Movement through motherhood: Exploring mood, wellbeing, and prenatal emotional availability (EA) through EA-based dance intervention.

Emotional availability (EA) is a construct that describes the observed emotional connection in parent-child relationships. During pregnancy, EA is assessed only using caregiver sensitivity and nonhostility. We used the nonverbal aspects of these qualities to create a new dance/movement intervention ("EA-Based Dance Intervention"). Given the scarcity of pregnancy interventions, we provided training to participants on how to be emotionally engaged with their unborn babies through dance/movement. The EA-Based Dance Intervention alone comprised the first intervention arm (n = 12). A second intervention arm involved the combination of EA-Based Dance Intervention with brief psychoeducation (n = 10). The third arm was a control group, which received only the assessments (n = 7). Measures of self-reported symptoms of depression and anxiety, emotional expressivity, flourishing, and the (newly developed) self-reported prenatal EA were used at pre- and posttest. The measure of observed prenatal EA was used to compare intervention versus control at posttest only. In this pilot study, we found that participants receiving the EA-Based Dance Intervention alone or combined with psychoeducation, self-reported improved anxiety symptoms and self-reported higher prenatal EA. When compared with the control group, those experiencing EA-Based Dance Intervention reported fewer depressive symptoms from pre- to posttest.

La disponibilidad emocional (EA) es una construcción que describe la observada conexión emocional en las relaciones entre progenitor y niño. Durante el embarazo, EA se evalúa solamente usando la sensibilidad y el nivel de no hostilidad de quien presta el cuidado. Usamos los aspectos no verbales de estas cualidades para crear una nueva intervención de baile/movimiento ("Intervención de Baile con Base en la Disponibilidad Emocional"). Dada la escasez de intervenciones de embarazo, les ofrecimos entrenamiento a las participantes en cuanto a cómo interactuar emocionalmente con sus bebés no nacidos por medio del baile/movimiento. La Intervención de Baile con Base en la Disponibilidad Emocional abarca por sí sola el primer grupo o brazo de la intervención (n = 12). Un segundo grupo o brazo de intervención incluyó la combinación de la Intervención de Baile con Base en la Disponibilidad Emocional con psicoeducación breve (n = 10). El tercer grupo o brazo de intervención fue un grupo de control, el cual sólo recibió las evaluaciones (n = 7). Anterior y posteriormente a la prueba, se usaron medidas de auto reportados síntomas de depresión y ansiedad, de expresividad emocional, de mejorar y salir adelante, y la (recién desarrollada) EA prenatal auto reportada. La medida de EA prenatal observada se usó para comparar los grupos de intervención vs. de control sólo con posterioridad a la prueba. En este estudio piloto, encontramos que las participantes que recibían la Intervención de Baile con Base en la Disponibilidad Emocional solamente o combinada con psicoeducación, auto reportaron mejoras en los síntomas de ansiedad y auto reportaron una EA prenatal más alta. Cuando se les comparó con el grupo de control, quienes experimentaban la Intervención de Baile con Base en la Disponibilidad Emocional reportaron menos síntomas depresivos desde antes hasta después de la prueba.

Emotional Availability as a Moderator of Stress for Young Children and Parents in Two Diverse Early Head Start Samples.

Positive parent-child relationship quality is critical for buffering children from the effects of stress on development. It is thus vital to develop interventions that target parent-child relationship quality for families experiencing stress. We examined the moderating role of parent-child relationship quality (as measured by parental emotional availability [EA]) in the intergenerational association between parental adverse childhood experiences (ACEs) and their young children's hair cortisol concentrations (HCCs)-a physiological marker of cumulative hypothalamic pituitary adrenal (HPA)-axis activity. Using data from 127 parent-child dyads collected by two of six ACF-funded Buffering Toxic Stress consortium sites, we tested interaction effects of parental ACEs with parental EA on young children's (Mage = 18.38, SDage = 7.10) HCC. Results revealed curvilinear main effects such that higher parental ACEs were significantly associated with greater HCC and stronger associations occurred at higher levels of parental ACEs. However, this association was moderated by parental EA. Thus, among children with higher parental history of ACEs, children of parents with higher EA had lower HCC compared to children of parents with lower EA. These findings provide support for the risk-buffering and risk-exacerbating role of parent-child relationship quality (e.g., EA) for the transmission of parents' early life adversity on their children's HPA-axis activity, documented here in a racially and ethnically diverse sample of children and parents served by Early Head Start. Findings suggest that intervention and prevention efforts targeting stress response in children of mothers with childhood adversity should also support parents in building an emotionally available relationship with their children.

