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."

Predicting attachment in Portuguese infants born very or extremely preterm: Understanding the roles of infant regulatory behavior, maternal sensitivity, and risk factors.

A growing body of research shows that early attachment relationships are foundational for children's later developmental and psychosocial outcomes. However, findings are mixed regarding whether preterm birth predicts later attachment, but insecurity is generally more prevalent among infants at higher medical and/or social/familial risk. This longitudinal study aimed to identify specific relational, familial/demographic, and perinatal predictors of attachment in a sample of 63 Portuguese infants born very or extremely preterm (VEPT, <32 gestational weeks) and their mothers from diverse socioeconomic backgrounds. One-third of the mothers had social/family risk factors (e.g., single parent, immigrant, unemployed, low education, and/or low income). At 3 months (corrected age), dyads were observed during social interaction in the Face-to-Face Still-Face paradigm (FFSF) and during free play. At 12 months, mother-infant dyads were observed in Ainsworth's Strange Situation. Over half (58.7%) of the infants were classified as insecurely attached. Social-Positive Oriented regulatory behavior pattern, higher maternal sensitivity, higher infant cooperation during free play, number of siblings and an absence of social/family risk factors were associated with attachment security. Perinatal variables were unrelated to attachment. Findings indicate that both relational and social contextual factors contribute to attachment in this biologically vulnerable sample.

Un creciente cuerpo investigativo muestra que las relaciones afectivas tempranas son fundamentales para posteriores resultados de desarrollo y sicosociales de los niños. Sin embargo, los resultados son variados acerca de si el nacimiento prematuro predice la afectividad posterior, pero la inseguridad es generalmente más prevalente entre infantes bajo más alto riesgo médico y/o social/familiar. Este estudio longitudinal se propuso identificar factores específicos de predicción de la afectividad, relacionales, familiar/demográficos y perinatales en un grupo muestra de 63 infantes portugueses nacidos muy o extremadamente prematuros (VEPT, < 32 semanas gestacionales) y sus madres de diversos niveles socioeconómicos. Un tercio de las madres tenían factores de riesgo social/familiar (v.g. madre soltera, inmigrante, desempleada, de baja educación y/o de bajos recursos económicos). A los tres meses (edad corregida), se les observó a las díadas durante la interacción social en el paradigma de Cara a Cara y Rostro Inmutable (FFSF) y durante el juego libre. A los 12 meses, se les observó a las díadas madre-infante por medio de la Situación Extraña de Ainsworth. Se clasificó más de la mitad (58.7%) de los infantes como afectivamente inseguros. Entre los factores de predicción de la afectividad segura se incluyó un patrón de conducta regulatoria con orientación social positiva durante FFSF, una sensibilidad materna más alta y la cooperación del infante durante el juego libre, así como la ausencia de factores de riesgo sociales/familiares. Las variables perinatales no estuvieron relacionadas con la afectividad. Los resultados indican que los factores contextuales, tanto relacionales como sociales contribuyen a la afectividad en este grupo biológicamente vulnerable.

Infant carrying: Associations with parental reflective functioning, parental bonding and parental responses to infant crying.

Infant carrying may have beneficial effects on the parent-infant relationship but only limited research has been conducted in this area. Therefore, the main aim of the current study was to investigate whether infant carrying is associated with parental reflective functioning, parental bonding, and parental (emotional) and behavioral responses to infant crying, key elements within the parent-infant relationship, promoting infant development. Parents reporting high levels (N = 389) of infant carrying (six times a week or daily) and parents reporting low levels (N = 128) of infant carrying (less than once a week or not at all) who participated in an online survey about the developing parent-infant relationship in Germany were included in the present study. Standardized questionnaires were used to assess parental reflective functioning, parental bonding impairments, and emotional responses to infant crying. Further insensitive (non-responsive and hostile) behaviors in response to infant crying were assessed. Parents with high levels of infant carrying showed better parental reflective functioning, lower parental bonding problems, less negative emotions, and less insensitive behaviors in response to infant crying.

