Caregiver-reported newborn term and preterm motor abilities: psychometrics of the PediaTracTM Motor domain.

BACKGROUND: Approximately 5-10% of children exhibit developmental deviations in motor skills or other domains; however, physicians detect less than one-third of these abnormalities. Systematic tracking and early identification of motor deviations are fundamental for timely intervention. METHODS: Term and preterm neonates were prospectively assessed at the newborn (NB) period in a study of the psychometric properties of the Motor (MOT) domain of PediaTracTM v3.0, a novel caregiver-based development tracking instrument. Item response theory graded response modeling was used to model item parameters and estimate theta, an index of the latent trait, motor ability. Exploratory factor analysis (EFA) was conducted to examine the dimensionality and factor structure. RESULTS: In a cohort of 571 caregiver/infant dyads (331 term, 240 preterm), NB MOT domain reliability was high (rho = 0.94). Item discrimination and item difficulty of each of the 15 items could be reliably modeled across the range of motor ability. EFA confirmed that the items constituted a single dimension with second-order factors, accounting for 43.20% of variance. CONCLUSIONS: The latent trait, motor ability, could be reliably estimated at the NB period. IMPACT: The caregiver-reported Motor domain of PediaTrac provides a reliable estimate of the latent trait of motor ability during the newborn period. This is the first known caregiver-reported instrument that can assess motor ability in the newborn period with high reliability in term and preterm infants. Item response theory methods were employed that will allow for future characterization of developmental subgroups and motor trajectories. The PediaTrac Motor domain can support early identification of at-risk infants. Including caregivers in digital reporting and child-centered monitoring of motor functioning may improve access to care.

Longitudinal caregiver-reported motor development in infants born at term and preterm.

AIM: To examine the extent to which estimates of a latent trait or underlying construct of motor ability differ in infants born at term and preterm, based on caregiver ratings of the motor domain of PediaTrac v3.0. METHOD: The sample consisted of 571 caregiver-infant dyads (331 born at term, 240 born preterm), 48% female, with 51.7% of caregivers identifying as an ethnic minority. Latent trait of motor ability was estimated based on item response theory modeling. Gestational group differences (term and preterm birth) were examined at the newborn/term-equivalent, 2-, 4-, 6-, 9-, and 12-month time points. RESULTS: Caregiver ratings of latent trait of motor ability were reliably modeled across the range of abilities at each time point. While the group born preterm exhibited significantly more advanced motor abilities at the term-equivalent time point, by 6 months the group born at term was more advanced. Biological sex difference main and interaction effects were not significant. INTERPRETATION: Caregivers provided reliable, longitudinal estimates of motor ability in infancy, reflecting important differences in the motor development of infants born at term and preterm. The findings suggest that significant motor development occurs in infants born preterm from birth to the term-equivalent time point and provide a foundation to examine motor growth trajectories as potential predictors in the early identification of neurodevelopmental conditions and needs.

Longitudinal changes in term and preterm infant night wakings: The role of caregiver anxious-depression.

Changes in infant night waking during the first year of life are associated with individual (e.g., prematurity) and family (e.g., caregiver psychopathology) factors. This study examined the association between infant night waking and caregiver anxious-depressive symptoms during the first year of life in preterm and term infants. We considered between-person differences and within-person changes in caregiver anxious-depressive symptoms in relation to changes in infant night waking from 2- to 9-months. Racially (30.0% Black, 60.4% White, 9.5% multiracial/other) and socioeconomically (40.0% below median household income) diverse caregivers (N = 445) of full term (n = 258) and preterm (n = 187) infants were recruited from hospitals and clinics in two midwestern states. Caregivers completed measures of anxious-depression and their infant's night waking at four sampling periods (2-, 4-, 6-, and 9-months). Infant night wakings declined from 2- to 9-months. Between-person differences were observed, such that caregivers with higher average anxious-depressive symptoms or infants born full term reported more night wakings. Within-person effects of caregiver anxious-depressive symptoms were not significant. Caregiver anxious-depression is closely associated with infant night wakings. By considering a caregiver's average severity of anxious-depression, healthcare providers can more effectively plan infant sleep interventions. If caregiver anxious-depressive symptoms are ameliorated, night wakings may also decrease.