Parents' adverse childhood experiences and parent-child emotional availability in an American Indian community: Relations with young children's social-emotional development.

This study examined relations among parent adverse childhood experiences (ACEs), parent mental distress, child social-emotional functioning, and parent emotional availability (EA) among parents and children served by an Early Head Start program in an American Indian community. The majority of parents and children in the study were American Indian/Alaska Native. American Indian/Alaska Native communities experience relatively high rates of trauma, socioeconomic disparities, and mental health challenges. In this context, young children may be especially vulnerable to early life stress. Further, a strong body of literature demonstrates the long-term effects of ACEs on individuals' mental health, as well as their child's social-emotional functioning. In this study we examined a model to test the relation of parent ACEs to children's social-emotional functioning, with an indirect effect via a latent "mental distress" variable consisting of parent depression, anxiety, and parenting-related distress. Results supported this model, suggesting that parent ACEs related to children's social-emotional problems by way of parent mental distress. However, when a categorical measure of parent EA was added as a moderator, the model only remained significant in the low EA parent group. These results provided evidence for a "buffering" effect of high parent EA on the relation between parent ACEs, parent mental distress, and children's social-emotional problems.

The "EA brief": A single session of parent feedback and coaching to improve emotional attachment and emotional availability (EA).

The goal of this study was to determine the extent to which a brief parenting intervention provided the context for helping families to support positive mother-child interactions as well as more optimal mother and child outcomes. Participants in this study were middle income mothers and their children were between 0-3 years of age (N = 25 dyads). Participants were filmed via Skype during a 20-minute mother-child free play and completed questionnaires (Time 1) before attending the brief intervention (involving: a single session of one-on-one parent feedback and coaching, and information via group meeting, texts, and reading) followed by a repeat of the 20-minute Skype interaction and the completion of the same questionnaires (Time 2). Paired samples t-tests were performed, revealing that mothers reported improvements in their personal well-being (using the Flourishing Scale), reports about the mother-child relationship (using the Emotional Availability Self Report), and observed interactions, particularly the child's side of the relationship (using the Emotional Availability System), from pretest to posttest. Results are discussed in terms of a single session of parent feedback and coaching (in conjunction with an informational group session and texts) potentially having a role in "planting a seed" for observed and self-reported parenting enhancement and child development.

La meta de este estudio fue determinar hasta qué punto una intervención de crianza breve ofrecía el contexto para ayudar a familias a apoyar las positivas interacciones madre-niño, así como también resultados más óptimos en la madre y el niño. Las participantes en este estudio fueron madres de ingresos medios y sus niños de edad de 0 a 3 años (N = 25 díadas). Las participantes fueron filmadas a través de Skype durante una sesión de juego libre de 20 minutos entre madre y niño y ellas completaron cuestionarios (Primer momento) antes de asistir a la breve intervención (la cual estaba compuesta de una sola sesión de entrenamiento uno a uno de la madre, y de información por medio de reuniones de grupo, textos y lecturas) seguida de una repetida interacción de 20 minutos a través de Skype y volver a completar el mismo cuestionario (Segundo momento). Se llevaron a cabo muestras emparejadas de exámenes t, revelando así que las madres reportaron mejoras en su bienestar personal (usando la Escala Flourishing), reportes acerca de la relación madre-niño (usando el Auto Reporte de Disponibilidad Emocional), y observadas interacciones, particularmente el lado del niño en la relación (usando las Escalas de Disponibilidad Emocional), desde el pre-examen hasta el post-examen. Se discuten los resultados en términos de una sola sesión de entrenamiento de la madre (en conjunto con una sesión informativa de grupo y textos) que potencialmente juega un papel en el proceso de "plantar la semilla" para las observadas y auto-reportadas mejorías en la crianza y el desarrollo del niño.

