Predicting externalizing behaviors in typically developing toddlers at 24 months: Insights from parenting at 12 months

Early observational assessment of parent and child behaviors may identify risk factors associated with the development of early child externalizing behaviors. This study aimed to examine factors associated with child externalizing behaviors at 24-months of age, including early maternal depression, family social risk and the parent-child relationship. Using a longitudinal design in 89 mother-child dyads (n = 43 female), maternal depressive symptoms and social risk were measured post-birth, and 12-months later parent-child interaction was assessed using the Emotional Availability Scales. To assess child externalizing behaviors, a parent-report questionnaire was administered when children were 24-months old. Increased early maternal depressive symptoms (p = .03), but not higher social risk (p = 0.17), were associated with higher child externalizing behaviors in children at age 24-months. After adjusting for early maternal depressive symptoms and familial social risk, lower levels of observed maternal structuring (β = -2.60, 95 %CI = -4.56, -0.64, p = .01) and lower levels of non-hostility (β = -3.39, 95 %CI -6.64, -0.14, p = .04) when the child was 12-months old were associated with higher parent-report of externalizing behaviors. However, the child's observed interaction behavior was not associated with the mother's report of child externalizing behavior. Interventions targeting specific post-natal maternal mental health and early parenting behaviors may reduce the risk for the development of later child externalizing problems.

Being an Infant in a Pandemic: Influences of the COVID-19 Pandemic on Infants, Toddlers and Their Mothers in a Clinical Population

The COVID-19 pandemic and the ongoing lockdowns might have had a strong impact on mental health of mothers and their infants/toddlers. For example, families had to deal with health issues and social isolation, which might have affected mental health and parent-child interactions. The aim of this study is to evaluate differences in (1) infantile regulatory disorders, (2) maternal mental health, (3) the impact of maternal mental health on infantile regulatory disorders, and (4) alterations in the mother-child interaction for participants recruited before versus after the onset of the first German lockdown. For this reason, mother-child dyads have been divided into two groups and were compared by analyzing clinical interviews on psychopathology of mother and child (M.I.N.I. & DC:05) and mother-child-interactions (Emotional Availability Scales). Results showed that (1) differences in infantile sleeping disorders emerged (phi = 0.243; p = 0.016) compared to the pre-lockdown group, while (2) the occurrence of maternal panic and anxiety increased in the post-lockdown group (phi = 0.229; p = 0.022). Moreover, there was (3) an association for maternal panic and child's sleep disorder, and (4) specific associations with maternal non-hostility in the mother-child-interaction. In conclusion, the present study highlights the differences of maternal mental health occurrences and infants' regulatory problems, as well as the possible effects of the COVID-19 pandemic for infants. In the pre-lockdown group, maternal non-hostility might have acted as a promotive factor against regulatory disorders, while this mechanism was mitigated in the post-lockdown group.

Longitudinal evidence that infants develop their imitation abilities by being imitated

Humans are widely considered the most socially sophisticated species on the planet. Their remarkable abilities in navigating the social world have given rise to complex societies and the advancement of cultural intelligence.1,2,3,4,5 But what characterizes us as ultra-social beings? Theoretical advances in social sciences over the last century purport imitation as a central mechanism for the emergence of humans' unique social-cognitive abilities.6,7,8 Uncovering the ontogeny of imitation is therefore paramount for understanding human cultural evolution. Yet how humans become able to imitate is unclear and intensely debated. Recently, multidisciplinary findings have challenged long-standing assumptions that imitation is inborn.9,10,11,12 So what are the underlying processes supporting the development of imitation? One fascinating possibility is that infants become able to imitate by being imitated.13,14,15 Cognitive theories have suggested that by perceiving others imitating one's own behavior, visual and motor representations of that behavior are coactivated and associated, leading to the emergence of imitation abilities.14,15 Here, we show that being imitated by sensitive caregivers in infancy constitutes a psychological process giving rise to infants' imitation abilities. Results demonstrated (1) that maternal imitation at 14 months positively predicted infants' imitation abilities at 18 months and (2) that maternal imitation at 14 months mediated the positive effect of maternal sensitivity at 6 months on infants' imitation abilities at 18 months. This offers substantial evidence for the role of social interactions in the emergence of imitation as a key factor for human cultural learning.

Are emotionally competent adults emotionally available parents? Examination of theoretical and empirical relationships in a video-recorded parent-child interaction clinical preschool-aged sample

OBJECTIVE

Emotional competence (EC) describes one's general ability to perceive, express, process, and regulate their own emotions as well as those of others. In the clinical context of parent-child interactions, the specific ability to perceive, express and regulate a child's emotions is conceptually covered by the Emotional Availability Scales (EAS). We aim to examine theoretical and empirical overlaps between EC (Rindermann) and emotional availability (EA; Biringen) for theoretical, diagnostic, and therapeutic reasons.

METHODS

Parents of a clinically referred sample of preschool-aged children (55 dyads) filled out a self-report questionnaire (ECQ), and certified and blinded raters applied the EAS via observations. In a novel approach, the EC was additionally estimated with independent ratings made by two further observers. All dyads were coded on 10-min video-recorded parent-child interactions during free play.

RESULTS

In bivariate and multivariate analyses, EC scores from observational ratings were strongly associated with independently rated clinical emotional availability scores. EC scores from self-reports were moderately associated with emotional availability scores. A post hoc power analysis estimated β error probabilities.

CONCLUSIONS

EC may represent an important personal precondition to an emotionally available parent. As such, we discuss implications for early risk factor assessments for child development and highlight new prevention approaches, new diagnostic options, and refined treatment goals. Limitations included the sample size, assessment, and the influence of study design on results.

