Observations on the Clinical Effects of Music Therapy on Premature Infants in Neonatal Intensive Care Units.

OBJECTIVE: This study aimed to explore the clinical effects of music therapy (MT) on premature infants in neonatal intensive care units (NICUs). METHODS: A total of 78 premature infants in NICUs admitted from January 2021 to January 2022 in Wuhan Children's Hospital, Tongji Medical College, and Huazhong University of Science and Technology were selected as the reference group and received routine management. Wuhan Children's Hospital implemented MT from February 2022 to February 2023, and 74 premature infants in NICUs admitted during the same period were selected as the observation group. The corresponding management mode was implemented on the second day of NICU admission for premature infants. Amplitude-integrated electroencephalogram (aEEG) and neonatal behavioral neurological assessment (NBNA) were adopted to evaluate the brain function, specifically the neurological function of neonates, after the end of management. The degree of parent-child attachment was measured using the pictorial representation of attachment measure (PRAM) in a nonverbal (visual) manner. The temperature, pulse, respiratory rate (RR), the number and duration of crying, and incidence of complications were all compared between the two groups. RESULTS: SPSS showed that no difference existed in the aEEG and NBNA scores between the two groups (P > 0.05). The distance of PRAM self-baby-distance was smaller in the observation group compared with the reference group (P < 0.05). Furthermore, there was no significant difference in temperature between the two groups (P > 0.05). The observation group had significantly lower pulse and RR values than the reference group (P < 0.05). Finally, no significant difference existed in the incidence of complications between the two groups (P > 0.05). CONCLUSION: MT has a certain application value for premature infants in NICUs and can thus be applied to newborns in other NICUs. However, further studies are required to completely verify the research results.

Evaluations of aggressive chasing interactions by 7-month-old infants.

Recent theories of socio-moral development assume that humans evolved a capacity to evaluate others' social actions in different kinds of interactions. Prior infant studies found both reaching and visual preferences for the prosocial over the antisocial agents. However, whether the attribution of either positive or negative valence to agents' actions involved in an aggressive chasing interaction can be inferred by both reaching behaviors and visual attention deployment (i.e., disengagement of visual attention) is still an open question. Here we presented 7-month-old infants (N = 92) with events displaying an aggressive chasing interaction. By using preferential reaching and an attentional task (i.e., overlap paradigm), we assessed whether and how infants evaluate aggressive chasing interactions. The results demonstrated that young infants prefer to reach the victim over the aggressor, but neither agent affects visual attention. Moreover, such reaching preferences emerged only when dynamic cues and emotional face-like features were congruent with agents' social roles. Overall, these findings suggested that infants' evaluations of aggressive interactions are based on infants' sensitivity to some kinematic cues that characterized agents' actions and, especially, to the congruency between such motions and the face-like emotional expressions of the agents.

The haves and have-nots: Infants use wealth to guide social behavior and evaluation.

Biases favoring the wealthy are ubiquitous, and they support and bolster vast resource inequalities across individuals and groups; yet, when these biases are acquired remains unknown. In Experiments 1 through 5 (Total N = 232), using multiple methods, we found that 14- to 18-month-old infants track individuals' wealth (Experiments 1-5), prefer and selectively help rich (vs. poor) individuals (Experiments 2 and 3), and negatively evaluate poor individuals (Experiments 4 and 5). In two subsequent experiments with 11- to 13-month-old infants (Total N = 65), however, we find no evidence of preferences for rich (vs. poor) individuals (Experiment 6) or differential evaluations of rich and poor people (Experiment 7). Together, these results demonstrate that in the second year of life, wealth emerges as a central and robust dimension of evaluation that guides social decision making. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Bidirectional Relations Among Maternal Positive Emotion, Infant Positive Emotionality, and Infant Physiological Regulation Across the First 18 Months of Life.

Respiratory sinus arrhythmia (RSA), a marker of self-regulation, has been linked to developmental outcomes in young children. Although positive emotions may have the potential to facilitate physiological self-regulation, and enhanced self-regulation could underlie the development of positive emotions in early childhood, the relation between positive emotions and physiological self-regulation in infancy has been relatively overlooked. The current study examined the bidirectional associations among maternal positive emotion, infant positive emotionality, and infant resting RSA across the first 18 months of life. We used data from the Longitudinal Attention and Temperament Study (LanTs; N = 309 in the current analysis) to test the within- and between-person relations of study variables over time using a random-intercepts cross-lagged panel model. We found that infants with higher overall levels of positive emotionality also displayed greater resting RSA, and their mothers exhibited higher levels of positive emotion. However, there were negative cross-lagged associations within-person; higher than average infant positive emotionality predicted lower levels of infant resting RSA at the subsequent timepoint during early infancy, whereas higher than average infant RSA subsequently predicted decreased levels of infant positive emotionality later in infancy. Results highlight the importance of considering transactional relations between positive emotion and physiological self-regulation in infancy.