Los cambios en el despertar nocturno del infante durante el primer año de vida se asocian con factores individuales (v.g. nacimiento prematuro) y familiares (v.g. sicopatología de quien presta el cuidado). Este estudio examinó la asociación entre el despertar nocturno del infante y los síntomas de depresión por ansiedad de quien presta el cuidado durante el primer año de vida de infantes nacidos prematuramente y de ciclo completo. Tomamos en cuenta las diferencias entre las personas y los cambios dentro de las personas en los síntomas de depresión por ansiedad de quien presta el cuidado con relación a los cambios en el despertar nocturno del infante de los 2 a los 9 meses. Se reclutaron en hospitales y clínicas de dos estados del medio oeste cuidadores (N = 445) racial (30.0% de raza negra, 60.4% blancos, 9.5% multirraciales o de otra raza) y socioeconómicamente (40.0% por debajo del promedio de ingresos caseros) diversos, de infantes de ciclo completo (n = 258) y prematuros (n = 187). Los cuidadores completaron medidas de depresión por ansiedad y el despertar nocturno de sus infantes en cuatro períodos muestra (a los 2, 4, 6 y 9 meses). El despertar nocturno del infante declinó de los 2 a los 9 meses. Se observaron las diferencias entre personas, de tal manera que los cuidadores con un promedio mayor de síntomas de depresión por ansiedad o infantes nacidos en el ciclo completo reportaron más despertar nocturno. Los efectos de dentro de las personas de los síntomas de depresión por ansiedad del cuidador no fueron significativos. La depresión por ansiedad del cuidador se asocia cercanamente con el despertar nocturno del infante. Por medio de considerar el promedio de la severidad de la depresión por ansiedad del cuidador, quienes ofrecen el cuidado de salud pueden planear más eficazmente las intervenciones en cuanto al sueño del infante. Si se mejoran los síntomas de depresión por ansiedad de quien presta el cuidado, el despertar nocturno también podría disminuir.

Les changements dans le réveil nocturne du bébé pendant la première année sont liés à des facteurs individuels (par exemple la prématurité) et familiaux (par exemple la psychopathologie de la personne prenant soin de l'enfant). Cette étude a examiné le lien entre le réveil nocturne du bébé et les symptômes anxieux-dépressifs de la personne prenant soin de l'enfant durant la première année de vie de bébés prématurés et à terme. Nous avons considéré les différences entre les personnes et les changements au sein de la personne dans les symptômes anxieux-dépressifs de la personne prenant soin de l'enfant, en lien aux changements dans le réveil nocturne du bébé de 2 à 9 mois. Des personnes (N = 445) prenant soin d'un bébé à plein terme (n = 258) et prématuré (n = 187), divers du point de vue de leur race (30,0% noirs, 60,4% blancs, 9,5% multiracial/autre) et de leur statut socioéconomique (40,0% en dessous du revenu moyen d'une famille) ont été recrutés dans des hôpitaux et des cliniques des états au centre nord des Etats-Unis. Les personnes prenant soin du bébé ont rempli des mesures de dépression anxiété et de la nuit de leur bébé à quatre périodes de prélèvement des renseignements (2-, 4-, 6-, et 9- mois). Les réveils nocturnes du bébé ont décliné de 2- à 9- mois. Des différences entre les personnes ont été observées, au point que les personnes prenant soin du bébé avec la moyenne de symptômes anxieux-dépressifs la plus élevée ou des bébé nés à terme ont fait état de plus de réveils nocturnes. Les effets au sein de la personne des personnes prenant soin du bébé avec des symptômes anxieux-dépressifs n'étaient pas importants. La personne prenant du bébé avec une dépression anxieuse est fortement liée aux réveils nocturnes du bébé. En considérant la sévérité moyenne de la dépression anxieuse de la personne prenant soin du bébé, les prestataires de santé peuvent planifier les interventions concernant le sommeil du bébé de manière plus efficace. Si les symptômes anxieux-dépressifs de la personne prenant soin du bébé sont améliorer, alors les réveils nocturnes pourraient aussi diminuer.