[Diagnostic of Parent-Child-Interaction andTheir Relationship: Results from a Multiprofessional and Task Specific Survey]

The assessment of parent-child interactions and relationships (PCIR) plays an important role for many diagnostic purposes in child and adolescent psychology and psychological health care. While child and adolescent psychology has been intensively researched, the field still faces a lack of knowledge about health care practice. To offer knowledge about practical routine needs and derived needs in these domains, we aimed to obtain information from professionals who routinely assess PCIR.We aimed to gain a basic description of task-specific diagnostic fields, professional staff and their education, their clients, key diagnostic questions, observational settings, guidelines used in assessing PCIR and professionals' personal understanding of PCIR. To gain information on how professionals assess PCIR, we used an online survey containing multiple choice questions and rating scales.We describe differences between task-specific diagnostic fields of inpatient and outpatient settings, consulting and officially appointed surveyors for court decision. Only responses from professionals performing PCIR are analyzed (N = 166). PCIR is regularly used for more than a half of children between 0-12 years of age and for more than a third of adolescents for answering a broad spectrum of diagnostical questions. We describe differences for nearly all facets of PCIR except for the content related domain. Based on these differences between task-specific fields, we give suggestions for standardized documentation of PCIR and how findings from this study can be used for scientific development.

Fostering Emotional Availability in Mother-Child-Dyads With an Immigrant Background: A Randomized-Controlled-Trial on the Effects of the Early Prevention Program First Steps

Background

In many Western countries like Germany, the social integration of children with an immigrant background has become an urgent social tasks. The probability of them living in high-risk environments and being disadvantaged regarding health and education-related variables is still relatively higher. Yet, promoting language acquisition is not the only relevant factor for their social integration, but also the support of earlier developmental processes associated with adequate early parenting in their first months of life. The Emotional Availability Scales (EAS) measure the quality of caregiver-child-interactions as an indicator of the quality of their relationship and thus of such early parenting, focusing on mutual and emotional aspects of their interaction.

Method

This pilot study examined in a randomized controlled trial the effects of the prevention project First Steps regarding the hypothesis that the Emotional Availability (EA) improved to a greater extent in "difficult-to-reach" immigrant mother-child dyads in a psychoanalytically oriented early intervention (A, FIRST STEPS) compared to a usual care intervention (B) offered by paraprofessionals with an immigrant background. A sample of N = 118 immigrant women in Germany from 37 different countries and their children was compared with regard to the parental EA-dimensions sensitivity, structuring, non-intrusiveness and non-hostility and the child dimensions responsiveness to and involvement of the caregiver in the pre-post RCT design.

Results and Conclusion

Different from what was expected, repeated ANOVAs revealed no significant pre-post group differences for the parental dimensions. For the child dimensions the effect of time of measurement was highly significant, which can be interpreted as mostly natural developmental effects. Still, on the level of simple main effects for each intervention, only in the FIRST STEPS groups child responsiveness significantly improved. When controlled for confounding variables, a significant interaction effect for maternal sensitivity in favor of the FIRST STEPS intervention was found. The systematic group differences indicate that the more extensive and professional intervention, focusing on the individual needs of the participants, is more suitable to support the quality of the mother-child-relationship amongst immigrant mother-child dyads than usual care. The results are discussed taking into account the context of the maternal migration process and potential maternal traumatization.

Clinical Trial Registration

[https://clinicaltrials.gov], identifier [DRKS00004632].

[The Prevailing Emphasis on the Quality of the Parent-Infant Relationship for Early Intervention]

Attachment theory is the buzzword in parenting guides and professional publications, and risk to the child's attachment development is widely used as the threshold for early intervention. Given the severe impact of inaccurately diagnosed attachment disturbances on the child's wellbeing (Granqvist et al., 2017), the valid assessment of the quality of the early parent-infant relationship is crucial.This is particularly relevant during the ongoing pandemic which specifically burdens young families. Based on the psychoanalytic understanding of the parent-infant relationship and its crucial importance for the infant's emerging self, this paper gives an introduction into the early relational development in infancy.The relevance of a psychodynamic diagnosis of relational disturbance in the first year is described using the Parent-Infant Relational Assessment Tool (PIRAT) Global Scales (Broughton, Hommel, the Parent-Infant Project, 2016; Hommel, 2018). Conceptualized at theAnna Freud Centre in London, the PIRAT was developed and validated, by the author.The prevailing emphasis on the importance of early intervention, and the evidence of the effectiveness of parent-infant psychotherapy in improving both parental functioning and fostering secure attachment relationships in young children (Barlow et al., 2013), support the clinical need to detect very early risks for parents and babies (Sleed, 2013).

The Connection and Development of Unpredictability and Sensitivity in Maternal Care Across Early Childhood

Both patterns of maternal sensory signals and sensitive care have shown to be crucial elements shaping child development. However, research concerning these aspects of maternal care has focused mainly on maternal sensitivity with fewer studies evaluating the impact of patterns of maternal behaviors and changes in these indices across infancy and childhood. The aims of this study were to explore how maternal unpredictability of sensory signals and sensitivity develop and associate with each other from infancy to toddlerhood and whether elevated maternal depressive and anxiety symptoms relate to maternal unpredictable signals and sensitivity in toddlerhood. The study population consisted of 356 mother–child dyads assessed at 30 months; a subset of 103 mother–child dyads additionally participated in 8 months assessment. Maternal unpredictability and sensitivity were assessed from video-recorded free-play episodes at 8 and 30 months. Maternal depressive and anxiety symptoms were assessed with questionnaires at gestational weeks 14, 24, 34 and 3, 6, 12, and 24 months. Mean level of mothers’ unpredictability decreased on average whereas sensitivity did not change between infancy and toddlerhood. Both maternal unpredictability and sensitivity showed moderate level of individual stability from infancy to toddlerhood and these two measures were modestly correlated within each age. Elevated maternal depressive and anxiety symptoms were not related to unpredictability but related to lower maternal sensitivity in toddlerhood. These results identify unpredictable sensory signals as a characteristic of parental care that is independent of standard quality measures and suggest that it may be less influenced by maternal depressive and anxiety symptoms.

