants with high and low mother-infant skin-to-skin contact experience in the infants' first month engaged with their mothers in a Still Face Task at 6 weeks of age. Infants with high skin-to-skin contact experience, but not those with low skin-to-skin contact experience, demonstrated the still face effect with their smiles. Infants with both high and low skin-to-skin contact experience demonstrated the still face effect with their visual attention. The behaviors of the Ghanaian infants and their mothers during the task were compared to archival evidence of Canadian mother-infant dyads' behaviors in skin-to-skin and control groups who engaged in the Still Face Task at the infant ages of 1 and 2 months. Similarities and differences between the behaviors of the mother-infant dyads in the two cultures were assessed.

Depressed and non-depressed mothers' touching during social interactions with their infants

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Depressed mothers engage in less touching that is playful and interactive in nature.

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Depressed mothers touch their infants less during face-to-face interactions.

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Nondepressed mothers maintain high levels of touch following a perturbation period.

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Depressed mothers decrease playful/stimulating touch after a perturbation period.

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Implications for intervention programs of early touch stimulation for at-risk dyads.

Touch is a critical channel of communication used by mothers to communicate and interact with their infants and to contribute to their infants’ socio-emotional development. The present study examined maternal touching in 41 mothers with and without depressive symptomatology. Mothers and their 4-month-old infants participated in the Still-Face (maternal emotional unavailability) and Separation (maternal physical unavailability) procedures. Maternal touching behaviours were video-recorded and coded using the Caregiver Infant Touch Scale (CITS). Results indicated that mothers with higher levels of depressive symptoms engaged in less touching following the perturbation period in the Still-Face procedure, whereas mothers with lower levels of depressive symptoms maintained stable levels of touching across both interaction periods. Mothers with higher levels of depressive symptoms displayed less playful/stimulating types of touching. Taken together, these results underscore the importance of touch and suggest key differences in touching behaviour between dyads with maternal depressive symptomatology and those without.

Effects of adults' contingent responding on infants' behavior in ambiguous situations

We examined the effect of adults' contingency in responding to infants' behavior in an ambiguous situation in two experiments. In Experiment 1, forty-four 12-month-old infants were exposed to an ambiguous toy. An unfamiliar adult responded either contingently or non-contingently to the infant's bids and then presented the toy and provided positive information. During toy presentation, infants in the non-contingent condition looked less at the experimenter than infants in the contingent condition. In a concluding free-play situation infants in the non-contingent condition played less and tended to touch the toy less. In Experiment 2 (forty-four 12-month-old infants), the parent either responded promptly or with a delay each time the infant made contact initiatives and then presented an ambiguous toy and delivered the positive information. The infants in the non-contingent condition tended to look less at the parent during toy presentation and also tended to play less with the toy during the concluding free-play situation. The findings show that adults' contingency in responding influences infants' behavior in ambiguous situations.

Cross-site randomized control trial of the Social ABCs caregiver-mediated intervention for toddlers with autism spectrum disorder

To evaluate the efficacy of the Social ABCs parent-mediated intervention for toddlers with suspected or confirmed autism spectrum disorder (ASD), through a cross-site randomized control trial, sixty-three parent-toddler dyads (toddler age: 16-30 months) were randomized into treatment (Social ABCs) or control (service-as-usual) conditions. Video data were obtained at three key time-points: Baseline; Post-training (PT; week 12); and Follow-Up (week 24). Analyses included 62 dyads. Treatment allocation significantly accounted for PT gains, all favouring the Treatment group, in (1) child functional vocal responsiveness to parent prompts (R²  = 0.43, P < .001), (2) child vocal initiations (R²  = 0.28, P < .001), (3) parent smiling (R²  = 0.09, P = .017), and (4) fidelity of implementation (R²  = 0.71, P < .001). A trend was observed for increased social orienting (R²  = 0.06, P = 0.054); gains in parent smiling significantly predicted increases in child smiling and social orienting. Parents in the treatment condition reported significant gains in self-efficacy following the intervention (P = 0.009). No differential effects emerged for performance on standardized measures. The Social ABCs is a relatively low-resource, efficacious intervention, with potential to be a cost-effective means of intervening at the first signs of possible ASD. Autism Res 2017, 10: 1700-1711. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Clinical Trial Title: Social ABCs for Toddlers with Signs of Autism Spectrum Disorder: RCT of a Parent-Mediated Intervention http//ClinicalTrials.gov identifier: NCT02428452.

Emergence of Functional Flexibility in Infant Vocalizations of the First 3 Months

Functional flexibility, as manifest in the use of any word or sentence to express different affective valences on different occasions, is required in linguistic communication and can be said to be an infrastructural property of language. Early infant vocalizations (protophones), believed to be precursors to speech, occur in the first month and are functionally different from non-speech-like signals (e.g., cries and laughs). Oller et al. (2013) showed that infants by 3 months used three different protophone types with a full range of affect as manifest in facial expression, from positive to neutral to negative. These differences in affect were also shown to correspond to different illocutionary functions, unlike fixed signals, or vegetative sounds, which showed functional rigidity. The present study investigated whether infants show functional flexibility in protophones even earlier than the ages studied by Oller et al. (2013). Data were obtained from 6 infants across the first 3 months. Results showed that as early as the first month, infant protophones were already accompanied by variable facial affect valences and continued to be affectively flexible at the later ages. The present study thus documents the very early emergence of an infrastructural property of human communication.