Disrupted caregiving behavior as a mediator of the relation between disrupted prenatal maternal representations and toddler social-emotional functioning.

The development of maternal representations of the child during pregnancy guides a mother's thoughts, feelings, and behavior toward her child. The association between prenatal representations, particularly those that are disrupted, and toddler social-emotional functioning is not well understood. The present study examined associations between disrupted prenatal representations and toddler social-emotional functioning and to test disrupted maternal behavior as a mediator of this association. Data were drawn from 109 women from a larger prospective longitudinal study (N=120) of women and their young children. Prenatal disrupted maternal representations were assessed using the Working Model of the Child Interview disrupted coding scheme, while disrupted maternal behavior was coded 12-months postpartum from mother-infant interactions. Mother-reported toddler social-emotional functioning was assessed at ages 12 and 24 months. Disrupted prenatal representations significantly predicted poorer toddler social-emotional functioning at 24 months, controlling for functioning at 12 months. Further, disrupted maternal behavior mediated the relation between disrupted prenatal representations and toddler social-emotional problems. Screening for disrupted representations during pregnancy is needed to facilitate referrals to early intervention and decrease the likelihood of toddler social-emotional problems.

Changes in Defense Mechanisms in Mothers From Pregnancy to 2 Years Postpregnancy.

ABSTRACT: The objective of this study was to assess changes in maternal defensive functioning from the third trimester of pregnancy to 2 years postpregnancy. A community sample of at-risk mothers ( N = 84; non-White [61%], unmarried [67%], high school or less education [72%], and income less than $20,000 [50%]) were recruited for this longitudinal study. Mothers responded to a semistructured interview during pregnancy and at 2 years postpregnancy about the parent-infant relationship; interview transcripts were coded using the Defense Mechanism Rating Scale (DMRS). Results indicated a significant increase in both total defense mechanisms used and the relative percentage of immature defense mechanisms used over time. A significant decrease in the relative percentage of healthy/adaptive defenses was noted. When all seven levels of defenses of the DMRS were assessed, it was an increase in minor image-distorting defenses, mechanisms that supported vulnerable self-esteem, that accounted for most of the change in immature defenses. Stability coefficients of defense mechanisms were reported, with large effect sizes, for overall defensive functioning, and mature and immature defenses over a 2-year period. These findings lend support to the importance of assessing defense mechanisms to better understand stressful life transitions in mothers.

Intergenerational transmission of trauma from mother to infant: the mediating role of disrupted prenatal maternal representations of the child.

Data from a multi-method, longitudinal study involving a community sample (N = 120) of pregnant women aged 18-42 were used to examine disrupted maternal representations of the child as a mechanism of the transmission of trauma from mother to infant. Using structural equation modeling, the best fitting model indicated that severity of mothers' childhood interpersonal trauma was associated with severity of disruption in prenatal representations of the child, which in turn was associated with less secure infant-mother attachment at 1 year of age. There was a significant indirect effect of maternal childhood interpersonal trauma on infant-mother attachment insecurity via disrupted prenatal maternal representations. Findings highlight an important mechanism of trauma transmission that could be targeted in interventions with mother-infant dyads.

Associations Between Adverse Childhood Experiences and Prenatal Mental Health and Substance Use Among Urban, Low-Income Women.

This study examined associations between Adverse Childhood Experiences (ACEs) and perinatal mental health and substance use among 98 low-income women (mean age 25.4 years; 93% Black/African American) referred to a mental health care manager in an urban women's clinic. Self-report and retrospective chart review data were utilized. Chi-squared and Fisher's Exact tests were performed to assess bivariate relationships between ACEs and mental health and substance use outcomes. Multivariate logistic regressions were used to examine the impact of ACEs on mental health and substance use, adjusting for marital status, education, and age. Findings indicate high levels of childhood adversity, specifically childhood abuse, are associated with negative perinatal mental health and substance use outcomes, including suicidal thoughts, anxiety, mood dysregulation, and tobacco and marijuana use. Inquiring about ACEs during prenatal care and/or in community health clinics may help identify patients' overall risk and provide opportunities for intervention for mothers and their infants.