Le but de cette étude était de déterminer dans quelle mesure une brève intervention de parentage offrait un contexte pour aider des familles à soutenir des interactions mère-enfant positives ainsi que des résultats mère et enfant plus optimaux. Les participants à cette étude étaient des mères de classe moyenne et leurs enfants âgés de 0 à trois ans d'âge (N = 25 dyades). Les participants ont été filmés au moyen de Skype pendant une séance de jeu libre de 20 minutes et ont complété des questionnaires (Temps 1) avant de participer à une brève intervention (qui comprenait: une seule séance de coaching d'un à un avec le parent, et des renseignements avec une réunion de groupes, des textos, et des lectures) suivie d'une répétition de l'interaction de 20 minutes au moyen de Skype et du remplissage des mêmes questionnaires (Temps 2). Des tests t d'échantillons appariés ont été faits, révélant que les mères faisaient part d'amélioration dans leur bien-être personnel (en utilisant l'Echelle d'Epanouissement, soit en anglais Flourishing Scale), et ainsi que dans les rapports de la relation mère-enfant (en utilisant l'Auto Déclaration de Disponibilité Emotionnelle), et dans les interactions observées, en particulier le côté de l'enfant de la relation (en utilisant les Echelles de Disponibilité Emotionnelle), du prétest au posttest. Les résultats sont discutés en termes de séance unique de coaching du parent (en conjonction avec une séance d'information en groupe et de textos) ayant potentiellement un rôle et "plantant une graine" pour l'amélioration autodéclarée et observée du parentage et le développement de l'enfant. Mots clés: parent-enfant, disponibilité émotionnelle, intervention.

Emotional attachment and emotional availability tele-intervention for adoptive families.

This study evaluated the new online Emotional Attachment and Emotional Availability (EA2) Intervention for use with adoptive families in enhancing parent-child EA, parental perceptions of EA, child attachment behaviors, parent-child emotional attachment, and reducing parent-reported child behavioral problems and parenting-related stress. Participants in this study were adoptive parents and their adopted children ages 1.5 to 5 years old (N = 15 dyads). Participants were placed in an immediate intervention group (IG) or a delayed intervention group (DG) that would receive the 6-week EA2 Tele-Intervention after the IG. Results revealed significant differences in the IG in child behavioral problems, parent-child EA, parental perceptions of EA, and parent-child emotional attachment, improvements not seen in the DG. Analysis of effects of the DG after receiving the EA2 Tele-Intervention revealed significant differences over time also in most of these qualities.

Bodily-tactile early intervention: a pilot study of the role of maternal touch and emotional availability in interactions between three children with visual impairment and additional disabilities and their mothers.

Background: Children with visual impairment and additional disabilities (VIAD) have difficulty accessing the visual information related to their parents' facial expressions and gestures. Similarly, it may be hard for parents to detect their children's subtle expressions. These challenges in accessibility may compromise emotional availability (EA) in parent-child interactions. The systematic use of the bodily-tactile modality for expressive and receptive communicative functions may function as a strategy to compensate for a child's lack of vision. This multiple-case study explored the effects of a bodily-tactile early intervention for three mothers and their one-year-old children with VIAD. Methods: Video data from baseline, intervention, and follow-up sessions were analyzed using a bodily-tactile coding procedure and EA Scales. Results: During the intervention, all mothers began to use a more bodily-tactile modality in early play routines and in different communicative functions. They increased their use of anticipatory cues, noticing responses, and tactile signs. Moreover, the children were more emotionally available to their mothers during the intervention and follow-up compared to the baseline. Conclusion: The results indicated that, during a short intervention, mothers could adopt a systematic use of the bodily-tactile modality in interactions with their children with VIAD. The results also suggest that, when mothers increased flexibility in communication channels, it was positively linked to their children's EA.

Attachment Security in Three-Year-Olds who Entered Substitute Care in Infancy.

