Maternal and infant touching behaviours during perturbed interactions: Associations with maternal depressive symptomatology and infant crying.

Touch is an important means through which mothers and infants co-regulate during periods of stress or perturbation. The present study examined the synchrony of maternal and infant touching behaviours among 41 mother-infant dyads, some of whom were deemed at-risk due to maternal depressive symptomatology. Mothers and their 4-month-old infants participated in the Still-Face (maternal emotional unavailability; SF) and Separation (maternal physical unavailability; SP) procedures. Infant crying was examined across procedures and investigated as a brief period of perturbation. Results revealed that mothers and infants displayed a positive pattern of tactile synchrony (coordinated, analogous changes in touch) during infant crying episodes. However, dyads in the high depression group displayed significantly less affectionate touch during instances of infant crying. Furthermore, more depressive symptoms were associated with less maternal and infant touch and lower rates of infant crying. This group of dyads may be less expressive via touch, be less affected by disruptions in their interactions, have impaired regulatory abilities, or simply require minimal amounts of touch to mutually regulate following social stressors and during brief perturbation periods. These findings enrich our limited knowledge about the dynamic interplay of maternal and infant touch and inform preventative intervention programs for at-risk groups.

Discrimination and imitation of facial expression by neonates.

Human neonates (average age, 36 hours) discriminated three facial expressions (happy, sad, and surprised) posed by a live model as evidenced by diminished visual fixation on each face over trials and renewed fixations to the presentation of a different face. The expressions posed by the model, unseeen by the observer, were guessed at greater than chance accuracy simply by observing the face of the neonate, whose facial movements in the brow, eyes, and mouth regions provided evidence for imitation of the facial expressions.

Effects of Brazelton demonstrations for mothers on the development of preterm infants.

Thirty healthy preterm infants were randomly assigned either to a control group or to one of two experimental groups. The mothers of the first experimental group were present during an administration of the Brazelton Neonatal Behavioral Assessment Scale and were asked to complete the Mother's Assessment of the Behavior of Her Infant Scale (MABI) at birth and weekly for four weeks after the discharge of their infants. The mothers of the second experimental group were not present during the administration of the Brazelton scale, but were asked to complete the MABI scale at birth and weekly for the first month after discharge. The mothers of the control infants did not observe administration of the Brazelton scale or complete the MABI scale, but were asked to complete a questionnaire on the developmental milestones of their infants. At 1, 4, and 12 months of age these infants were visited in their homes by teams of researchers blind to the hypothesis of the study and to the group assignment of the infants. The results at 1 month demonstrated that the experimental groups performed more optimally on the Brazelton scale interactive process items. These infants also received superior ratings on the video-taped feeding and face-to-face play sequences. At 4 months the experimental group infants showed better fine motor-adaptive abilities on the Denver Developmental Screening Test than did the control group. In addition, the face-to-face interaction ratings of the two experimental groups were significantly better that were those of the control group. The Bayley Scales of Infant Development were administered when the infants were 12 months corrected age. The infants of the experimental groups received significantly higher scores on the Mental Development Scale. This study suggests that teaching mothers the amazing skills of their newborns on the Brazelton and MABI scales may facilitate early interactions which, in turn, may contribute to early cognitive development.

Tactile/kinesthetic stimulation effects on preterm neonates.

Tactile/kinesthetic stimulation was given to 20 preterm neonates (mean gestational age, 31 weeks; mean birth weight, 1,280 g; mean time in neonatal intensive care unit, 20 days) during transitional ("grower") nursery care, and their growth, sleep-wake behavior, and Brazelton scale performance was compared with a group of 20 control neonates. The tactile/kinesthetic stimulation consisted of body stroking and passive movements of the limbs for three, 15-minute periods per day for a 10 days. The stimulated neonates averaged a 47% greater weight gain per day (mean 25 g v 17 g), were more active and alert during sleep/wake behavior observations, and showed more mature habituation, orientation, motor, and range of state behavior on the Brazelton scale than control infants. Finally, their hospital stay was 6 days shorter, yielding a cost savings of approximately $3,000 per infant. These data suggest that tactile/kinesthetic stimulation may be a cost effective way of facilitating growth and behavioral organization even in very small preterm neonates.

Perinatal cocaine effects on neonatal stress behavior and performance on the Brazelton Scale.