Cargar al infante pudiera tener efectos beneficiosos para la relación progenitor­infante, pero sólo una limitada investigación se ha llevado a cabo en esta área. Por tanto, el objetivo principal del presente estudio fue investigar si cargar al infante se asocia con que el funcionamiento con reflexión del progenitor, los lazos de afectividad del progenitor, así como las respuestas de comportamiento (emocional) del progenitor al llanto del infante, elementos claves dentro de la relación progenitor­infante, promueven el desarrollo del infante. Se incluyó en el presente estudio a los progenitores que reportaron altos niveles (N=389) de llanto del infante (seis veces por semana o diariamente) y a los progenitores que reportaron bajos niveles (N=128) del llanto del infante (menos de una vez por semana o nunca), quienes participaron en una encuesta electrónica acerca de la relación progenitor­infante en desarrollo, en Alemania. Se usaron cuestionarios estandarizados para evaluar el funcionamiento con reflexión del progenitor, los impedimentos de lazos afectivos del progenitor, así como las respuestas emocionales al llanto del infante. Se evaluaron además comportamientos insensibles (sin respuesta afectiva y hostil) como respuesta al llanto del infante. Los progenitores con altos niveles de cargar al infante demostraron un mejor funcionamiento con reflexión del progenitor, más bajos problemas en cuanto a lazos de afectividad del progenitor, menos emociones negativas y menos comportamientos insensibles como respuesta al llanto del infante.

Porter un bébé peut avoir des effets bénéfiques sur la relation parent­bébé mais il n'existe que peu de recherches sur ce domaine. C'est pour cette raison que le but principal de cette étude était d'investiguer si le fait de porter un bébé est lié avec une fonction réflexive parentale, le lien parental et les réactions parentales (émotionnelles) et comportementales aux pleurs du bébé, des éléments clef au sein de la relation parent­bébé, promouvant le développement du bébé. Les parents faisant état de niveaux élevés (N=389) de portage du bébé (six fois par semaine ou tous les jours) et les parents faisant état de niveaux bas (N=128) de portage du bébé (moins d'une semaine ou pas du tout) qui ont participé à un questionnaire en ligne sur la relation parent­bébé se développant en Allemagne ont été inclus dans cette étude. Des questionnaires standardisés ont été utilisés afin d'évaluer la fonction réflexive parentale, les troubles du lien parental, et les réactions émotionnelles aux pleurs du bébé. D'autres comportement insensibles (non­réactifs et hostile) en réaction aux pleurs du bébé ont été évalués. Les parents avec des niveaux élevés de portage du bébé ont fait preuve d'une meilleure fonction réflexive parentale, de moins de problèmes de lien parental, de moins d'émotions négatives, et de moins de comportements insensibles en réaction aux pleurs du bébé.

Pandemic beyond the virus: maternal COVID-related postnatal stress is associated with infant temperament.

BACKGROUND: Studies have shown that infant temperament varies with maternal psychosocial factors, in utero illness, and environmental stressors. We predicted that the pandemic would shape infant temperament through maternal SARS-CoV-2 infection during pregnancy and/or maternal postnatal stress. To test this, we examined associations among infant temperament, maternal prenatal SARS-CoV-2 infection, maternal postnatal stress, and postnatal COVID-related life disruptions. METHODS: We tested 63 mother-infant dyads with prenatal maternal SARS-CoV-2 infections and a comparable group of 110 dyads without infections. To assess postnatal maternal stress, mothers completed the Perceived Stress Scale 4 months postpartum and an evaluation of COVID-related stress and life disruptions 6 months postpartum. Mothers reported on infant temperament when infants were 6-months-old using the Infant Behavior Questionnaire-Revised (IBQ-R) Very Short Form. RESULTS: Maternal SARS-CoV-2 infection during pregnancy was not associated with infant temperament or maternal postnatal stress. Mothers with higher self-reported postnatal stress rated their infants lower on the Positive Affectivity/Surgency and Orienting/Regulation IBQ-R subscales. Mothers who reported greater COVID-related life disruptions rated their infants higher on the Negative Emotionality IBQ-R subscale. CONCLUSIONS: Despite no effect of prenatal maternal SARS-CoV-2 infection, stress and life disruptions incurred by the COVID-19 pandemic were associated with infant temperament at 6-months. IMPACT: SARS-CoV-2 infection during pregnancy is not associated with postnatal ratings of COVID-related life disruptions, maternal stress, or infant temperament. Postnatal ratings of maternal stress during the COVID-19 pandemic are associated with normative variation in maternal report of infant temperament at 6 months of age. Higher postnatal ratings of maternal stress are associated with lower scores on infant Positive Affectivity/Surgency and Orienting/Regulation at 6 months of age. Higher postnatal ratings of COVID-related life disruptions are associated with higher scores on infant Negative Emotionality at 6 months of age.