This study assessed relations among number of out-of-home placement changes, time in caregivers' care, caregiver type (i.e., foster parent, adoptive parent, kinship relation, and biological parent), child gender, and caregiver-child Emotional Availability (EA) as predictive of child attachment security when children were 3 years old in a sample of 104 caregivers and children. Children entered court-ordered care by six months of age. On average, children at the age of three spent 30 months with their caregivers, and nearly half of them were adopted by that time. Child attachment was assessed using the Attachment Q-set (Waters & Deane, 1985), and caregiver-child EA was assessed using the EA Scales, 4th edition (Biringen, 2008). Sixty-six percent of children at age 3 showed secure attachments with caregivers, and EA subscale scores were also relatively high on average. The study predictor variables of EA Caregiver Sensitivity, Child Responsiveness, and Child Involvement predicted attachment security, with girls more likely to be securely attached to their substitute caregivers at age three than boys. Study limitations and directions for future research are discussed.

Mother-Child and Father-Child Emotional Availability during the COVID-19 Pandemic.

While the body of literature on COVID-19's impacts on family life is rapidly expanding, most studies are based entirely on self-report data, leaving a critical gap in observational studies of parent-child interactions. The goal of this study was to evaluate parent-child relationships during the COVID-19 pandemic using the observational emotional availability (EA) construct. Parents (n = 43) were assessed using the Epidemic-Pandemic Impacts Inventory (EPII), the Flourishing Scale (FLS), and the adverse childhood experiences (ACEs) questionnaires. The subcategories of the EPII were used to develop an EPII negative and an EPII positive for each parent. EA (sensitivity, structuring, nonhostility, nonintrusiveness, child responsiveness, and child involvement) was coded from filmed parent-child interactions. Separate hierarchical multiple regressions (HMRs) were run to evaluate each of the variables of interest (EPII and FLS) as predictive of EA. Child age (M = 6, SD = 4.68) and ACEs were added in subsequent steps for EPII negative and positive if the initial step was significant. For mothers (n = 25), results demonstrated EPII negative as a significant predictor of EA with child age and ACEs adding only small amount of variance to the prediction. The same HMR process was repeated for flourishing, with the covariate child age alone. For fathers (n = 18), flourishing was a significant predictor of EA and child age added only a small amount of variance to the prediction. Results indicate that experiencing high COVID-19-related stressors is associated with lower EA for mothers, but not fathers. Having high levels of flourishing during the pandemic was predictive of higher EA for fathers, but not mothers.

Emotional availability: concept, research, and window on developmental psychopathology.

The construct of emotional availability (EA) refers to the capacity of a dyad to share an emotional connection and to enjoy a mutually fulfilling and healthy relationship. The EA Scales were designed to assess multiple components of a relationship from the perspective of both partners. The four caregiver components include sensitivity, structuring, nonintrusiveness, and nonhostility; two scales measure the child's responsiveness to the caregiver and involvement of the caregiver. We describe the EA construct and introduce the papers in this issue, focusing on the contributions of this Special Section to a developmental psychopathology framework.

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

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

Maternal representations and emotional availability among drug-abusing and nonusing mothers and their infants.

Both negative and idealized maternal prenatal representations may constitute a risk for mother-infant interaction. This study analyzed the role of maternal prenatal representations and pre- to postnatal representational change in predicting mother-infant emotional availability (EA) among 51 drug-abusing mothers and their infants who participated in either psychodynamic group therapy (PGT) or received psychosocial support (PSS) and among 50 nonusing comparison dyads. Maternal representations of her child, the child's father, her own mother, self-as-mother, and self-as-woman were measured during pregnancy and at 4 and 12 months' postpartum with the Interview of Maternal Representations (M. Ammaniti et al., 1992; M. Ammaniti, R. Tambelli, & P. Perucchini, 1998). EA was measured with the Emotional Availability Scales, fourth edition (Z. Biringen, 2008) at 4 and 12 months. The results showed that drug-abusing mothers had more negative prenatal representations of the self-as-woman and of the child's father. Postnatally, PSS mothers tended to first idealize their child, but later to experience disillusionment of idealization. Both negative and idealized prenatal representations of the self-as-mother predicted mother-infant EA problems, but only among the PGT mothers. For all mothers, negative representational change was detrimental for the mother-infant EA whereas for drug-abusing mothers, also increasing idealization from the prenatal period to the postnatal period was harmful. Clinicians working with drug-abusing mothers should aim at supporting the development of a realistically positive view of motherhood.

