Embodied intersubjective engagement in mother-infant tactile communication: a cross-cultural study of Japanese and Scottish mother-infant behaviors during infant pick-up

Major Occupations and Private Insurance of Working Postpartum Women in Poverty in the United States, 2019

Background

Although working postpartum women in poverty still have unmet medical needs, relevant research is lacking. Thus, we aimed to determine the five most frequent occupations of U.S. postpartum women in poverty and further examine whether the most frequent occupations are associated with poverty/being uninsured by an employer.

Methods

This is a cross-sectional study. We included women who had a job and gave birth within the last 12 months from a 2019 American Community Survey Public Use Microdata Sample. To examine the associations between the most frequent occupations and being in poverty/uninsured through an employer/union, we used age- and race-adjusted and multivariable-adjusted logistic regression models.

Results

A total of 14.3% of working postpartum women lived in poverty, and their most frequent major occupations were sales and related work, followed by food preparation and serving-related work, office and administrative support work, health care support work, and cleaning and ground maintenance. A total of 51.2% of women in the most frequent major occupations were uninsured through an employer/union. Compared with women in other occupations, women in the most frequent major occupations had fewer working hours and weeks that included paid leave. In particular, cleaners and ground maintenance workers and food preparation and serving-related workers were most likely to be in poverty and uninsured through an employer/union.

Conclusions

Compared with other occupations, the most frequent occupations were more likely to be insecure and less likely to provide health insurance. Our U.S.-based study suggested that current policies regarding employee benefits needed to be improved especially for the most frequent major occupations.

Effect of the Parenting Preparation Program on Maternal Role Competence: A Systematic Review and Meta-Analysis

Background

The maternal sense of competence refers to the mother's sense of ability to care for the baby. Maternal competence can affect the mother's parenting capacities. Maternal preparation programs are aimed to increase mothers' knowledge and improve their maternal competence. This systematic review and meta-analysis investigated the effect of a maternal preparation program on maternal role competence.

Materials and Methods

A systematic search was conducted using the following MeSH terms: "education", "program", and "parenting sense of competence" in databases including PubMed, Web of Science, Cochrane Central, and Scopus, from inception till July 2022. All Randomized Controlled Trials (RCTs) published in any language were extracted. Articles were screened based on predefined inclusion and exclusion criteria. The quality of the included articles was assessed by two qualified reviewers based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Results

Of the 170 published works that were retrieved in the initial stage, five articles including 647 first-time mothers were analyzed. A meta-analysis showed that parenting preparation program interventions increased maternal role competence in first-time mothers as opposed to those who received routine care Mean Difference (MD) = 3.31, 95% Confidence Interval (CI) [2.07, 4.55].

Conclusions

The results of this study encourage health policymakers to develop maternal preparation programs for first-time mothers and their children.

Six-month-old infants' communication in a comparative perspective: Do maternal attention and interaction matter?

Developmental precursors of the prelinguistic transition from gestures to word use can be found in the early pragmatic usage of auditory and visual signals across contexts. This study examined whether 6-month-old infants are capable of attention-sensitive communication with their mother, that is, adjusting the sensory modality of their communicative signals to their mother's attention. Proxies of maternal attention implemented in experimental conditions were the mother's visual attention (attentive/inattentive), interaction directed at the infant (interactive/non-interactive), and distance (far/close). The infants' signals were coded as either visual or auditory, following an ethological coding. Infants adjusted the sensory modality of their communicative signals mostly to maternal interaction. More auditory signals were produced when the mother was non-interactive than when she was interactive. Interactive conditions were characterized by higher rates of visual signaling and of gaze-coordinated non-vocal oral sounds. The more time infants spent looking at their attentive mother, the more they produced auditory signals, specifically non-vocal oral sounds. These findings are discussed within the articulated frameworks of evolutionary developmental psychology and early pragmatics.