Listening in: An Alternative Method for Measuring the Family Emotional Environment

The family emotional environment influences children's development of emotion regulation in various ways. Children's difficulties with effectively regulating emotions, in turn, can contribute to the development of psychopathology. However, the pathways that explain how environmental emotion-including overheard emotion among family members-influences children's development of healthy or problematic emotion regulation are unclear. In this article, we briefly discuss the most common methods (e.g., questionnaires, laboratory observations) used to assess emotion in the family. We consider the benefits and limitations of these methods and discuss the need for objective measurement of the family emotional environment. We include a description of the Electronically Activated Recorder (EAR), which provides unobtrusive, extended sampling of the emotional tone of family interaction in the home. We present preliminary evidence of its use with 7- and 8-year-old and their families during one day at home. The method reveals that objectively assessed parent-to-parent interactions that are negatively toned, but not parental self-report of conflict or expressivity, are associated with children's self-reported emotional reactions to hearing independently recorded clips of their mothers' voices during simulated angry interactions. The finding suggests unique contributions of objective, unobtrusive, extended measurement of the family emotional environment to understanding aspects of children's emotional development that may not be captured with other commonly used methods. We discuss future directions that explore how EAR may be used to further our knowledge of the pathways between environmental emotion as a risk factor that influences children's emotional functioning and their psychological well-being.

Dyadic development in the family: Stability in mother-child relationship quality from infancy to adolescence

A central concern of family psychology and developmental science is assessing the stability or instability (i.e., relative standing) of family-level constructs across time. Almost exclusively, such constructs have heretofore been unitary variables. Using a longitudinal design, for the first time, this study traces the developmental stability of the dyadic construct of mother-child relationship quality from infancy to adolescence. Multiple age-appropriate measures converging on the construct of relationship quality were assessed in 375 mother-child dyads at 4 times: 5 months and 4, 10, and 14 years. Mother-child relationship quality showed stability (βs = .18-.53) in all families together, in families with girls and boys, and when family socioeconomic status was controlled. Consistent patterns of relationship quality are developmentally significant in themselves, convert to broader behavioral tendencies in children, and guide more effective intervention designs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Baby's first bites: Association between observed maternal feeding behavior and infant vegetable intake and liking

Positive experiences with the introduction of solid food in infancy may lead to positive associations with feeding in both parent and infant. During this transitional period, parental feeding behavior and infant eating behavior might mutually reinforce each other. A feeding style that is found to be associated with positive child eating behavior, is sensitive feeding. In the present study we tested bidirectional prospective relations between mother and infant behavior in a cross-lagged model using observations of two feeds on two consecutive days on which the first bites of solid food were offered. The sample consisted of 246 first-time mothers and their infants, whose feeding interactions were videotaped during two home visits. Maternal sensitive feeding behavior (consisting of responsiveness to child feeding cues, general sensitivity and non-intrusiveness) and maternal positive and negative affect were coded. In addition, infant vegetable intake was weighed and vegetable liking was reported by mother. Results showed at least some stability of maternal feeding behavior and infant vegetable intake and liking from the first to the second feed. In addition, during the second feed maternal sensitive feeding and positive affect were associated with infant vegetable intake (r=.34 and r=.14) and liking (r=.33 and r=.39). These associations were mostly absent during the first feed. Finally, infant vegetable liking during the first feed positively predicted maternal sensitive feeding behavior during the second feed (β=.25), suggesting that the infant's first response might influence maternal behavior. Taken together, mother and infant seem more attuned during the second feed than during the first feed. Future studies might include multiple observations over a longer time period, or micro-coding. Such insights can inform prevention programs focusing on optimizing feeding experiences during the weaning period.

Maternal psychosocial predictors of pacifier use in a mother-infant interaction task: An observational study from the MPEWS pregnancy cohort

The prevalence of pacifier use is high but when it occurs outside of the recommended sleep context, it becomes more controversial. Using 211 mother-infant dyads recorded as part of the Mercy Pregnancy and Emotional Wellbeing Study, we examined the maternal psychosocial predictors of pacifier use within an interaction task (i.e., ten minutes face-to-face followed by 30-minutes unstructured play). Predictors included maternal emotional availability measured with the Emotional Availability Scales; depression measured by the Structured Clinical Interview for the DSM-IV-TR Clinician Version; and maternal history of childhood trauma measured by the Childhood Trauma Questionnaire. An unadjusted odds ratio demonstrated that women classified as non-emotionally available to their infants were three-and-a-half-times more likely to use a pacifier. Multivariate logistic regression including all maternal psychosocial predictors demonstrated that even when adjusting for cessation of breastfeeding, maternal emotional availability remained the only significant predictor of pacifier use. This is the first time that predictors of pacifier use have been examined with a sample of clinically depressed women, as well as women with childhood trauma history. The results provide preliminary evidence that women who are not emotionally available might be more likely to rely on a pacifier during mother-infant interaction.