Maternal perceived stress and infant behavior during the COVID-19 pandemic.

BACKGROUND: Maternal stress has negative consequences on infant behavioral development, and COVID-19 presented uniquely stressful situations to mothers of infants born during the pandemic. We hypothesized that mothers with higher levels of perceived stress during the pandemic would report higher levels of infant regulatory problems including crying and interrupted sleep patterns. METHODS: As part 6 sites of a longitudinal study, mothers of infants born during the pandemic completed the Perceived Stress Scale, the Brief Infant Sleep Questionnaire, and an Infant Crying survey at 6 (n = 433) and 12 (n = 344) months of infant age. RESULTS: Maternal perceived stress, which remained consistent at 6 and 12 months of infant age, was significantly positively correlated with time taken to settle infants. Although maternal perceived stress was not correlated with uninterrupted sleep length, time taken to put the infant to sleep was correlated. Perceived stress was also correlated with the amount of infant crying and fussiness reported at 6 months. CONCLUSIONS: Mothers who reported higher levels of perceived stress during the pandemic reported higher levels of regulatory problems, specifically at 6 months. Examining how varying levels of maternal stress and infant behaviors relate to overall infant developmental status over time is an important next step. IMPACT: Women giving birth during the COVID-19 pandemic who reported higher levels of stress on the Perceived Stress Scale also reported higher levels of infant fussiness and crying at 6 months old, and more disruptive sleep patterns in their infants at 6 months and 12 months old. Sleeping problems and excessive crying in infancy are two regulatory problems that are known risk factors for emotional and behavioral issues in later childhood. This paper is one of the first studies highlighting the associations between maternal stress and infant behaviors during the COVID-19 pandemic.

Sympathetic nervous system functioning during the face-to-face still-face paradigm in the first year of life.

Contemporary theories of early development and emerging child psychopathology all posit a major, if not central role for physiological responsiveness. To understand infants' potential risk for emergent psychopathology, consideration is needed to both autonomic reactivity and environmental contexts (e.g., parent-child interactions). The current study maps infants' arousal during the face-to-face still-face paradigm using skin conductance (n = 255 ethnically-diverse mother-infant dyads; 52.5% girls, mean infant age = 7.4 months; SD = 0.9 months). A novel statistical approach was designed to model the potential build-up of nonlinear counter electromotive force over the course of the task. Results showed a significant increase in infants' skin conductance between the Baseline Free-play and the Still-Face phase, and a significant decrease in skin conductance during the Reunion Play when compared to the Still-Face phase. Skin conductance during the Reunion Play phase remained significantly higher than during the Baseline Play phase; indicating that infants had not fully recovered from the mild social stressor. These results further our understanding of infant arousal during dyadic interactions, and the role of caregivers in the development of emotion regulation during infancy.

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

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

Cross-modal coherence and incoherence of early infant interactive behavior: links to attachment in infants born very preterm or full-term.