The relationship between maternal and infant empathy: The mediating role of responsive parenting

Individual empathy emerges during infancy, and its development is influenced by family environmental factors such as parental characteristics and parenting style. In this study, we examined how maternal empathy was related to infant empathy and the mediating role of responsive parenting in this relationship using situational observation and scale measurement data. Thirty-three infants aged 11-30 months (M = 20.18, SD = 5.18) and their mothers (all from middle-income Chinese families) participated in simulated distress scenarios and structured mother-infant interaction sessions. These paradigms are widely used to study infant empathy and responsive parenting. The maternal empathy levels were measured using the Adult Empathy Scale (E-scale). The results indicate that (1) by their second year, infants largely acquire the capacity for other-oriented empathy and display significantly greater levels of empathy toward their mothers than toward strangers; (2) maternal empathy is significantly and positively correlated with responsive parenting and infant empathy, responsive parenting is significantly and positively correlated with infant empathy; and (3) responsive parenting fully mediates the effect of maternal empathy on infant empathy. These findings indicate that maternal empathy level can be enhanced to improve the quality of parent-child interaction, thereby promoting infant empathy development.

[Tactile communication within the father-mother-baby triad]

This literature review focuses on tactile interactions between parents and their infants. Research on the dyad has explored both cultural differences in touch and the relationship between touch style and hormonal secretion in both parents. The few studies that have examined this communicative modality within the triad have investigated the frequency and type of parent-infant touch, as well as the effect of skin-to-skin contact on tactile interactions at three months postpartum.

Directedness and engagement in chimpanzee vocal ontogeny

Directedness and engagement during pre-verbal vocal communication play a major role in language development. What was their role in the evolution of language? This question invites us to examine these behaviours in chimpanzee vocal ontogeny. We collected observational data on infant (N = 15) and juvenile (N = 13) chimpanzees at Chimfunshi Wildlife Orphanage, Zambia. We examined the impact of age and vocalization type (grunts, whimpers, laughs and screams) on directed cues (gaze directedness and face directedness) and engagement (mutual face directedness) during vocal communication. We also assessed the impact of directed cues and engagement on social interactions by coding the behaviour of social partners before, during and after a vocalisation, and examining whether they contingently changed their behaviour in response to the vocalisation if it was directed or if engagement occurred. We found that face directed vocalisations showed a general increase during ontogeny and we observed call-type dependent effects of age for mutual face directedness. Only face directed vocalisations were significantly predictive of behavioural responses in social partners. We conclude that like young humans, young chimpanzees routinely exhibit directed behaviours and engagement during vocal communication. This social competency improves during ontogeny and benefits individuals by increasing the chances of eliciting behavioural responses from social partners. Directedness and engagement likely provide a foundation for language phylogenetically, as well as ontogenetically. RESEARCH HIGHLIGHTS: We show that directedness and engagement routinely occur during early chimpanzee vocalisations. Directedness increases throughout chimpanzee vocal ontogeny, similar to human infants. Directedness enhances social partner responsiveness, demonstrating a direct benefit to this style of communication. Directedness and engagement could provide a route towards language phylogenetically as well as ontogenetically.

Narrative as co-regulation: A review of embodied narrative in infant development

We review evidence of non-verbal, embodied narratives in human infancy to better understand their form and function as generators of common experience, regulation, and learning. We examine their development prior to the onset of language, with a view to improve understanding of narrative as regular motifs or schemas of early experience in both solitary and social engagement. Embodied narratives are composed of regular patterns of interest, arousal, affect, and intention that yield a characteristic four-part structure of (i) introduction, (ii) development, (iii) climax, and (iv) resolution. Made with others these form co-created shared acts of meaning, and are parsed in time with discreet beginnings and endings that allow a regular pattern to frame and give predictive understanding for prospective regulation (especially important within social contexts) that safely returns to baseline again. This characteristic pattern, co-created between infant and adult from the beginning of life, allows the infant to contribute to, and learn, the patterns of its culture. We conclude with a view on commonalities and differences of co-created narrative in non-human primates, and discuss implications of disruption to narrative co-creation for developmental psychopathology.