Maternal trauma and emotional availability in early mother-infant interaction: findings from the Mercy Pregnancy and Emotional Well-being Study (MPEWS) cohort

Understanding how a mother's traumatic experiences influence her interactions with her infant may have importance for understanding infant development and mental health. Data for this study were drawn from an Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study. Maternal trauma from Childhood, Childbirth Experiences, and Stressful Life Events were examined. At six-months postpartum, 211 predominantly first-time mothers (mean age 31.5 years), and their infants, were video-recorded interacting for 40 minutes. Interactions were assessed with the Emotional Availability (EA) Scales. Using structural equation modelling to test multiple mediation pathways, moderate-to-severe childhood trauma had only a direct effect on reducing maternal EA with the infant (β=-.17, p=.031), as did current stressful life events (β=-.19, p=.019), after controlling for maternal depression, age, and tertiary education. This highlights that proximate trauma specific to the perinatal period may not account for the effect of distal childhood trauma on maternal EA at six-months postpartum.

Parents' Past Bonding Experience with Their Parents Interacts with Current Parenting Stress to Influence the Quality of Interaction with Their Child

Healthy dyadic interactions serve as a foundation for child development and are typically characterised by mutual emotional availability of both the parent and child. However, several parental factors might undermine optimal parent-child interactions, including the parent's current parenting stress levels and the parent's past bonding experiences with his/her own parents. To date, no study has investigated the possible interaction of parenting stress and parental bonding history with their own parents on the quality of emotional availability during play interactions. In this study, 29 father-child dyads (18 boys, 11 girls; father's age = 38.07 years, child's age = 42.21 months) and 36 mother-child dyads (21 boys, 15 girls; mother's age = 34.75 years, child's age = 41.72 months) from different families were recruited to participate in a 10-min play session after reporting on their current parenting stress and past care and overprotection experience with their parents. We measured the emotional availability of mother-child and father-child play across four adult subscales (i.e., sensitivity, structuring, non-intrusiveness, non-hostility) and two child subscales (i.e., involvement and responsiveness). Regression slope analyses showed that parenting stress stemming from having a difficult child predicts adult non-hostility, and is moderated by the parents' previously experienced maternal overprotection. When parenting stress is low, higher maternal overprotection experienced by the parent in the past would predict greater non-hostility during play. This finding suggests that parents' present stress levels and past bonding experiences with their parents interact to influence the quality of dyadic interaction with their child.

Stabilities of Infant Behaviors and Maternal Responses to Them

Consistency in the order of individuals in a group across substantial lengths of time-stability-is a central concept in developmental science for several reasons. Stability underscores the meaningfulness of individual differences in psychological phenomena; stability informs about the origins, nature, and overall developmental course of psychological phenomena; stability signals individual status and so affects the environment, experience, and development; stability has both theoretical and clinical implications for individual functioning; and stability helps to establish that a measure constitutes a consequential individual-differences metric. In this three-wave prospective longitudinal study (Ns = 40 infants and mothers), we examined stabilities of individual variation in multiple infant behaviors and maternal responses to them across infant ages 10, 14, and 21 months. Medium to large effect size stabilities in infant behaviors and maternal responses emerged, but both betray substantial amounts of unshared variance. Documenting the ontogenetic trajectories of infant behaviors and maternal responses helps to elucidate the nature and structure of early human development.

Maternal depression and the emotional availability of mothers at six months postpartum: Findings from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS) pregnancy cohort

BACKGROUND

Existing research suggests maternal depression may reduce the quality of early mother-infant interaction and this might increase our understanding of how maternal mental health impacts on child development outcomes. However, most studies recruit from community samples and few include both a diagnostic measure of maternal depression together with an observational measure of the quality of the mother-infant relationship.

METHODS

Data was drawn from 210 women recruited in early pregnancy until 6 months postpartum within an Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study. Those women who at six months postpartum were video recorded interacting with their infant for at least 40-minutes were included in this study, with the quality of those interactions assessed using the Emotional Availability Scales coding system. Depression was measured using the Structured Clinical Interview for the DSM-IV-TR Clinician Version and the Edinburgh Postnatal Depression Scale, and covariates included maternal age and education.

RESULTS

Whilst results showed a small negative association between antenatal depressive symptoms in trimester one of pregnancy and maternal EA, there was no effect of maternal depression diagnosis or of maternal depressive symptoms in later pregnancy or postpartum.

LIMITATIONS

This study focuses exclusively on mothers and does not account for the role of partners.

CONCLUSIONS

Maternal depression might have a smaller effect on maternal EA then some existing research implies, with that effect most prevalent in early pregnancy. Clinical intervention might not be necessary for all mother-infant dyads experiencing depressive symptomology, but instead be directed to those with additional risk factors.

Psychometric Properties of Parent-Child (0-5 years) Interaction Outcome Measures as Used in Randomized Controlled Trials of Parent Programs: A Systematic Review

This systematic review sought to identify observational measures of parent-child interactions commonly implemented in parenting program research, and to assess the level of psychometric evidence available for their use with this age group. Two separate searches of the same databases were conducted; firstly, to identify eligible instruments, and secondly to identify studies reporting on the psychometric properties of the identified measures. Five commercial platforms hosting 19 electronic databases were searched from their inception to conducted search dates. Fourteen measures were identified from Search 1; a systematic search of randomized controlled trial evaluations of parenting programs. For Search 2, inclusion/exclusion criteria were applied to 1327 retrieved papers that described the development and/or validation of the 14 measures identified in Search 1. Seventeen articles met the inclusion criteria, resulting in five observational measures for the final review. Data were extracted and synthesized using the COSMIN rating system to describe the methodological quality of each article alongside the overall quality rating of the psychometric property reported for each measure using the Terwee checklist. Measure reliability was categorized into four domains (internal consistency, test-re-test, inter-rater, and intra-rater). Measure validity was categorized into four domains (content, structural, convergent/divergent, and discriminant). Results indicated that the majority of psychometric evidence related to children aged from birth the three with internal consistency, inter-rater reliability, and structural validity the most commonly reported properties, although this evidence was often weak. The findings suggest further validation of the included measures is required to establish acceptability for the whole target age group.