Infant mental health home visiting: intervention dosage and therapist experience interact to support improvements in maternal reflective functioning.

This study examined changes in parental reflective functioning (PRF) among mothers enrolled in Infant Mental Health-Home Visiting (IMH-HV) and explored whether parental risk, treatment dosage or therapist experience predicted change in PRF. Participants included 75 mothers and their children who were enrolled in IMH-HV delivered by Community Mental Health therapists. Results indicated significant improvements in PRF from baseline to 12-months. Maternal demographic and psychosocial risk, therapist experience and treatment dosage were not directly associated with changes in PRF. However, Mothers who received more treatment sessions from therapists with six or more years of experience demonstrated the greatest improvements in PRF, while mothers who received more treatment sessions from therapists who had been practicing IMH for less than 15 months showed a decline in PRF. Therapists working with very high-risk families may need specific training and ongoing reflective supervision over a period of years to promote improvement in PRF.

Maternal prenatal depression, PTSD, and problematic parenting: the mediating role of maternal perceptions of infant emotion.

Background: Perinatal illness is alarmingly common and has negative effects on maternal and infant well-being. Depression and posttraumatic stress disorder (PTSD), specifically, are characterised by negative views of the self and others, which may impact a mother's perceptions of herself and her child. Objective: This study examined the relationship between depression and PTSD symptoms, maternal perceptions of infant emotions, and parenting behaviours. Methods: 120 pregnant, mostly low-income women and their infants (after birth) participated in a longitudinal study. Maternal depression and PTSD symptoms were assessed during pregnancy and 1 year postpartum; maternal perceptions of infant emotions and parenting quality were assessed at 1 year. Results: Correlation analyses revealed significant, negative associations between prenatal (but not postnatal) psychiatric symptoms and positive perceptions of infant emotions, as well as between positive perceptions of infant emotions and negative parenting. Results also revealed significant indirect effects of prenatal depressive and PTSD symptoms on negative parenting via perceptions of infant emotion (95% CIs:.0013 -.0200 and.0008 -.0083, respectively). Conclusion: Findings highlight that mothers should be routinely screened for psychiatric symptoms during the perinatal period, and perceptions of infant emotions may be an important target for parent-infant mental health interventions.

The emotional tone of child descriptions during pregnancy is associated with later parenting.

INTRODUCTION: How parents think and feel about their young children has implications for the parent-child relationship. We examined prospective associations between prenatal descriptions of the unborn child's personality and later parenting behavior. METHODS: Pregnant women (N = 120; mean age = 26.16, SD = 5.71) were recruited in their third trimester for a longitudinal study. The sample is demographically diverse and predominantly economically disadvantaged. During prenatal interviews, women described their unborn child's personality, from which positive and negative emotion words were coded. Parenting behavior was coded 12 months postpartum (n = 105 for longitudinal analyses). RESULTS: Use of positive and negative words was negatively correlated (r = -.34, p < .001). Greater use of positive words to describe the unborn child's personality was associated with higher observed sensitivity, warmth, and engagement during mother-infant interactions, whereas negative words were associated with higher interference and lower levels of sensitivity. Mothers who used anxiety- and/or anger-related words to describe their unborn child, relative to mothers who did not, demonstrated higher interference and lower warmth and sensitivity. CONCLUSION: Descriptions of a child's personality before the child is born were associated with postnatal parenting behavior. Prenatal interventions that address negative thoughts and feelings regarding the child may be beneficial for promoting positive parenting postnatally.

Infant mental health home visiting therapists' fidelity to the Michigan IMH-HV model in community practice settings.