Maternal sensitivity and intrusiveness in early childhood as predictors of children's weight at school age.

BACKGROUND: While previous research indicates that low maternal sensitivity in mother-child interactions puts children at risk of overweight and obesity, maternal intrusiveness has rarely been investigated in association with children's weight. We investigated whether maternal sensitivity and intrusiveness in early childhood predict children's increased body mass index standard deviation scores (BMI-SDS) at school age. BMI-SDS are standardized for age and gender with respect to a reference standard. METHODS: At baseline (t1), we assessed maternal sensitivity and (non-)intrusiveness of 116 mothers with their children (48.3% female) aged 5-47 months (M = 24.00, SD = 11.36) using the emotional availability scales. We obtained anthropometric data for mothers at t1 by measuring height and weight in the laboratory and for children at birth assessed by medical staff. Six years later (t2) we obtained anthropometric data for children in the laboratory or based on parental report. Linear regression analyses were run with child BMI-SDS at t2 as outcome and sensitivity and (non-)intrusiveness as predictors, adjusting for confounders and exploring child age and gender as moderators. RESULTS: Maternal sensitivity only negatively predicted children's BMI-SDS in girls, while maternal intrusiveness predicted higher child BMI-SDS at school age regardless of child gender. The effect of maternal non-intrusiveness remained significant when controlling for confounders. CONCLUSION: Maternal intrusiveness in early childhood seems to represent a risk factor for increased BMI-SDS in children, while lower maternal sensitivity tends to be a risk factor for increased BMI-SDS in girls. This may have implications for prevention or intervention programmes.

Neurobiological Implications of Parent-Child Emotional Availability: A Review.

Parental influences are important for a child's behavior, overall adjustment, as well as cognitive/language development. New research is exploring how relationships with parents can influence a child's neurobiological functioning and development. In this systematic review, our first aim is to describe how the caregiving environment influences these aspects of child development. The second and main aim is to review and recommend that the concept (and measurement) of "emotional availability" may provide a new window in this continued exploration. Emotional availability (EA) refers to the capacity of a dyad to share an emotionally healthy relationship. The EA Scales assess this construct using a multi-dimensional framework, with a method to measure the affect and behavior of both the child and adult partner (caregiver). In this review, we first provide an overview of child development research, with regards to stress physiology, neuroendocrine system, genetics and epigenetics, and brain mechanisms. We then summarize the results of specific EA research in these areas, and propose a theoretical model integrating these constructs. Finally, we offer areas for future research in this area.

Development of autonomy: role of walking onset and its timing.

The observations of psychoanalytically oriented clinicians such as Mahler, Pine, and Bergman and Greenacre were descriptive of intriguing aspects of the infant's transition to upright locomotion. Yet, research on how walking creates changes in the infant and in the family have scarcely been studied. In this naturalistic home study, 46 infants were designated "earlier" (13 girls and 10 boys) and "later" (12 girls and 11 boys) walkers based on their relative timing of entry into this developmental transition. Analyses between these two groups were done with age held constant and indicated that the earlier walkers showed a greater rise in autonomous functioning across the transition to self-produced, upright locomotion. Autonomy was assessed as infant proximity-seeking and distancing with respect to mother and "testing of wills" between mother and child. These findings suggested that the timing of beginning to walk crucially affects the development of autonomy. In addition to these clear differences associated with the walking transition, there were differences between the two groups in an aspect of temperament, Distress to Limitations, even prior to walking onset as well as at all time points of measurement.

Emotional Availability, Neuropsychological Functioning, and Psychopathology: The Context of Parental Substance Use Disorder.