Infants exhibit flexibly organized configurations of facial, vocal, affective, and motor behavior during caregiver-infant interactions that convey convergent messages about their internal states and desires. Prior work documents that greater cross-modal discrepancy at 4 months predicts disorganized attachment. Here, we evaluated whether: very preterm (VPT) or full-term (FT) status predicts cross-modal coherence or incoherence in infants' behavior with the caregiver at 3 months; and, regardless of prematurity, whether cross-modal interactive coherence or incoherence predicts 12-month attachment. Participants included 155 infants (85 FT; 70 VPT), and their mothers followed from birth to 12 months (corrected age). Infants' cross-modal coherent and incoherent responses were scored microanalytically from videotaped en-face interactions. Infants' attachment security was evaluated during Ainsworth's Strange Situation. Infants born VPT exhibited more incoherent cross-modal responses and insecure attachment than infants born FT. Regardless of prematurity, infants' coherent and incoherent cross-modal interactive behaviors at 3 months predicted different attachment patterns at 12 months.

Prenatal Programming of Behavior Problems via Second-by-Second Infant Emotion Dynamics.

Fetal adaptations to prenatal maternal stress may confer high risk for childhood behavior problems, potentially operating via dynamic fluctuations in infants' emotions during mother-infant interactions. These fluctuations over time may give rise to behavior problems. Among a sample of 210 low-income mothers of Mexican origin and their 24-week-old infants, dynamic structural equation modeling was used to examine whether within-infant second-by-second emotion processes were predicted by maternal prenatal stress and predicted behavior problems at 36 and 54 months. The mean level around which infant negative affect fluctuated was related to prenatal stress, but not to childhood behavior problems. The volatility in infant negative affect, reflecting greater ebb and flow in infant negative affect during playful interaction, was predicted by prenatal stress and predicted enduring behavior problems in childhood. Results highlight a potential child-driven pathway linking prenatal exposure with childhood behavior problems via infant negative emotional volatility.

Testing the mid-range model: Attachment in a high risk sample.

Infant attachment is a key predictor of later socioemotional functioning, but it is not clear how parental responsivity to infant expressive behavior is associated with attachment outcomes. A mid-range model of responsivity holds that both unresponsive and highly reactive parental behaviors lead to insecure and disorganized attachment. We examined the relationship between maternal (and infant) contingent responsivity and attachment in a high-risk sample. Participants were 625 infant-mother pairs from a longitudinal study of children with and without prenatal drug exposure and variable levels of associated social risks. Infant-mother pairs participated in the Face-to-Face/Still-Face paradigm (FFSF) at 4-months and in the Strange Situation Procedure (SSP) at 18-months. A model incorporating both linear and quadratic responsivity effects indicated that mothers who were either very high (reactive) or very low (unresponsive) in responsivity were more likely to have infants with disorganized attachment outcomes. While maternal responsivity was associated with attachment disorganization, no associations between maternal responsivity, and attachment security/insecurity were detected. Infant responsivity to mother was not associated with attachment outcomes. The findings suggest the importance of mid-range levels of maternal responsivity in the development of organized attachment among infants facing high levels of prenatal and social risk.

How do maternal emotional regulation difficulties modulate the mother-infant behavioral synchrony?

Mother-infant synchrony is one of the most important processes in the development of socio-affective competencies in children. While maternal abilities and psychopathology are related to maladaptive mother-infant synchrony, it is as yet unclear how maternal emotion regulation difficulties contribute to it. Based on a panel of behavioral indicators (i.e., gaze, vocal, and motor), the present study examined mother-infant synchrony at 6 months of age in a modified version of Ainsworth's Strange Situation (n = 72 dyads). Mother-infant interaction sequences were characterized by indicators of complexity (LZ complexity of joint behavioral sequences) and of synchronization quality (cross-recurrence plot quantification). Results showed that mothers' touch was greater in the reunion condition than in the initial condition. Mothers' motor behaviors were associated with the global levels of infants' behavioral involvement in the reunion condition, unlike the symmetrical influence observed between mothers and infants in the initial condition. Results show that maternal anxiety mediates the relationships between mothers' emotion regulation difficulties and gaze, vocal, and motor synchrony between mothers and infants in the initial and reunion conditions. This study emphasizes the central role of maternal emotion regulation difficulties in the establishment of maladaptive synchrony and in the adjustments of maternal physical contacts with infants.