Implementation research suggests that fidelity to a therapeutic model is important for enhancing outcomes, yet can be difficult to achieve in community practice settings. Furthermore, few published studies have reported on characteristics of treatment fidelity. The present study examined fidelity to the Infant Mental Health Home Visiting (IMH-HV) model among 51 therapists with a range of experience practicing in community settings across the state of Michigan. IMH therapists completed fidelity checklists after every session with participating families to track use of 15 treatment strategies central to the IMH-HV model across the 12-month study period. Results indicated that the most commonly endorsed components utilized in home visits were developmental guidance and infant-parent psychotherapy, followed by the provision of emotional support. Use of IMH-HV components did not vary over time for the entire sample; however, patterns of strategies used showed somewhat more variability among more experienced therapists and when serving higher risk families. Findings demonstrate that IMH-HV therapists report a range of adherence to the model in community settings, with greatest fidelity to several model core components. Ongoing training in the flexible use of all core strategies may further enhance fidelity and contribute to positive outcomes for caregivers and their children receiving IMH-HV services.

Infant mental health home visiting therapists' reflective supervision self-efficacy in community practice settings.

In recent years, there has been an increase in the research on reflective supervision, including the development of tools designed to measure reflective practice in the context of reflective supervision. The Reflective Supervision Self-Efficacy Scale for Supervisees (RSSESS) is a self-report measure that has been used in previous evaluations and is designed to assess perceived reflective practice self-efficacy for Infant Mental Health-Home Visiting (IMH-HV) therapists. Properties of the RSSESS including factor structure and reliability are explored in a first study that lays the foundation for the use of the RSSESS in an IMH-HV evaluation in the State of Michigan. IMH-HV therapists completed the RSSESS at 4 time points over a 12-month period and also completed a Clinician Profile Form that included questions about their IMH background and their work experience, including job satisfaction and burnout. Results indicated that the RSSESS is a reliable tool to measure change in reflective practice skills. IMH-HV therapists demonstrated growth in their use of reflective practice skills with families and their observational skills over the 12-month period. In addition, results indicated correlations between reflective supervision self-efficacy and job satisfaction as well as burnout.

Community-delivered infant-parent psychotherapy improves maternal sensitive caregiving: Evaluation of the Michigan model of infant mental health home visiting.

The current study evaluated the effectiveness of a home-based psychotherapeutic Infant Mental Health Home Visiting (IMH-HV) intervention for enhancing parenting sensitivity; a secondary aim was to evaluate whether the use of video feedback was associated with greater treatment response. Participants were N = 78 mothers and their children (age at entry ranged from prebirth to 24-month old (M = 9.8, SD = 8.4), who were initiating IMH-HV services with community mental health-based therapists (N = 51). Dyads were assessed during extended home visits via standardized interviews and observational and questionnaire methods within the first month of treatment (baseline), and again 6 and 12 months thereafter. Following each of these extended home visits, study evaluators completed a standard Q-sort to capture observations of maternal sensitivity during the visit. Therapists completed fidelity checklists used to derive the total number of IMH-HV sessions received (i.e., dosage) and frequency with which therapists provided video feedback. Results indicated a dose-response relationship between number of sessions and maternal sensitivity, and that video review with parents independently contributed to improved maternal sensitivity. Discussion focuses on the effectiveness of this community-based psychotherapeutic home visiting model for enhancing parenting, as well as the value of video feedback as a specific therapeutic strategy.

Impact of Behavioral Feeding Intervention on Child Emotional and Behavioral Functioning, Parenting Stress, and Parent-Child Attachment.