Short-term test–retest reliability and continuity of emotional availability in parent–child dyads

The emotional availability scales (EAS), 4th edition, are widely used in research and clinical practice to assess the quality of parent–child interaction. This study examined the short-term reliability and continuity of the EAS (4th ed.) assessed in two similar observational contexts over a one-week interval. Sixty-two Dutch parents (85% mothers) and their 9- to 12-month-old infants ( Mage = 10.07 months, SD = 0.47, 53% boys) were videotaped twice while they interacted with each other during several tasks (free play, structured play, book reading, toys taken away). The videotapes were coded with the EAS 4th edition by two reliable coders. Moderate to strong test–retest reliability was found for the three EA parent-dimensions: sensitivity, structuring, and nonintrusiveness. Child involvement was not reliable over a one-week period, and child responsiveness could only be reliably assessed in boys. Test–retest reliability of structuring was also higher for boys than for girls. Regarding continuity, mean levels of sensitivity, structuring, nonintrusiveness, and involvement did not change over a one-week interval, but responsiveness increased for girls only. Thus, the parenting dimensions of the 4th edition of the EAS reflect stable and consistent characteristics of the parent–child dyad on the short term, but the child measures do not.

Developmental patterns of change in mother and child emotional availability from infancy to the end of the preschool years: A four-wave longitudinal study

In this four-wave longitudinal study, we examined intraindividual developmental patterns of change in mother-child emotional availability (EA) during infancy and the preschool years, the factors that promote or hinder it, and the longitudinal within-dyad association between maternal and child EA. Mother-infant dyads (N = 56) were observed at home when children were 6,12, 18 and 55-months-old. Multilevel growth modeling revealed that mother and child EA follow distinct trajectories across time. While maternal EA was found to be stable, a significant increase in child EA was found across the infancy years and into preschool. The results from the study also provide evidence for a sustained within-dyad relation between mother and child EA across time and suggest that mother, child, and contextual factors can create variations in the trajectories of maternal EA over time. The findings lead to a deeper understanding of the intraindividual changes that occur in mother and child EA across the infancy years and into preschool and the factors that can promote or hinder it.

Emotional Availability Scale Among Three U.S. Race/Ethnic Groups

This study used a cross-sectional design to conduct a subgroup psychometric analysis of the Emotional Availability Scale among matched Hispanic ( n = 20), African American ( n = 20), and European American ( n = 10) English-speaking mother-child dyads in the United States. Differences by race/ethnicity were tested ( p < .05) among (a) Emotional Availability Scale dimensions with ANOVA, and (b) relationships of Emotional Availability Scale dimensions with select Dyadic Parent-Child Interaction Coding System variables with Pearson correlation and matched moderated regression. Internal consistency was .950 (Cronbach's α; N = 50). No significant differences in the six Emotional Availability Scale dimension scores by race/ethnicity emerged. Two Dyadic Parent-Child Interaction Coding System behaviors predicted two Emotional Availability Scale dimensions each for Hispanic and African American mother-child dyads. Results suggest emotional availability similarity among race/ethnic subgroups with few predictive differences of emotional availability dimensions by specific behaviors for Hispanic and African American subgroups.

Patterns of Emotional Availability between Mothers and Young Children: Associations with Risk Factors for Borderline Personality Disorder

Emotional availability (EA) characterizes a warm, close relationship between caregiver and child. We compared patterns (clusters) of EA on risk factors, including those for borderline personality disorder (BPD). We sampled 70 children aged 4 to 7 years from low-socioeconomic backgrounds, 51% of whose mothers had BPD. We coded filmed interactions for EA: mothers' sensitivity, structuring, non-intrusiveness, non-hostility, and children's responsiveness to, and involvement of, mothers. We additionally coded children's over-responsiveness and over-involvement. Using person-centered analyses, we identified four clusters: high-functioning, low-functioning, asynchronous (mothers above average on two of four dimensions, children below) and below average. Mothers in the low-functioning cluster had lower income, less social support, more of the borderline feature of negative relationships and more depression than did mothers in the high-functioning cluster. The children in the low-functioning group had more risk factors for BPD (physical abuse, neglect, and separation from, or loss of caregivers, and negative narrative representations of the mother-child relationship in their stories) than did children in the high-functioning group. The asynchronous group included older girls who were over-responsive and over-involving with their mothers in an apparent role reversal. Interventions targeting emotional availability may provide a buffer for children facing cumulative risks and help prevent psychopathology.

Socioeconomic disadvantage, neural responses to infant emotions, and emotional availability among first-time new mothers

During the early postpartum period, mothers exhibit increased amygdala responses to positive infant expressions, which are important for positive mother-infant relationships. Socioeconomic disadvantage is associated with altered amygdala response to emotional stimuli as well as more negative mother-infant relationships. However, little is known about the role of socioeconomic disadvantage in neural responses specifically to infants. Thus, we examined whether socioeconomic disadvantage (indexed by lower income-to-needs ratio) is associated with neural responses to infant emotions and parenting behaviors among new mothers. Using fMRI, neural responses to infants' emotional expressions (positive, negative, and neutral faces) were assessed among 39 low- and middle-income first-time mothers during 0-6 postpartum months. Lower income-to-needs ratio was associated with dampened amygdala responses to positive infant faces, but increased amygdala responses to negative infant faces. An indirect effect of socioeconomic disadvantage on emotional availability via amygdala activation suggests that socioeconomic disadvantage is associated with heightened neural sensitivity to infants' negative emotions, which is further associated with mothers' intrusiveness observed during interactions with their own infant. The findings suggest that low-income mothers may be more vulnerable to altered neural processing of infants' emotional expressions which may further influence mothers' emotional availability during interactions with their own infants.