Parent-child relationship and child anger proneness in infancy and attachment security at toddler age: a short-term longitudinal study of mother- and father-child dyads.

Early parent-child relationship and child negative emotionality have both been studied as contributors to attachment security, but few studies have examined whether negative emotionality can moderate effects of parent-child relationship on security and whether the process is comparable across mother- and father-child dyads and different security measures. In 102 community families, we observed parent-child shared positive affect and infants' anger proneness at 7 months, and attachment security at 15 months, using observer-rated Attachment Q-Set (AQS) and a continuous measure derived from Strange Situation Paradigm (SSP). For mother-child dyads, high shared positive affect and low anger proneness were associated with AQS security. Those effects were qualified by their interaction: Variations in shared positive affect were associated with security only for relatively more anger-prone children.  That effect reflected the diathesis-stress model. For father-child dyads, shared positive affect was associated with security. There were no effects for SSP security with either parent.

The Power of Smiling: The Adult Brain Networks Underlying Learned Infant Emotionality.

The perception of infant emotionality, one aspect of temperament, starts to form in infancy, yet the underlying mechanisms of how infant emotionality affects adult neural dynamics remain unclear. We used a social reward task with probabilistic visual and auditory feedback (infant laughter or crying) to train 47 nulliparous women to perceive the emotional style of six different infants. Using functional neuroimaging, we subsequently measured brain activity while participants were tested on the learned emotionality of the six infants. We characterized the elicited patterns of dynamic functional brain connectivity using Leading Eigenvector Dynamics Analysis and found significant activity in a brain network linking the orbitofrontal cortex with the amygdala and hippocampus, where the probability of occurrence significantly correlated with the valence of the learned infant emotional disposition. In other words, seeing infants with neutral face expressions after having interacted and learned their various degrees of positive and negative emotional dispositions proportionally increased the activity in a brain network previously shown to be involved in pleasure, emotion, and memory. These findings provide novel neuroimaging insights into how the perception of happy versus sad infant emotionality shapes adult brain networks.

Comparing Automatic and Manual Measures of Parent-Infant Conversational Turns: A Word of Caution.

The Language ENvironment Analysis system (LENA) records children's language environment and provides an automatic estimate of adult-child conversational turn count (CTC). The present study compares LENA's CTC estimate to manually coded CTC on a sample of 70 English-speaking infants recorded longitudinally at 6, 10, 14, 18, and 24 months of age. At each age, LENA's CTC was significantly higher than manually coded CTC (all ps < .001, Cohen's ds: 0.9-2.05), with the largest discrepancies between the two methods observed at younger ages. The Limits of Agreement Analyses confirm wide disagreements between the two methods, highlighting potential problems with automatic measurement of parent-infant verbal interaction. These findings suggest that future studies should validate LENA's CTC estimates with manual coding.

Associations between infant-mother physiological synchrony and 4- and 6-month-old infants' emotion regulation.

In this study we assessed whether physiological synchrony between infants and mothers contributes to infants' emotion regulation following a mild social stressor. Infants between 4 and 6 months of age and their mothers were tested in the face-to-face-still-face paradigm and were assessed for behavioral and physiological self-regulation during and following the stressor. Physiological synchrony was calculated from a continuous measure of respiratory sinus arrhythmia (RSA) enabling us to cross-correlate the infants' and mothers' RSA responses. Without considering physiological synchrony, the evidence suggested that infants' distress followed the prototypical pattern of increasing during the Still Face episode and then decreasing during the reunion episode. Once physiological synchrony was added to the model, we observed that infants' emotion regulation improved if mother-infant synchrony was positive, but not if it was negative. This result was qualified further by whether or not infants suppressed their RSA response during the Still Face episode. In sum, these findings highlight how individual differences in infants' physiological responses contribute significantly to their self-regulation abilities.