OBJECTIVES: Behavioral intervention is the only treatment for pediatric feeding problems with well documented empirical support. However, parents may be hesitant to pursue behavioral intervention because of concerns about possible negative side effects on child behavioral health and the parent-child relationship. This study investigated associations between behavioral feeding treatment and parenting stress, internalizing and externalizing behavior problems in young children, and parent-child attachment quality. METHODS: Participants included 16 mother-child dyads seeking treatment from a behavioral feeding clinic at a large Midwestern university medical center. Children were between the ages of 30 and 45 months (adjusted) at baseline. Caregivers completed the Child Behavior Checklist for ages 1.5 to 5 (CBCL/1.5-5), the Parenting Stress Index, 3rd Edition Short Form (PSI/SF), and mother-child dyads participated in the Strange Situation procedure at baseline and again after 6 months. The treatment group (n = 12) began outpatient behavioral feeding intervention following the baseline evaluation, whereas the control group (n = 12) remained on the clinic waitlist until after the 6-month follow-up. RESULTS: The treatment group demonstrated decreases in internalizing and externalizing child behavior problems and parenting stress compared with the control group. No significant differences were demonstrated in parent-child attachment quality within or between groups. CONCLUSIONS: Behavioral feeding intervention had positive effects on perceptions of child emotional and behavioral functioning and maternal parenting stress. Intervention also did not impact the quality of the mother-child attachment relationship. Further research with a larger sample size and additional observational measures of behavior is needed to support the replicability and generalizability of these results.

Trajectories of maternal depressive symptoms across the birth of a child: associations with toddler emotional development.

Depression during the perinatal period is common and impacts the physical and psychological well-being of those who experience it. One area of particular significance is the course of maternal depression across time, including the differential effects of depression trajectories during the perinatal period on early child development. The current study explored trajectories of maternal depressive symptoms from pregnancy through 2 years postpartum and their relation to toddler emotional development. Participants included 120 primarily low-income, ethnically diverse women and their toddlers. Depression was assessed during pregnancy, at 3 months postpartum, and at 1 and 2 years postpartum. Toddler emotional development was assessed at age 2 via video observations and mother report. Results indicated a four-class model that best fits the data: low-decreasing (47.5 %), stable-low (22.5 %), stable-moderate (21.7 %), and increasing (8.3 %) trajectories of maternal depressive symptoms. Women in the increasing group reported significantly more toddler social and emotional problems at age 2 than women in all other groups, and women in the stable-moderate group reported significantly more toddler social and emotional problems at age 2 than women in the stable-low group. No associations between trajectories and observed toddler affect expression were found. Results highlight variable courses of depressive symptoms for women across the birth of a child as well as the importance of reducing depression for the benefit of both mother and child. It is important for clinicians working with pregnant and postpartum mothers to assess for depressive symptoms over time and not just at a single time point.

THE CAREGIVING HELPLESSNESS QUESTIONNAIRE: EVIDENCE FOR VALIDITY AND UTILITY WITH MOTHERS OF INFANTS.

Severe disruptions in the caregiving system can lead to disorganized caregiving characterized by maternal helplessness and fear. Such caregivers abdicate their caregiving role and fail to provide protection to the child. The measurement of disorganized caregiving has historically been limited to lengthy, labor-intensive interviews, indicating a need for other feasible tools to assess this important construct. Furthermore, few studies have investigated correlates of disorganized caregiving. Participants included 120 diverse, primarily economically disadvantaged women who were part of a longitudinal study examining psychosocial risk factors before and after the birth of a child. Participants completed the Caregiving Helplessness Questionnaire (CHQ; C. George & J. Solomon, 2011) along with measures assessing maternal mental health, trauma exposure, parenting stress, and infant socioemotional adjustment. Results indicated that caregiver helplessness and fear, based on the CHQ, were positively associated with maternal depression, parenting stress, and perceptions of infant socioemotional problems. Importantly, results also revealed significant associations between current maternal trauma experiences and mothers' reports of helplessness and fear. Findings from the present study indicate that the CHQ may be a valid screening tool for disorganized caregiving among mothers of infants. In addition, a number of maternal experiences may be related to disorganized caregiving following the birth of a child.

Secure base scripts are associated with maternal parenting behavior across contexts and reflective functioning among trauma-exposed mothers.