A comparative study of mother-infant co-regulation of distance at home in Japan and Scotland

Mothers and infants co-regulate their distance from one another at home. Continuous, naturalistic home observations of the changes in mother-infant distance were carried out in Japan and Scotland during infant ages of 0-1, 6-7, and 12-13 months. This study examined mutual distance-increasing and distance-reducing behaviours, referred to as parent-infant 'centrifugalism' and 'centripetalism'. Cultural differences emerged in the modes of mother-infant distance co-regulation. Scottish mothers were more active in initiating contact and leaving infants alone to sleep, whereas Japanese mothers showed stronger infant-centredness by maintaining physical contact with infants when they fell asleep and reacting to their crying when they woke up. Age differences were found relating to decrease in sleep and increase in object play in the middle of the first year, which resulted in more separation within a 0.5 m distance at 6-7 months, a compromise between closeness and distancing between mothers and awake infants. Cultural and age differences in the co-regulation of mother-infant distance were discussed in relation to the development of locomotion, object play, and intention-reading.

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.

Comparison of Japanese and Scottish Mother-Infant Intersubjectivity: Resonance of Timing, Anticipation, and Empathy During Feeding

Feeding involves communication between mothers and infants and requires precise synchrony in a special triadic relationship with the food. It is deeply related to their intersubjectivity. This study compared the development of mother-infant intersubjectivity through interactional synchrony in feeding between 11 Japanese and 10 Scottish mother-infant dyads, observed at 6 and 9 months by video. Japanese mothers were more deliberate in feeding at an earlier age, whereas Scottish mothers were significantly more coercive than Japanese mothers at an earlier age. Japanese mothers brought the spoon to infants with a pause to adjust the timing of insertion to match their infants' readiness, whereas this pause was not observed in Scottish mothers. Isomorphic mouth opening between mothers and infants was observed. This empathic maternal display is an important element of intersubjectivity in infant feeding that differed between Scottish and Japanese mothers. Scottish mothers' mouth opening always followed their infants' mouth opening, but about half of Japanese mothers preceded their infants. Further, the mouths of Scottish infants and mothers opened almost at the same time as spoon insertion. In contrast, Japanese mothers' mouth opening did not co-occur with the insertion but was close to spoon arrival, a subtle but important difference that allows for greater infant autonomy. The time structure of Scottish mother-infant interactions was simpler and more predictable at 9 months than in Japan, where the structure was more variable, likely due to a stronger regulation by Scottish mothers. In conclusion, Scottish mother-infant intersubjectivity is characterized as more maternally reactive and mother-centered, whereas Japanese mother-infant intersubjectivity is characterized as more maternally empathetic and infant-centered. Cultural differences in intersubjectivity during feeding between Japan and Scotland are further discussed in relation to triadic relationships and parenting styles.

Newborn infants who received skin-to-skin contact with fathers after Caesarean sections showed stable physiological patterns

Aim

Separating infants and their parents after a Caesarean section is still the routine care worldwide. This study investigated three caregiving models on the wakefulness and physiological parameters of full‐term infants after an elective Caesarean section.

Methods

Newborn infants born in a Chilean public hospital in 2009‐12 were randomised to three groups: cot, fathers' arms or skin‐to‐skin contact with their father. They were assessed at 15‐minute intervals, from 45 to 120 minutes after the Caesarean section. Their physiological parameters were measured, and their wakefulness was assessed using the Neonatal Behavioural Assessment Scale.

Results

We studied 95 infant (53% girls) born at a mean gestational age of 38.9 ± 0.9 weeks. Heart rates were significantly higher in the skin‐to‐skin than cot or fathers' arms groups and showed greater stability over time. Wakefulness was initially higher in the skin‐to‐skin group, but there were no significant differences by the end of the observation. There were no differences between the groups in peripheral oxygen saturation. Skin‐to‐skin contact had no negative impact on the infants.

Conclusion

The skin‐to‐skin group showed some advantages over the cot and fathers' arms groups when it came to establishing stable physiological parameters and wakefulness. This approach should be supported during mother‐infant separation.