Infants' stress responses and protest behaviors at childcare entry and the role of care providers.

During the transition from home to childcare, 70 15-month-old infants were videotaped, and their negative emotions were rated. Infants' attachments to mothers were assessed prior to child care entry and to care providers five months later using the Strange Situation Procedure (SSP). Infant heart rate was monitored at home, during adaptation to childcare (mothers present), and during subsequent separations. Respiratory sinus arrhythmia (RSA) was computed from the beat-to-beat measures of heart rate to reflect vagal tone, which is reduced during chronic states of stress, and was collected upon Arrival, during in-group Play, and when in the Group more generally. All infants responded to childcare entry with low RSA levels indicating stress. However, during adaptation with the mother present, RSA was higher for securely attached infants. On the first separation day, 35.3% of the infants fussed and cried extensively. These intense protests predicted later secure attachments to care providers, which adaptively helped to reduce stress, especially in infants who protested extensively, as if summoning their mothers back. Because extensive protest suggests limited regulatory capacities, infants risk overburdening the stress system when left unsupported.

Impact of Covid-19 in pregnancy on mother's psychological status and infant's neurobehavioral development: a longitudinal cohort study in China.

BACKGROUND: Evidence concerning the long-term impact of Covid-19 in pregnancy on mother's psychological disorder and infant's developmental delay is unknown. METHODS: This study is a longitudinal single-arm cohort study conducted in China between May 1 and July 31, 2020. Seventy-two pregnant patients with Covid-19 participated in follow-up surveys until 3 months after giving birth (57 cases) or having abortion (15 cases). We collected data from medical records regarding Covid-19, delivery or abortion, testing results of maternal and neonatal specimens, and questionnaires of quarantine, mother-baby separation, feeding, and measuring of mothers' mental disorders and infants' neurobehavioral disorders. RESULTS: All cases infected in the first trimester and 1/3 of cases infected in the second trimester had an abortion to terminate the pregnancy. 22.2% of pregnant patients were suffering from post-traumatic stress disorder or depression at 3 months after delivery or induced abortion. Among 57 live births, only one neonate was positive of nucleic acid testing for throat swab, but negative in repeated tests subsequently. The median duration of mother-baby separation was 35 days (interquartile range 16 to 52 days). After the termination of maternal quarantine, 49.1% of mothers chose to prolong the mother-baby separation (median 8 days; IQR 5 to 23 days). The breastfeeding rate was 8.8% at 1 week after birth, 19.3% at the age of 1 month, and 36.8% at the age of 3 months, respectively. The proportion of "monitoring" and "risk" in the social-emotional developmental domain at the age of 3 months was 22.7% and 63.6%, respectively. After the adjustment of preterm, neonatal sex, admitted to NICU, and the mother's Covid-19 condition, the negative associations were significantly identified (p < 0.05) between mother-baby separation days and three developmental domains: communication, gross motor, and personal-social. CONCLUSIONS: There is no definite evidence on vertical transmission of SARS-CoV-2. In addition to control infection risk, researchers and healthcare providers should pay more attention to maternal mental health and infant's feeding, closeness with parents, and early development.

Maternal mental health and infant emotional reactivity: a 20-year two-cohort study of preconception and perinatal exposures.