Transition to Kindergarten: Negative Associations between the Emotional Availability in Mother-Child Relationships and Elevated Cortisol Levels in Children with an Immigrant Background

Background: The transition to child care is a challenging time in a child's life and leads to elevated levels of cortisol. These elevations may be influenced by the quality of the mother-child relationship. However, remarkably little is known about cortisol production in response to the beginning of child care among children-at-risk such as children with an immigrant background. However, attending kindergarten or any other child day-care institution can for example have a compensating effect on potential language deficits thus improving the educational opportunities of these children. Method: Data of a subsample of N = 24 "hard-to-reach" mother-child dyads was collected in the context of the psychoanalytic early prevention project FIRST STEPS. The project focuses on the earliest integration of children with an immigrant background by supporting parenting capacities in the critical phase of migration and early parenthood. Children's hair cortisol concentration (HCC) was assessed 1 week before (mean age = 38.77 months) and 3 months after kindergarten entry (mean age = 42.26 months). Hair analysis was conducted for both times of measurement, reflecting the first 3 months after kindergarten entry and 3 months prior. Furthermore, the emotional quality of the mother-child relationship was assessed with the help of the Emotional Availability Scales (EAS; Biringen, 2008) shortly before kindergarten entry when the children were about 3 years old (mean age = 37.2). Results and Conclusion: Children's mean cumulated HCC was higher after kindergarten entry than before. The increase correlated negatively with several dimensions of the EAS. Repeated measures ANCOVA revealed that particularly responsive children and children who had experienced less intrusive mother-child relationships demonstrated lower elevations in HCC after kindergarten entry. Furthermore, a decreased EA score was found in all EA dimensions, besides the dimension "mother's non-hostility," indicating problematic EA within the mother-child relationships of the sample. The results suggest that children with an immigrant background who experience more emotional available mother-child relationships seem to regulate stress induced by kindergarten entry more effectively, indicated by lower cortisol elevations after entry. This implicates that supporting early mother-child relationships by intervention may have a positive effect on the children's ability to regulate stress induced by kindergarten entry thus promoting child development.

Trajectories of mothers' emotional availability: relations with infant temperament in predicting attachment security

The present study examined observations of parenting quality (mothers' emotional availability - EA) during infant bedtimes at 4 points across the infants' first year, assessing relations between levels and trajectories of EA and infant attachment at 12 months and the role of infant temperament in moderating these associations. The sample (N = 128) was predominantly Euro-American (82.5%) and at low socioeconomic risk. Latent growth curve modeling with latent basis coefficients indicated substantial individual differences in initial levels and slopes in EA trajectories across the first year. Both levels of maternal EA and EA trajectories across the first year predicted 12-month infant attachment security. Although maternal EA tended to decrease across the first year in the full sample, EA trajectories that showed a "bounce-back" between 6 and 12 months, suggesting more successful maternal adaptation to an expanding infant developmental repertoire, predicted greater infant security at 12 months. In addition, linkages between latent EA trajectories and 12-month attachment were moderated by 3-month infant temperamental reactivity and regulation. These findings indicate that infant attachment security is sensitive to both static and dynamic aspects of parenting quality across the first year, and that infant temperament can interact with both in predicting infant attachment.

Impact of a maternal history of childhood abuse on the development of mother-infant interaction during the first year of life

The aim of this study was to examine the impact of a maternal history of abuse on mother-infant interaction (emotional availability; EA) in infancy and early toddlerhood. Over an 18-month period, women giving birth to a child in the local obstetric units were screened using the Childhood Trauma Questionnaire. Women who reported moderate or severe sexual and/or physical abuse were included in the maltreatment group (n=58; MG) and compared with a non-maltreated comparison group (n=61; CG). EA was investigated under experimental conditions when the children were 5 and 12 months of age using the Emotional Availability Scales. While mother-child dyads in the MG showed only very discrete interactional alterations at an infant age of 5 months, their EA differed significantly from the CG at 12 months due to the lack of an increase in EA observed in the MG. Exploratory analyses showed an additional effect of emotional abuse on EA at 12 months. These data indicate that the period when child locomotion develops might represent a critical time window for mothers with a history of abuse. Our results constitute an advance in research on child abuse as they identify a possible time window of non-normative alteration in mother-child interaction. This period could be targeted by strategies to prevent intergenerational transmission of abusive experiences.

Infant frontal asymmetry predicts child emotional availability

While factors influencing maternal emotional availability (EA) have been well investigated, little is known about the development of child EA. The present longitudinal study investigated the role of frontal brain asymmetry in young children with regard to child EA (child responsiveness and involvement) in mother–child interaction in a sample of 28 children at 7, 14, and 50 months of age. When infants were 7 months of age, mother–child interaction quality was assessed using the EA-Scales. At 14 months, infants’ resting asymmetric frontal activity was assessed by means of the electroencephalogram (EEG). When children were 50 months old, mother–child interaction quality was measured again. Analyses showed that relatively higher left frontal EEG activation was related to higher child involvement at 50 months, but not to child responsiveness. Those findings suggest a specific relation between individual differences in frontal asymmetry, and child approach and initiating behaviors in mother–child interaction.