Parental Substance Use Disorder (SUD) constitutes a high-risk condition for parent-child interactions and child development. Empirical evidence indicates high rates of psychopathology and neuropsychological impairments in individuals with SUD. Despite research indicating that parenting skills are related to psychological well-being and cognitive/neuropsychological functioning, prior studies have not examined the associations between these areas of parental functioning and the quality of parent-child interactions in the context of SUD. Aim(s). The present study adopts an integrated perspective to investigate the way in which maternal neuropsychological functioning and psychopathology are associated with mother-child emotional availability (EA), in the context of parental Substance Use Disorder. Methods. Twenty-nine mothers with SUD were assessed in interaction with their children, as well as with respect to their neuropsychological functioning and psychopathology. Results. In this group, high rates of maternal neuropsychological impairments and psychopathology, as well as generally low levels of EA, were uncovered. Regression analyses showed that maternal neuropsychological functioning was significantly associated with mother-child EA, specifically sensitivity; the role of maternal psychopathology, however, was only marginally significant. Conclusion. In the context of SUD, maternal neuropsychological impairments are significantly associated with mother-child EA. Clinical implications of the findings are discussed.

Emotional availability in a sample of mothers with a history of abuse.

Maternal history of abuse has been proposed as a risk factor for child maltreatment, but the background of this "cycle of abuse" is as yet poorly understood. As a contribution toward a deeper understanding of this phenomenon, this study analyzed whether emotional availability is altered by maternal experiences of physical or sexual abuse during their upbringing. Mothers were contacted by mail and presented with the Childhood Trauma Questionnaire. To form the index group, women who reached a cutoff for severe sexual and/or physical abuse and whose children were term babies with APGAR scores 7 were included in the study. The women were invited to the laboratory when their infants were 5 months old. Emotional availability was compared with a group of mother-infant pairs matched for infant gender, maternal education, marital status, number of infants, and birth weight. The results show that 5-month postnatal mothers with a history of physical or sexual abuse were significantly more intrusive toward their children than were control mothers.

Parents behaving badly: Gender biases in the perception of parental alienating behaviors.

According to gender role theory, individuals who confirm expectations associated with their gender roles are rewarded and judged against these expectations when they deviate. Parental roles are strongly tied to gender, and there are very different expectations for behaviors of mothers and fathers. This study examined how mothers' and fathers' behaviors that support or discourage a positive relationship with the other parent are perceived in terms of their acceptability. Two-hundred twenty-eight parents completed an online survey assessing perceptions of acceptability of negative (parental alienating) and positive coparenting behaviors. Results provided support for our hypothesis: Although parental alienating behaviors were rated unacceptable, they were more acceptable for mothers than fathers. Expectancy violation theory can explain why parental alienating behaviors are not viewed as negatively when mothers exhibit them than fathers. (PsycINFO Database Record

Applying the Emotional Availability Scales to children with disabilities.

In this article, we describe issues regarding emotional availability and its application to children with disabilities. We then apply this approach to the scoring of emotional availability for caregiver-child interactions of children with disabilities, with information based on children with genetic mental retardation syndromes, children with autism, and children with hearing impairments.

Emotional availability in infant psychiatry.

In a child psychiatric population, 68 mother-child pairs were observed, with children ranging in age from 6 weeks to 3 years 10 months. The children were diagnosed using the Zero to Three DC 0-3 guidelines (Zero-to-Three, 1998). Each dyad also was rated in terms of the intensity of recommended therapeutic measures upon intake at our clinic. Following videotaping of parent-child interactions, the dyads were rated for emotional availability using the Emotional Availability Scales (EAS; Biringen, Robinson, & Emde, 1998). The group with feeding disorders showed the lowest EAS ratings. The group with regulation disorders (sleeping and crying disorders) had the highest ratings followed by the group with externalizing disorders (motor disorganized and/or aggressive behavior) and attachment disorders. Further, the lower the EAS ratings, the higher the intensity of recommended treatments for the family. These findings indicate the importance of standardized observing of parent-child interactions in infant psychiatric disorders. Some clinical impressions regarding the work with the EAS also are described.