Modeling the relationship between maternal health and infant behavioral characteristics based on machine learning.

This study investigates the impact of maternal health on infant development by developing a mathematical model that delineates the relationship between maternal health indicators and infant behavioral characteristics and sleep quality. The main contributions of this study are as follows: (1) The use of Spearman's correlation coefficient to conduct correlation analysis and explore the main factors that influence infant behavioral characteristics based on maternal indicators. (2) The development of a combined model using machine learning techniques, including random forest (RF) and multilayer perceptron (MLP) to establish the relationship between maternal health (physical and psychological health) and infant behavioral characteristics. The model is trained and validated by the real data respectively. (3) The use of the Fuzzy C-means (FCM) dynamic clustering model to classify infant sleep quality. An RF regression model is constructed to predict infant sleep quality using maternal indicators. This study is significant in gaining a deeper understanding of the relationship between maternal health indicators and infant development, and provides a basis for future intervention measures.

Optimizing Neonatal Prefeeding Habilitation: A Holistic Approach Integrating Neonatal Learning Behaviors, Motor Development, and Evidence-Based Interventions.

Neonatal clinicians utilize prefeeding interventions with premature infants to promote a natural process of oral-sensory development, hoping to prepare the infant for future oral feeding. Prefeeding interventions require a holistic approach, ensuring infants are actively involved in learning. Therapists can achieve this by prioritizing the development of intentionality, which is the conscious pursuit of action driven by motivation. The authors present a conceptual model of six neonatal behavioral states of learning called the "Neonatal Intentional Capacities." This model illustrates how purposeful actions evolve into extended learning sequences and helps determine how well an infant can participate in learning experiences. The authors will elucidate the dynamic relationship between intentionality and the development of adaptive motor skills of prefeeding. Lastly, this article presents a consolidated and categorized grouping of current evidence-based prefeeding interventions. Utilizing the framework presented, the authors offer clinical guidance to support prefeeding treatment planning.

Emerging Adults Mirror Infants' Emotions and Yawns.

Infants' nonverbal expressions-a broad smile or a sharp cry-are powerful at eliciting reactions. Although parents' reactions to their own infants' expressions are relatively well understood, here we studied whether adults more generally exhibit behavioral and physiological reactions to unfamiliar infants producing various expressions. We recruited U.S. emerging adults (N = 84) prior to parenthood, 18-25 years old, 68% women, ethnically (20% Hispanic/Latino) and racially (7% Asian, 13% Black, 1% Middle Eastern, 70% White, 8% multiracial) diverse. They observed four 80-s audio-video clips of unfamiliar 2- to 6-month-olds crying, smiling, yawning, and sitting calmly (emotionally neutral control). Each compilation video depicted 9 different infants (36 clips total). We found adults mirrored behaviorally and physiologically: more positive facial expressions to infants smiling, and more negative facial expressions and pupil dilation-indicating increases in arousal-to infants crying. Adults also yawned more and had more pupil dilation when observing infants yawning. Together, these findings suggest that even nonparent emerging adults are highly sensitive to unfamiliar infants' expressions, which they naturally "catch" (i.e., behaviorally and physiologically mirror), even without instructions. Such sensitivity may have-over the course of humans' evolutionary history-been selected for, to facilitate adults' processing of preverbal infants' expressions to meet their needs.

The infant parasympathetic nervous system is socially embedded and dynamic at multiple timescales, within and between people.