Fifty-two newborns were assessed for the effects of maternal cocaine use on their performance on the Brazelton Neonatal Behavior Assessment Scale and on their stress behaviors during the Brazelton as tapped by the Neonatal Stress Scale. The cocaine-exposed newborns experienced more obstetric complications, had smaller head circumferences, showed more limited habituation abilities on the Brazelton Scale, and exhibited more stress behaviors than control newborns.

Cocaine-exposed preterm neonates show behavioral and hormonal differences.

OBJECTIVE: Prematurity has been associated with prenatal cocaine exposure, but most studies on the behavioral effects of prenatal cocaine exposure have been restricted to full-term infant samples. The current study focused on behavioral and hormonal responses in preterm cocaine-exposed infants compared with a cohort of non-cocaine-exposed infants of similar gestational age. METHODOLOGY: A comparison between 30 cocaine-exposed and 30 non-cocaine-exposed preterm neonates suggested that the cocaine-exposed neonates were born to mothers who had higher parity and more obstetric complications. In addition, mothers of cocaine-exposed preterm neonates visited, touched, held, and fed their infants less frequently than mothers of nonexposed infants. RESULTS: The cocaine-exposed infants had smaller head circumferences at birth, spent more time in the neonatal intensive care unit, and had a greater incidence of periventricular-intraventricular hemorrhages. They also had inferior Brazelton cluster scores, including lower state regulation and range-of-state scores, and greater depression. During sleep-wake behavior observations, they showed difficulty maintaining alert states and self-regulating their behavior, and they spent more time in indeterminate sleep and had decreased periods of quiet sleep and increased levels of agitated behavior, including tremulousness, mouthing, multiple limb movements, and clenched fists. Finally, higher urinary norepinephrine, dopamine, and cortisol levels and lower plasma insulin levels were noted in the cocaine-exposed preterm neonates. CONCLUSIONS: These findings highlight the need for follow-up assessments and early intervention.

Respiratory distress syndrome: perinatal prediction of one year development outcome.

A number of perinatal variables were entered into multivariate regression analyses to determine which variables predicted the one-year Bayley Mental and Motor scores of 46 infants surviving the respiratory distress syndrome. Significant predictors were gestational age, 5 minute Apgar scores, obstetric complications, duration of IPPV and intensive care. Although gestational age was the strongest single predictor of developmental outcome, its predictive power was enhanced by the addition of the other significant perinatal variables. A greater number of the RDS infants received low motor scores as opposed to low mental scores, suggesting that intervention efforts with this group might focus on the development of early sensorimotor skills.

Positive effects of tactile versus kinesthetic or vestibular stimulation on neuroendocrine and ODC activity in maternally-deprived rat pups.

Previous studies in our laboratory have shown that even short-term separation of preweanling rat pups from the mother produces adverse effects in the pup. These include alterations in ornithine decarboxylase activity and in the secretion of growth hormone and corticosterone. The present study demonstrates that while intermittent heavy stroking effectively reverses or prevents all the changes associated with maternal deprivation neither kinesthetic nor vestibular stimulation affects these responses. The results verify earlier findings from this laboratory indicating that tactile interactions between rat pups and their mother modulate pup physiology and provide experimental support for the hypothesized role of tactile stimuli on early infant development.

Massage therapy effects.

Massage therapy is older than recorded time, and rubbing was the primary form of medicine until the pharmaceutical revolution of the 1940s. Popularized again as part of the alternative medicine movement, massage therapy has recently received empirical support for facilitating growth, reducing pain, increasing alertness, diminishing depression, and enhancing immune function. In this article studies are reviewed that document these effects, and models are proposed for potential underlying mechanisms.

Transcutaneous oxygen tension in preterm neonates during neonatal behavioral assessments and heelsticks.

This study evaluates the effects of neonatal behavioral assessments and heelsticks on transcutaneous oxygen tension (TcPO2) in 37 preterm neonates from a neonatal intensive care unit. Two behavioral assessments were evaluated, the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) and the Neurobehavioral Assessment for Preterm Infants (NAPI). TcPO2 during heelsticks was used as a comparison because reliable decreases have typically been noted during heelsticks. Although the heelsticks resulted in significant declines in TcPO2, the behavioral assessments led to only negligible changes in TcPO2. Observed changes during the behavioral assessments occurred in a small number of infants, primarily during the few test procedures administered to the infants outside of their isolettes. Accordingly, it is suggested that time outside the isolette and associated temperature changes may be more critical variables than the assessments per se.