There is growing evidence that "secure-base scripts" are an important part of the cognitive underpinnings of internal working models of attachment. Recent research in middle class samples has shown that secure-base scripts are linked to maternal attachment-oriented behavior and child outcomes. However, little is known about the correlates of secure base scripts in higher-risk samples. Participants in the current study included 115 mothers who were oversampled for childhood maltreatment and their infants. Results revealed that a higher level of secure base scriptedness was significantly related to more positive and less negative maternal parenting in both unstructured free play and structured teaching contexts, and to higher reflective functioning scores on the Parent Development Interview-Revised Short Form. Associations with parent-child secure base scripts, specifically, indicate some level of relationship-specificity in attachment scripts. Many, but not all, significant associations remained after controlling for family income and maternal age. Findings suggest that assessing secure base scripts among mothers known to be at risk for parenting difficulties may be important for interventions aimed at altering problematic parental representations and caregiving behavior.

Maternal reflective functioning among mothers with childhood maltreatment histories: links to sensitive parenting and infant attachment security.

This study examined relationships among maternal reflective functioning, parenting, infant attachment, and demographic risk in a relatively large (N = 83) socioeconomically diverse sample of women with and without a history of childhood maltreatment and their infants. Most prior research on parental reflective functioning has utilized small homogenous samples. Reflective functioning was assessed with the Parent Development Interview, parenting was coded from videotaped mother-child interactions, and infant attachment was evaluated in Ainsworth's Strange Situation by independent teams of reliable coders masked to maternal history. Reflective functioning was associated with parenting sensitivity and secure attachment, and inversely associated with demographic risk and parenting negativity; however, it was not associated with maternal maltreatment history or PTSD. Parenting sensitivity mediated the relationship between reflective functioning and infant attachment, controlling for demographic risk. Findings are discussed in the context of prior research on reflective functioning and the importance of targeting reflective functioning in interventions.

Intimate partner violence and infant socioemotional development: the moderating effects of maternal trauma symptoms.

The aim of the present study was to investigate the impact of intimate partner violence (IPV) on infant regulatory difficulties at 3 months of age and infant socioemotional problems at 12 months of age. Maternal trauma symptoms were explored as potential moderators of these associations. Participants included 120 primarily low-income, ethnically diverse women and their infants. Results revealed that infants whose mothers experienced IPV during pregnancy did not have significantly more regulatory difficulties at 3 months than did infants whose mothers did not experience prenatal IPV. However, infants whose mothers experienced IPV during the first year after birth displayed significantly more socioemotional problems at 12 months, as evidenced by both maternal report and observational data. Furthermore, maternal posttraumatic stress avoidance symptoms served as a moderator of the association between prenatal IPV and infant regulatory difficulties at 3 months whereas maternal posttraumatic stress hyperarousal and reexperiencing symptoms served as moderators of the association between IPV during the first year after birth and infant socioemotional problems at 12 months. The findings highlight the detrimental impact that IPV can have on very young children and the importance of maternal trauma symptoms as a context for understanding the effect of IPV on young children's functioning.

Caregiver-reported infant motor and imitation skills predict M-CHAT-R/F.

Altered motor and social-communicative abilities in infancy have been linked to later ASD diagnosis. Most diagnostic instruments for ASD cannot be utilized until 12 months, and the average child is diagnosed substantially later. Imitation combines motor and social-communicative skills and is commonly atypical in infants at risk for ASD. However, few measures have been developed to assess infant imitation clinically. One barrier to the diagnostic age gap of ASD is accessibility of screening and diagnostic services. Utilization of caregiver report to reliably screen for ASD mitigates such barriers and could aid in earlier detection. The present study developed and validated a caregiver-report measure of infant imitation at 4, 6, and 9 months and explored the relationship between caregiver-reported imitation and motor abilities with later ASD risk. Participants (N = 571) were caregivers of term and preterm infants recruited as part of a large multi-site study of PediaTrac™, a web-based tool for monitoring and tracking infant development. Caregivers completed online surveys and established questionnaires on a schedule corresponding to well-child visits from birth to 18 months, including the M-CHAT-R/F at 18 months. Distinct imitation factors were derived from PediaTrac at 4, 6, and 9 months via factor analysis. The results supported validity of the imitation factors via associations with measures of infant communication (CSBS; ASQ). Imitation and motor skills at 9 months predicted 18-month ASD risk over and above gestational age. Implications for assessment of infant imitation, detecting ASD risk in the first year, and contributing to access to care are discussed.