Neurobehaviour between birth and 40 weeks' gestation in infants born <30 weeks' gestation and parental psychological wellbeing: predictors of brain development and child outcomes

BACKGROUND

Infants born <30 weeks' gestation are at increased risk of long term neurodevelopmental problems compared with term born peers. The predictive value of neurobehavioural examinations at term equivalent age in very preterm infants has been reported for subsequent impairment. Yet there is little knowledge surrounding earlier neurobehavioural development in preterm infants prior to term equivalent age, and how it relates to perinatal factors, cerebral structure, and later developmental outcomes. In addition, maternal psychological wellbeing has been associated with child development. Given the high rate of psychological distress reported by parents of preterm children, it is vital we understand maternal and paternal wellbeing in the early weeks and months after preterm birth and how this influences the parent-child relationship and children's outcomes. Therefore this study aims to examine how 1) early neurobehaviour and 2) parental mental health relate to developmental outcomes for infants born preterm compared with infants born at term.

METHODS/DESIGN

This prospective cohort study will describe the neurobehaviour of 150 infants born at <30 weeks' gestational age from birth to term equivalent age, and explore how early neurobehavioural deficits relate to brain growth or injury determined by magnetic resonance imaging, perinatal factors, parental mental health and later developmental outcomes measured using standardised assessment tools at term, one and two years' corrected age. A control group of 150 healthy term-born infants will also be recruited for comparison of outcomes. To examine the effects of parental mental health on developmental outcomes, both parents of preterm and term-born infants will complete standardised questionnaires related to symptoms of anxiety, depression and post-traumatic stress at regular intervals from the first week of their child's birth until their child's second birthday. The parent-child relationship will be assessed at one and two years' corrected age.

DISCUSSION

Detailing the trajectory of infant neurobehaviour and parental psychological distress following very preterm birth is important not only to identify infants most at risk, further understand the parental experience and highlight potential times for intervention for the infant and/or parent, but also to gain insight into the effect this has on parent-child interaction and child development.

Infant pain-related negative affect at 12 months of age: early infant and caregiver predictors

OBJECTIVES

To examine the predictive relationships of early infant and caregiver variables on expressed pain-related negative affect duration at the 12-month immunization.

METHODS

Infants and their caregivers (N = 255) were followed during immunization appointments over the first year of life. Latent growth curve modeling in a structural equation modeling context was used.

RESULTS

Higher levels of initial infant pain reactivity at 2 months and caregiver emotional availability averaged across 2, 4, and 6 months of age were related to larger decreases in the duration of infant negative affect over the first 6 months of life. Longer duration of infant negative affect at 2 months and poorer regulation of infant negative affect over the first 6 months of life predicted longer durations of infant negative affect by 12 months.

CONCLUSIONS

Infant negative affect at 12 months was a function of both infant factors and the quality of caregiver interactive behaviors (emotional availability) in early infancy.

Effect of situation on mother-infant interaction

Research has shown that the early parent-infant relationship is of critical importance for children's developmental outcomes. While the effect of different settings on mother-infant interactive behavior is well studied, only few researchers systematically examined the effect of situational variables on mother-infant interaction. In the present study the effect of situational variables within the home setting on the quality of mother-infant interaction at 6 months was examined as well as the consistency in the quality of behaviors of mother and infant across these situations. During a home visit 292 mother-infant dyads were videotaped in three different situations (i.e., free play, face-to-face play, and diaper change). Interactive behaviors of mother and infant were assessed with the NICHD global ratings scales. Results showed substantial effects of situation on the interactive behavior of the mother-infant dyad. Despite the observed situational effects maternal sensitivity to non-distress, intrusiveness, stimulation of development, and positive regard and all five infant behavioral scales remained stable across the different situations. Insight into situational effects within the home setting on the quality of mother-infant interactive behavior may assist researchers to make well-informed decisions about measuring the parent-infant interaction in one or more specific situations.

Rating parent-child interactions: joint engagement, communication dynamics, and shared topics in autism, Down syndrome, and typical development

A battery of 17 rating items were applied to video records of typically-developing toddlers and young children with autism and Down syndrome interacting with their parents during the Communication Play Protocol. This battery provided a reliable and broad view of the joint engagement triad of child, partner, and shared topic. Ratings of the child's joint engagement correlated very strongly with state coding of joint engagement and replicated the finding that coordinated joint engagement was less likely in children with autism. Ratings of other child actions, of parent contributions, and of shared topics and communicative dynamics also documented pervasive variations related to diagnosis, language facility, and communicative context.

Emotional availability, attachment, and intervention in center-based child care for infants and toddlers

According to data from the 1997 NICHD Study of Child Care, center-based child care can have deleterious effects on children's social-emotional development. We hypothesized that training child care professionals to develop positive relationships with children in their care would improve the quality of center-based child care. Thirty-three professional caregiver-child pairs participated in the intervention group and 24 professional caregiver-child pairs were assigned to a care as usual comparison group. The intervention consisted of an informational and a practice component with an emotional availability (EA) coach. The infants and toddlers (ages 11 to 23 months) in the classrooms were enrolled in the project only if they spent at least 20 hr per week in center-based care. The measures included were (a) the EA Scales, (b) the Attachment Q-Sort, and (c) the Classroom Interaction Scale. The intervention group professional caregiver-child relationships showed improvements on the EA Scales, Attachment Q-Sort, and the Classroom Interaction Scale from pre- to posttest, compared to the comparison group, who showed some decrements over a comparable period of time.