The relationship of Internet use to depression and social isolation among adolescents.

The present study investigated whether higher levels of Internet use are associated with depression and social isolation among adolescents. Eighty-nine high school seniors were administered a questionnaire that measured low (less than 1 hour per day), moderate (1-2 hours per day), and high (more than 2 hours per day) Internet use; relationships with mother, father, and peers; and depression. Low Internet users, as compared with high users, reported better relationships with their mothers and friends.

Adolescents' academic expectations and achievement.

Previous research has indicated that adolescents' relationships with their mother influence their academic expectations and achievement. Substance use has also been found to have a strong influence on academic expectations and achievement. In the present study, 80 high school seniors from middle to upper socioeconomic status families completed questionnaires on behavioral and psychological aspects of adolescent life. Academic expectations were found to be highly correlated with academic achievement (r = .60). A stepwise regression analysis revealed that relationship with mother, academic achievement, and alcohol use accounted for 56% of the total variance in academic expectations. Stepwise regression on academic achievement revealed that cocaine use, marijuana use, and academic expectations accounted for 48% of the total variance.

Angry adolescents who worry about becoming violent.

In the present study, 31 of 89 adolescents responded affirmatively to the following statement: "Sometimes I get so angry that I worry I will become violent." These adolescents (the anger group) were compared with the nonanger group, and several differences were found. The anger group (1) reported less intimacy with parents, received less support from them, and was less close to siblings; (2) had more opposite-sex friends, dated more frequently, and more frequently had a boyfriend or girlfriend; (3) had a lower grade point average; (4) were more depressed; and (5) used marijuana more frequently. Results of a regression analysis revealed that depression and dating were the only significant predictors of anger, explaining 17% of the variance.

Moderate involvement in sports is related to lower depression levels among adolescents.

Sports involvement has been found to be related to social and psychological well-being in Icelandic adolescents. The present study investigated whether similar relationships exist for American adolescents. A group of 89 high school seniors completed a questionnaire that gathered data on sports involvement, depression, intimacy with parents and friends, and grade point average. It was found that the moderate sports involvement group (3 to 6 hours per week) had lower depression scores than did the low sports involvement group (2 hours or less per week). The findings are discussed.

Adolescents with attention deficit hyperactivity disorder benefit from massage therapy.

Twenty-eight adolescents with attention deficit hyperactivity disorder were provided either massage therapy or relaxation therapy for 10 consecutive school days. The massage therapy group, but not the relaxation therapy group, rated themselves as happier and observers rated them as fidgeting less following the sessions. After the 2-week period, their teachers reported more time on task and assigned them lower hyperactivity scores based on classroom behavior.

Adolescent depressed mood and parental unhappiness.

A set of self-report scales on depression, parental happiness, intimate relationships, social support, self-esteem, and risk-taking behavior were administered to 455 adolescents to determine the relationship between depression and these other variables. Adolescents with depressed mood were found to be less intimate with both parents, felt less social support, and had lower self-esteem than their peers. Adolescents who perceived their mother or father as unhappy also reported less intimacy with both parents and less social support.

Polydrug-using adolescent mothers and their infants receiving early intervention.

This study investigated the effects of an intervention for polydrug-using adolescent mothers. The program included educational, vocational, and parenting classes; social and drug rehab; and day care for their infants while they attended school half-day. The drug-exposed infants were similar to the nonexposed infants on traditional birth measures, although they had inferior Brazelton Neonatal Behavioral Assessment Scale scores, including habituation, orientation, abnormal reflexes, general irritability, and regulatory capacity. The drug-exposed infants also spent less time in quiet sleep and more time crying and showing stress behaviors. Both the mothers and the infants in the drug groups demonstrated inferior interactions, and their dopamine and serotonin levels were significantly higher. As early as 3 months (following 3 months of intervention), the drug rehab mothers and their infants looked more like the nondrug group in their interactions; by 6 months, they looked similar on virtually every measure. At 12 months, the infants of drug rehab mothers (versus the drug control group) had superior Early Social Communication Scale scores and Bayley Mental scale scores, as well as significantly greater head circumference and fewer pediatric complications. The drug rehab mothers also improved on several lifestyle variables. They demonstrated a lower incidence of continued drug use and repeat pregnancy, and a greater number continued school, received a high school or general equivalency diploma, or were placed in a job. Thus, a relatively cost-effective high school based intervention had positive effects on both adolescent mothers who had used drugs and their infants.