Human interpersonal capacities emerge from coordinated neural, biological, and behavioral activity unfolding within and between people. However, developmental research to date has allocated comparatively little focus to the dynamic processes of how social interactions emerge across these levels of analysis. Second-person neuroscience and dynamic systems approach together to offer an integrative framework for addressing these questions. This study quantified respiratory sinus arrhythmia and social behavior (∼360 observations per system) from 44 mothers and typically developing 9-month-old infants during a novel modified "still-face" (text message perturbation) task. Stochastic autoregression models indicate that the infant parasympathetic nervous system is coupled within and between people second by second and is sensitive to social context. Intraindividual, we found positive coupling between infants' parasympathetic nervous system activity and their social behavior in the subsequent second, but only during the moments and periods of active caregiver engagement. Between people, we found a bidirectional coregulatory feedback loop: Mothers' parasympathetic activity positively predicted that of their infant in the subsequent second, a form of synchrony that decreased during the text message perturbation and did not fully recover. Conversely, infant parasympathetic activity negatively predicted that of their mother at the subsequent second, a form of synchrony that was invariant over social context. Findings reveal unidirectional parasympathetic coupling within infants and a complementary allostatic feedback loop between mother and infant parasympathetic systems. They offer novel evidence of a dynamic, socially embedded parasympathetic system at previously undocumented timescales, contributing to both basic science and potential clinical targets to better support adaptive, multisystem social development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Co-regulation, relationship quality, and infant distress vocalizations observed during mother-infant interactions: Influences of maternal depression and different contexts.

Mother-infant interactions are co-regulated and provide the foundation for mother-infant relationship quality. The implications of maternal depression and contextual demands (i.e., reinstating the interaction following maternal unavailability and vocalized infant distress) on observationally coded co-regulation in mother-infant dyads (n = 40) at 4-months was investigated. Associations among co-regulation patterns and mother-infant relationship quality was also examined. Dyads participated in Still-Face (SF) and Separation (SP) procedures, with periods of maternal emotional and physical unavailability. Co-regulation was captured using the Revised Relational Coding System. Relationship quality was examined using the Emotional Availability Scales. Dyads in the depressed group had significantly more unilateral exchanges than the non-depressed group following the SF and SP perturbations. The depressed group also had significantly more distress vocalizations during the SP perturbation than the non-depressed group. Co-regulation in the depressed group was less disrupted by the SF perturbation. Positive relationship quality dimensions (maternal sensitivity, structuring, and infant responsiveness) were associated with more symmetrical and less unilateral co-regulation regardless of the interaction period. There were also context-specific results pertaining to patterns of co-regulation and associated maternal hostility and infant responsiveness. Results highlight co-regulatory differences in depressed mothers and their infants and how these differences are exacerbated by contextual demands.

Outcome of creating clustering nursing care and healing environment on premature infants' behavioural outcomes.

We conducted a quasi-experimental study in two neonatal intensive care units (NICUs) from January to July 2021, focusing on the effects of clustering nursing care and creating a healing environment on premature infants' behavioural outcomes. The study included 106 infants, with 53 in both the study and control groups. Significant improvements were observed in organisation state/sleep and responsiveness/interaction domains in the study group, along with shorter hospital stays and greater weight gain on discharge. These findings highlight the positive impact of targeted interventions on premature infants' developmental outcomes, emphasising the need for comprehensive care strategies in NICU settings.

Facing infant cuteness: How nurturing care motivation and oxytocin system gene methylation are associated with responses to baby schema features.

Baby schema features are a specific set of physical features-including chubby cheeks, large, low-set eyes, and a large, round head-that have evolutionary adaptive value in their ability to trigger nurturant care. In this study among nulliparous women (N = 81; M age = 23.60, SD = 0.44), we examined how sensitivity to these baby schema features differs based on individual variations in nurturant care motivation and oxytocin system gene methylation. We integrated subjective ratings with measures of facial expressions and electroencephalography (EEG) in response to infant faces that were manipulated to contain more or less pronounced baby schema features. Linear mixed effects analyses demonstrated that infants with more pronounced baby schema features were rated as cuter and participants indicated greater motivation to take care of them. Furthermore, infants with more pronounced baby schema features elicited stronger smiling responses and enhanced P2 and LPP amplitudes compared to infants with less pronounced baby schema features. Importantly, individual differences significantly predicted baby schema effects. Specifically, women with low OXTR methylation and high nurturance motivation showed enhanced differentiation in automatic neurophysiological responses to infants with high and low levels of baby schema features. These findings highlight the importance of considering individual differences in continued research to further understand the complexities of sensitivity to child cues, including facial features, which will improve our understanding of the intricate neurobiological system that forms the basis of caregiving behavior.

Endogenous Control and Reward-based Mechanisms Shape Infants' Attention Biases to Caregiver Faces.