Adaptation and Integration of Psychosocial Stimulation, Maternal Mental Health and Nutritional Interventions for Pregnant and Lactating Women in Rural Bangladesh

Supporting caregivers’ mental wellbeing and ability to provide psychosocial stimulation may promote early childhood development. This paper describes the systematic approach of developing an integrated stimulation intervention, identifying the feasibility and challenges faced throughout the period. We developed an integrated curriculum by culturally adapting three interventions (Reach Up, Thinking Healthy, and general nutrition advice) and piloted this curriculum (Mar–April 2017) in courtyard groups sessions and individual home visits with pregnant women (n = 11) and lactating mothers (of children <24 months) (n = 29). We conducted qualitative interviews with the participants (n = 8) and the community health workers who delivered the intervention (n = 2). Most participants reported willingness to attend the sessions if extended for 1 year, and recommended additional visual cues and interactive role-play activities to make the sessions more engaging. Participants and community health workers found it difficult to understand the concept of “unhealthy thoughts” in the curriculum. This component was then revised to include a simplified behavior-focused story. Community health workers reported difficulty balancing the required content of the integrated curriculum but were able to manage after the contents were reduced. The revised intervention is likely feasible to deliver to a group of pregnant and lactating mothers in a low-resource setting.

Making Meaning Together: Embodied Narratives in a Case of Severe Autism

Shared understanding is generated between individuals before speech through a language of body movement and non-verbal vocalisation, expression of feeling and interest made in gestures of movement and voice. Human understanding is co-created in these embodied projects, displayed in serially organised expressions with shared timing of reciprocal actions between partners. These develop in narrative events that build over cycles of reciprocal expressive action in a four-part structure shared by all the time-based arts: "introduction," "development," "climax," and "conclusion." Pre-linguistic narrative establishes the foundation of later, linguistic intelligence. Yet, participating in social interactions that give rise to narrative development is a central problem of autism spectrum disorder. In this paper, we examine the rapid growth of narrative meaning-making between a non-verbal young woman with severe autism and her new therapist. Episodes of embodied, shared understanding were enabled through a basic therapeutic mode of reciprocal, creative mirroring of expressive gesture. These developed through reciprocal cycles and as the relationship progressed, complete co-created narratives were formed resulting in shared joy and the mutual interest and trust of companionship. These small, embodied stories enabled moments of co-regulated arousal that the young woman had previous difficulty with. These data provide evidence for an intact capacity for non-verbal narrative meaning-making in autism.

Mother-infant interaction quality and sense of parenting competence at six months postpartum for first-time mothers in Taiwan: a multiple time series design

BACKGROUND

For first-time mothers, not knowing how to interact with newborn infants increases anxiety and decreases the quality of the parent-infant interactions. A substantial lack of interactional knowledge can ultimately limit the adjustments necessary for a stable transition into motherhood. This study investigated how postpartum parenting education influenced first-time mothers' mother-infant interaction quality and parenting sense of competence.

METHODS

Eighty-one healthy first-time-mother and infant dyads were recruited. The control group (n = 40) received postpartum care based on the medical and cultural norms practiced in Taiwan, while the experimental group (n = 41) received, on top of typical care, education by way of a 40-min videotape on infant states, behaviors, and communication cues, as well as a handout on play practices. Data were collected at five points: within the first week, and during follow-ups in the first, second, third, and sixth months after birth. We administered the Chinese versions of the Parenting Sense of Competence Scale and Edinburgh Perinatal Depression Scale, and used the Nursing Child Assessment Teaching Scale to score videotaped mother-infant interactions.

RESULTS

We observed an increase in the quality of mother-infant interaction within the experimental group only. Furthermore, at the five assessment points, we observed no significant changes in perceived parenting competence. Among all subjects, there were correlations between postpartum depression scores, parenting competency, and quality of mother-infant interaction.

CONCLUSIONS

Our results indicate that first-time mothers in Taiwan who are provided with extra education on infants' abilities and how to effectively play with infants are likely to exhibit improvements in quality of interaction.