Postadoption parenting and socioemotional development in postinstitutionalized children

Children adopted from institutions (e.g., orphanages) overseas are at increased risk of disturbances in social relationships and social understanding. Not all postinstitutionalized children exhibit these problems, although factors like the severity of deprivation and duration of deprivation increase their risk. To date, few studies have examined whether postadoption parenting might moderate the impact of early adverse care. Three groups were studied: postinstitutionalized and foster care children both adopted internationally and nonadopted children reared in their families of origin. The Emotional Availability (EA) Scales were assessed at 18 months in parent-child dyads. Parent emotional availability was found to predict two aspects of social functioning shown in previous studies to be impaired in postinstitutionalized children. Specifically, EA positively correlated with emotion understanding at 36 months; in interaction with initiation of joint attention at 18 months and group, it predicted indiscriminate friendliness as scored from a parent attachment interview at 30 months. Among the postinstitutionalized children but not among the children in other groups, higher EA scores reduced the negative association between initiation of joint attention and indiscriminate friendliness, thus suggesting that parenting quality may moderate the effects of early institutional deprivation.

Assessment of behavioral and emotional problems in infancy: a systematic review

Behavioral and emotional problems are highly prevalent in early childhood and represent an important focus of practice for clinical child and pediatric psychologists. Although psychological or psychiatric disorders are not typically diagnosed in children under the age of 2 years, recent research has demonstrated the appropriateness of assessing behavioral and emotional problems during the first 2 years of life (defined throughout as "infancy"). The current paper provides a systematic review of assessment procedures used to identify behavioral and emotional problems during infancy. Existing assessment procedures for infants take the form of parent- or caregiver-report questionnaires, observational coding procedures, and diagnostic classification systems. The questionnaires and observational coding procedures both had substantial psychometric evidence for use with infants, although observational coding may have limited utility in clinical practice. The classification systems have less empirical support for use with infants, and further research is necessary to demonstrate the appropriateness of these procedures with infants. Utilizing the reviewed procedures to assess behavioral and emotional problems in infants can have a substantial impact in research and practice settings, and further research is needed to determine the usefulness of these procedures in developing, testing, and implementing preventive and early intervention programs for infants and their families.

Emotional relationships between mothers and infants: knowns, unknowns, and unknown unknowns

An overview of the literature pertaining to the construct of emotional availability is presented, illustrated by a sampling of relevant studies. Methodological, statistical, and conceptual problems in the existing corpus of research are discussed, and suggestions for improving future investigations of this important construct are offered.

Maternal and infant behavior and context associations with mutual emotion availability

Emotional availability (EA) is a prominent index of mutual socioemotional adaptation in the parent-infant dyad. This study examines zero-order and unique associations of multiple maternal and infant behavior and context indicators to variation in aspects of EA in mothers and their young infants. The associations to each were explored in separate analyses for maternal sensitivity and infant responsiveness in 369 European American mothers and their firstborn 5½-month-olds. Beyond zero-order relations, robust regression analyses revealed differentiated patterns of unique relations of mother and infant behavior and context indicators to the EA dimensions of maternal sensitivity and infant responsiveness. Although potential behavior and context relations to EA are many, prominent relations to maternal sensitivity and infant responsiveness are few, and patterns of association vary for the two dimensions of EA. Adequate EA is fundamental to a healthy parent-infant relationship, and understanding the behavior and context indicators associated with EA is fundamental to its enhancement.

Parenting in an Individualistic Culture with a Collectivistic Cultural Background: The Case of Turkish Immigrant Families with Toddlers in the Netherlands

Expanding our knowledge on parenting practices of immigrant families is crucial for designing culturally sensitive parenting intervention programs in countries with high immigration rates. We investigated differences in patterns of parenting between second-generation immigrant and native families with young children. Authoritarian and authoritative control and sensitivity of second-generation Turkish immigrant mothers of 2-year-old children (n = 70) and native Dutch mothers (n = 70) were observed in the home and in the laboratory. Controlling for maternal age and education, Turkish immigrant mothers were less supportive, gave less clear instructions to their children, were more intrusive and were less authoritative in their control strategies than native Dutch mothers. No differences were found in authoritarian control. In both ethnic groups supportive presence, clarity of instruction, authoritative control, and low intrusiveness loaded on one factor. No differences between ethnic groups were found in gender-differentiated parenting. Maternal emotional connectedness to the Turkish culture was associated with less authoritative control, whereas more use of the Turkish language was related to more sensitivity. Even though mean level differences in parenting behaviors still exist between second-generation Turkish immigrant and native Dutch mothers, the patterns of associations between parenting behaviors were comparable for both groups. This suggests that existing parenting interventions for native families may be applicable to second-generation Turkish immigrants as well.

Developmental Continuity and Stability of Emotional Availability in the Family: Two Ages and Two Genders in Child-Mother Dyads from Two Regions in Three Countries

This study employs an intra-national and cross-national, prospective and longitudinal design to examine age, gender, region, and country variation in group mean-level continuity and individual-differences stability of emotional availability in child-mother dyads. Altogether, 220 Argentine, Italian, and U.S. American metropolitan and rural residence mothers and their daughters and sons were observed at home when children were 5 and 20 months of age. Similar patterns of continuity and discontinuity of emotional availability from 5 to 20 months were observed across regions and countries, but not between genders. Stability of emotional availability from 5 to 20 months was moderate and similar across genders, regions, and countries. Universal and gender-specific developmental processes in child-mother emotional availability as revealed in intra- and cross-national study are discussed.