Infants rely on developing attention skills to identify relevant stimuli in their environments. Although caregivers are socially rewarding and a critical source of information, they are also one of many stimuli that compete for infants' attention. Young infants preferentially hold attention on caregiver faces, but it is unknown whether they also preferentially orient to caregivers and the extent to which these attention biases reflect reward-based attention mechanisms. To address these questions, we measured 4- to 10-month-old infants' (N = 64) frequency of orienting and duration of looking to caregiver and stranger faces within multi-item arrays. We also assessed whether infants' attention to these faces related to individual differences in Surgency, an indirect index of reward sensitivity. Although infants did not show biased attention to caregiver versus stranger faces at the group level, infants were increasingly biased to orient to stranger faces with age and infants with higher Surgency scores showed more robust attention orienting and attention holding biases to caregiver faces. These effects varied based on the selective attention demands of the task, suggesting that infants' attention biases to caregiver faces may reflect both developing attention control skills and reward-based attention mechanisms.

Emergence of locomotor behaviors: Associations with infant characteristics, developmental status, parental beliefs, and practices in typically developing Brazilian infants aged 5 to 15 months.

Independent locomotion provides autonomy for infants, drastically changing their relationship with their surroundings. From a dynamic systems perspective, the interaction between environment, tasks, and organismic constraints leads to the emergence of new behaviors over time. This 6-month longitudinal study aimed to verify associations between the emergence of locomotor behaviors and infants' characteristics, developmental status, parental beliefs, and practices. This observational study remotely assessed 37 full-term Brazilian infants aged 5 to 15 months, divided into two groups (G1: 5 to 11 months, n = 19; and G2: 9 to 15 months, n = 18). The motor developmental status of infants was closely associated with the emergence of behaviors (p < 0.05). Infants in G2 whose parents agreed with the statement "In typically developing infants, motor development occurs naturally and there is no need to actively stimulate it" started to walk later than those whose parents disagreed. Infants whose parents expected them to walk around 10-11 months walked earlier compared to those expected to walk after 11 months (G2, p = 0.011). Infants in G2 with a high frequency of staying in the supine position started to walk, both with and without support, later than those with a low frequency (p < 0.05). For infants in G1 with a high frequency of playing on the floor, locomotion (p = 0.041) and crawling on hands-and-knees (p = 0.007) started sooner compared to those with a low frequency. Staying in the cradle more frequently was related to a later emergence of supported walk (p = 0.046) among infants in G2. The emergence of locomotor behaviors is associated with motor developmental status, the surfaces where the infant plays, and body position. Parental beliefs and expectations influence how infants are stimulated and, consequently, the emergence of independent walking.

Infants' salivary oxytocin and positive affective reactions to people.

Oxytocin is a neuropeptide positively associated with prosociality in adults. Here, we studied whether infants' salivary oxytocin can be reliably measured, is developmentally stable, and is linked to social behavior. We longitudinally collected saliva from 62 U.S. infants (44 % female, 56 % Hispanic/Latino, 24 % Black, 18 % non-Hispanic White, 11 % multiracial) at 4, 8, and 14 months of age and offline-video-coded the valence of their facial affect in response to a video of a smiling woman. We also captured infants' affective reactions in terms of excitement/joyfulness during a live, structured interaction with a singing woman in the Early Social Communication Scales at 14 months. We detected stable individual differences in infants' oxytocin levels over time (over minutes and months) and in infants' positive affect over months and across contexts (video-based and in live interactions). We detected no statistically significant changes in oxytocin levels between 4 and 8 months but found an increase from 8 to 14 months. Infants with higher oxytocin levels showed more positive facial affect to a smiling person video at 4 months; however, this association disappeared at 8 months, and reversed at 14 months (i.e., higher oxytocin was associated with less positive facial affect). Infant salivary oxytocin may be a reliable physiological measure of individual differences related to socio-emotional development.

Infant sensorimotor decoupling from 4 to 9 months of age: Individual differences and contingencies with maternal actions.

Triadic interactions, wherein infants coordinate attention between caregivers and objects of shared focus, are believed to facilitate infant learning, and emerge around 9-12 months of age (Carpenter et al., 1998). Sensorimotor decoupling, wherein infants look at one percept while manipulating another, or use each hand for different actions, was hypothesized (de Barbaro et al., 2016) to contribute to triadic skills by allowing infants to smoothly shift attention between objects and social partners. We explored the development of Hand-Hand (H-H) and Gaze-Hand (G-H) decoupling in 38 infants at 4, 6, and 9 months. We also tested contingencies between maternal behaviors and infant decoupling: i.e., whether decoupling events followed maternal object-directed actions. Both overall and contingent infant decoupling increased from 4 to 9 months. Decoupling rates (both G-H and H-H) predicted variance in infants' fine and gross motor scores. Contingent G-H decoupling at 6 months predicted BSID-III communication scores at 18 months. Thus the development of infant sensorimotor skills, including decoupling, allows infants to smoothly shift attention and participate in triadic interactions.