BACKGROUND: Maternal mental health during pregnancy and postpartum predicts later emotional and behavioural problems in children. Even though most perinatal mental health problems begin before pregnancy, the consequences of preconception maternal mental health for children's early emotional development have not been prospectively studied. METHODS: We used data from two prospective Australian intergenerational cohorts, with 756 women assessed repeatedly for mental health problems before pregnancy between age 13 and 29 years, and during pregnancy and at 1 year postpartum for 1231 subsequent pregnancies. Offspring infant emotional reactivity, an early indicator of differential sensitivity denoting increased risk of emotional problems under adversity, was assessed at 1 year postpartum. RESULTS: Thirty-seven percent of infants born to mothers with persistent preconception mental health problems were categorised as high in emotional reactivity, compared to 23% born to mothers without preconception history (adjusted OR 2.1, 95% CI 1.4-3.1). Ante- and postnatal maternal depressive symptoms were similarly associated with infant emotional reactivity, but these perinatal associations reduced somewhat after adjustment for prior exposure. Causal mediation analysis further showed that 88% of the preconception risk was a direct effect, not mediated by perinatal exposure. CONCLUSIONS: Maternal preconception mental health problems predict infant emotional reactivity, independently of maternal perinatal mental health; while associations between perinatal depressive symptoms and infant reactivity are partially explained by prior exposure. Findings suggest that processes shaping early vulnerability for later mental disorders arise well before conception. There is an emerging case for expanding developmental theories and trialling preventive interventions in the years before pregnancy.

The social foundation of executive function.

In this study, we propose that infant social cognition may 'bootstrap' the successive development of domain-general cognition in line with the cultural intelligence hypothesis. Using a longitudinal design, 6-month-old infants (N = 118) were assessed on two basic social cognitive tasks targeting the abilities to share attention with others and understanding other peoples' actions. At 10 months, we measured the quality of the child's social learning environment, indexed by parent's abilities to provide scaffolding behaviors during a problem-solving task. Eight months later, the children were followed up with a cognitive test-battery, including tasks of inhibitory control and working memory. Our results showed that better infant social action understanding interacted with better parental scaffolding skills in predicting simple inhibitory control in toddlerhood. This suggests that infants' who are better at understanding other's actions are also better equipped to make the most of existing social learning opportunities, which in turn may benefit future non-social cognitive outcomes.

Effect of neonatal therapy on the motor, cognitive, and behavioral development of infants born preterm: a systematic review.

AIM: To synthesize the existing literature and determine the efficacy of neonatal therapy, starting in the neonatal intensive care unit (NICU), on the motor, cognitive, and behavioral outcomes of infants born preterm. METHOD: Databases were searched for randomized controlled trials or quasi-randomized controlled trials of direct therapy early intervention for infants with a gestational age of less than 37 weeks, initiated in the NICU and delivered by a therapist or parent with therapist support. Quality was evaluated using the Cochrane standardized risk of bias assessment tool. Recommendations were made using the Grading of Recommendations, Assessment, Development and Evaluations approach. RESULTS: Fifteen studies met the inclusion criteria. Studies were categorized into four intervention categories: (1) parent-delivered motor intervention (PDMI); (2) therapist-delivered postural control intervention (TDPCI); (3) developmental care; and (4) oromotor intervention. Risk of bias varied from low (10 studies) to high (three studies) or was unclear (two studies). INTERPRETATION: Preliminary support indicates that daily PDMI improves motor and cognitive outcomes in the short-term and possibly long-term. TDPCI is effective in promoting short-term gains in motor development. Developmental care programs designed by a neonatal therapist appear to be effective in improving short-term behavior but are inconclusive for motor and cognitive outcomes or long-term behavioral outcomes. Regarding oromotor interventions, there is insufficient research to be confident in their efficacy on improving developmental outcomes. WHAT THIS PAPER ADDS: Parent-delivered motor interventions (PDMIs) are more effective in improving motor and cognitive outcomes than other interventions. Preliminary support indicates that daily PDMI improves motor and cognitive outcomes in the short- and possibly long-term. Therapist-delivered postural control interventions are effective in promoting short-term gains in motor development. Developmental care programs designed by a neonatal therapist are effective in improving the short-term behavior of infants born preterm. Oral motor interventions were found to have no effect on improving developmental outcomes.