PIP: The impact of an early childhood intervention program on polydrug-abusing US adolescent mothers and their infants was evaluated. The program, which was located in a vocational school attended by the mothers, included drug rehabilitation, social skills training, parenting classes, job training, and relaxation therapy. Outcomes in 126 drug-exposed mothers 16-21 years of age who participated in the program were compared to those recorded among non-drug-using adolescent mothers who participated in the program and drug-using control mothers who did not participate. All three groups were similar in terms of age, education, socioeconomic status, and ethnicity, but drug-abusing mothers had higher rates of depression and stress. At baseline, drug-exposed infants had lower scores on the measures of habituation, orientation, abnormal reflexes, general irritability, and regulatory capacity on the Neonatal Behavioral Assessment Scale. Drug-exposed infants spent less time sleeping and more time crying and showing stress behaviors. The drug groups also had lower Optimal Interaction Rating Scale scores for both mothers and infants. Their dopamine and serotonin levels were higher than those recorded among non-drug-using mothers and their cortisol levels were lower. However, after 6 months of participation in the intervention program, the drug-using mothers had Beck Depression Inventory scores and interaction ratings that approached those of non-drug-using mothers and exceeded those among drug-using controls. Similar trends were observed for infants' head circumference and scores on the Early Social Communication Scale and the Bayley Mental Status Scale. Moreover, drug-using adolescent mothers who participated in the program demonstrated a lower incidence of repeat pregnancy and continued drug use than those who were not enrolled in the program; moreover, they were more likely to receive their high school diploma and be placed in jobs. Interventions such as this have the potential to attenuate the developmental delays of infants of drug-exposed adolescents.

Visual and cardiac responses to animate and inanimate faces by young term and preterm infants.

Infants' looking and looking-away behaviors, as well as cardiac responses to mothers' spontaneous and imitative and to dolls' animated and still faces, were recorded for 18 term and 18 preterm infants when they were 3 months old. Infants spent less time looking at their mothers' than at the doll's faces, and their heart-rate levels were elevated while looking at mothers' faces. These effects were most pronounced for the preterm infants whose inferior scores on the animate visual item of the Brazelton neonatal scale suggested a continuity of visual inattentiveness to animate stimuli. Both groups also looked at the inanimate more than the animate doll's face and evidenced lower heart-rate levels during that situation. An information-processing/arousal-modulation interpretation was made for infant looking-away behavior and elevated heart rate during the more arousing mother's-face situations.

Young children's adaptations to repeated separations from their mothers.

80 infants, toddlers, and preschoolers were observed before, during, and after separations from their mothers, who were attending conferences (M duration = 4 days). Half the sample was separated only once and the other half experienced 3 separations across a 6-month period. The study was designed: (a) to determine how separations affect children's behavior when there are no changes in the family constellation as there typically are during other separations, such as the birth of a new child, and (b) to determine the effects of repeated separations. Fewer changes in sleep and play behaviors suggested that this type of separation was less stressful than separations for the birth of another child. Nonetheless, the separations were still stressful, but principally for the single-separation group. In that group, changes were noted in both play and sleep behaviors. Following reunion, their sleep behaviors and more sophisticated play behaviors returned to baseline. However, activity level and the more insecure behaviors, such as wandering aimlessly, watching other children play, and interacting with their teachers, remained elevated following the mother's return. The multiple-separation group, in contrast, showed only 1 behavior change during their third separation, i.e., reduced interactions with their peers during the separation period, which returned to baseline following reunion. Repeated-measures analyses of the first and third separations of the multiple-separations group suggested that only the first separation was stressful. Thus, the infants and children in this study seemed to adapt to repeated separations.

Sensory deprivation stress and supplemental stimulation in the rat pup and preterm human neonate.

This article reviews the literature and presents data from our laboratories on sensory deprivation stress and supplemental stimulation of the rat pup and the preterm neonate. The data suggest that the effects of maternal deprivation in the rat pup (suppression of growth hormone release and protein synthesis) are regulated by a specific form of tactile stimulation: only brush stroking of maternally deprived rat pups returned growth parameters to normal; other forms of stimulation, including kinesthetic and vestibular stimulation, were ineffective in restoring normal functions. Other data are presented demonstrating that very small preterm neonates given tactile-kinesthetic stimulation gain more weight per day, spend more time awake and active, and show more mature habituation, orientation, motor, and range of state behaviors on the Brazelton assessment.