Trajectories of brain and behaviour development in the womb, at birth and through infancy.

Birth is often seen as the starting point for studying effects of the environment on human development, with much research focused on the capacities of young infants. However, recent imaging advances have revealed that the complex behaviours of the fetus and the uterine environment exert influence. Birth is now viewed as a punctuate event along a developmental pathway of increasing autonomy of the child from their mother. Here we highlight (1) increasing physiological autonomy and perceptual sensitivity in the fetus, (2) physiological and neurochemical processes associated with birth that influence future behaviour, (3) the recalibration of motor and sensory systems in the newborn to adapt to the world outside the womb and (4) the effect of the prenatal environment on later infant behaviours and brain function. Taken together, these lines of evidence move us beyond nature-nurture issues to a developmental human lifespan view beginning within the womb.

What we don't know about what babies know: Reconsidering psychophysics, exploration, and infant behavior.

Researchers must infer "what babies know" based on what babies do. Thus, to maximize information from doing, researchers should use tasks and tools that capture the richness of infants' behaviors. We clarify Gibson's views about the richness of infants' behavior and their exploration in the service of guiding action - what Gibson called "learning about affordances."

Neonatal neurobehavior associated with developmental changes from age 2 to 3 in very preterm infants.

OBJECTIVE: Understand how high-risk infants' development changes over time. Examine whether NICU Network Neurobehavioral Scale (NNNS) profiles are associated with decrements in developmental outcomes between ages 2 and 3 years in infants born very preterm. STUDY DESIGN: The Neonatal Outcomes for Very preterm Infants (NOVI) cohort is a multisite prospective study of 704 preterm infants born <30 weeks' gestation across nine university and VON affiliated NICUs. Data included infant neurobehavior measured by NNNS profiles at NICU discharge and the Bayley Scales of Infant and Toddler Development (BSID-III) at ages 2 and 3 years. Generalized estimating equations tested associations between NNNS profiles and BSID-III composite score changes between ages 2 and 3 years. RESULTS: The final study sample included 433 infants with mean gestational age of 27 weeks at birth. Infants with dysregulated NNNS profiles were more likely to have decreases in BSID-III Cognitive (OR = 2.66) and Language scores (OR = 2.53) from age 2 to 3 years compared to infants with more well-regulated neurobehavioral NNNS profiles. Further, infants with more well-regulated NNNS profiles were more likely to have increases in BSID-III Cognitive scores (OR = 2.03), rather than no change, compared to infants with dysregulated NNNS profiles. CONCLUSIONS AND RELEVANCE: Prior to NICU discharge, NNNS neurobehavioral profiles identified infants at increased risk for developing later language and cognitive challenges. Findings suggests that neonatal neurobehavior provides a unique, clinically significant contribution to the evaluation of very preterm infants to inform treatment planning for the most vulnerable.

The impact of goal saliency and verbal information on selective imitation in 16- to 18-month-olds.

This study aimed to assess which action component (movement or goal) infants prioritize in their imitation behavior when they get information about its relevance from two important sources: perceptual goal saliency and experimenter's verbal information. 16- to 18-month-olds (N = 72) observed how the experimenter moved a toy mouse with a hopping or sliding movement onto one of two empty spaces (low goal saliency) or 2D circles (medium saliency), or inside one of two 3D houses (high saliency). Before the demonstration, the experimenter verbally announced the movement style or the goal. Results showed that verbal action descriptions did not influence infants' imitation. However, matching previous findings, infants imitated the goal more often than the movement in the high-saliency condition, and the movement more often than the goal in the low-saliency condition. Moreover, in the novel medium-saliency condition, infants imitated both components equally often. Thus, selective imitation varied as a function of perceptual goal saliency, but not of verbal cues. This suggests that perceptual features can enhance infants' bottom-up processing and imitation of action components, while the impact of top-down processes based on verbal cues may vary depending on task characteristics and infants' verbal abilities, inducing a need for further research.