Efectos de la terapia neonatal en el desarrollo motor, cognitivo y conducta de los niños nacidos pretérmino: una revisión sistemática OBJETIVO: Sintetizar la literatura existente y determinar la eficacia de la terapia neonatal, comenzando en la unidad de cuidados intensivos neonatales (UCIN), en el desarrollo motor, cognitivo y conducta de niños pretérmino. MÉTODO: En diferentes bases de datos buscamos ensayos aleatorios y controlados o ensayos cuasi aleatorios y controlados de intervención temprana en niños con edad gestacional menor a 37 semanas, iniciadas en UCIN y realizadas por un terapeuta o un padre con el apoyo de un terapeuta. La calidad se evaluó usando la herramienta de evaluación estandarizada de riesgo de sesgo de Cochrane. Las recomendaciones se realizaron utilizando el enfoque de Calificación de Recomendaciones, Valoración, Desarrollo y evaluaciones. RESULTADOS: Quince estudios reunieron los criterios de inclusión. Los estudios se dividieron en 4 categorías de intervención: (1) intervenciones motoras realizadas por padres (PDMI); (2) intervención de control postural administrada por terapeutas; (3) cuidados del desarrollo; y (4) intervención oromotora. El riesgo de sesgo vario de bajo (10 estudios) a alto (3 estudios) o no estaba claro (2 estudios). INTERPRETACIÓN: El soporte preliminar indica que el PDMI diario mejora los resultados motores y cognitivos a corto plazo y posiblemente a largo plazo. La intervención de control postural administrada por terapeuta es efectiva para promover ganancias a corto plazo en el desarrollo motor. Los programas de atención del desarrollo diseñados por un terapeuta neonatal parecen ser efectivos para mejorar el comportamiento a corto plazo, pero no son concluyentes para los resultados motores y cognitivos o los resultados conductuales a largo plazo. Con respecto a las intervenciones oromotoras, no hay investigaciones suficientes para confiar en su eficacia para mejorar los resultados del desarrollo.

Efeito da terapia neonatal no desenvolvimento motor, cognitivo e comportamental de lactentes nascidos prematuros: uma revisão sistemática OBJETIVO: Sintetizar a literatura existente e determinar a eficácia da terapia neonatal, iniciando na unidade de terapia intensiva neonatal (UTIN) nos resultados motores, cognitivos, e comportamentais de lactentes nascidos prematuros. MÉTODO: Bases de dados foram pesquisadas quanto a estudos clínicos randomizados ou quasi-randomizados sobre a intervenção precoce direta para crianças com idade gestacional menor do que 37 semanas, iniciada na UTIN e realizada por um terapeuta ou pai/mãe com suporte de terapeuta. A qualidade foi avaliada usando a ferramenta padronizada Cochrane para risco de viés. Recomendações foram feitas usando a abordagem Grade para Recomendações, Avaliação, Desenvolvimento e Acompanhamento. RESULTADOS: Quinze estudos atenderam aos critérios de inclusão. Os estudos foram categorizados em quatro categorias de intervenção: (1) intervenção motora realizada pelos pais (IMRP); (2) intervenção de controle postural realizada por terapeuta; (3) cuidado desenvolvimental; e (4) intervenção oromotora. O risco de viés variou de baixo (10 estudos) a alto (três estudos) ou não estava claro (dois estudos). INTERPRETAÇÃO: Estudos preliminares indicam que a IMRP melhora os resultados motores e cognitivos no curto prazo e provavelmente no longo prazo. Intervenção para controle postural realizada por terapeutas é efetiva em promover ganhos em curto prazo no desenvolvimento motor. Programas de atenção ao desenvolvimento traçados por terapeuta neonatal parecem ser efetivos para melhorar o comportamento em curto prazo, mas são inconclusivos para resultados motores e cognitivos, ou resultados comportamentais no longo prazo. Com relação às intervenções oromotoras, as pesquisas são insuficientes para dar confiança sobre sua eficácia em melhorar resultados desenvolvimentais.