Infant embodied requests and teacher-practitioner offers during early childhood education mealtimes.

The importance of building healthy relationships with food in children's early years is of paramount importance. Building on prior work exploring the social and linguistic practices in infant eating interaction experiences, this research uses a multimodal conversation analysis approach to explore how mealtime interactions are managed as a co-constructed activity between infants (0-2 years) and early childhood teacher-practitioners. Here we will explore video data recorded during mealtimes in an early childhood setting in Mid-Wales, where infants orient to recruitments for assistance and teachers provide offers of help with food items throughout the data. Analysis demonstrates 1) infant recruitment of help through embodied 'showing' an item causing a problem in multimodal ways, initiating joint attention that mobilises an offer from an adult in the shape of 'do you want me to X' and 2) adult initiation of an offer of help in the shape of 'would you like me to X' that are not prompted by infants 'showing' an item. Such practices demonstrate infant social competence in recruiting assistance through multimodal resources, and adult's noticings that help is required and their initiation of provision of assistance. The detailed exploration into the ways in which mealtimes are a collaboratively achieved experience reveals how infants effectively contribute in resourceful ways, and how teacher-practitioner responses frame mealtimes as co-produced activities.

Effect of prematurity and temperament on the mother-infant interaction / Efeito da prematuridade e temperamento na interação mãe-bebê / Efecto de la prematurez y el temperamento en la interacción madre-bebé

Abstract We evaluated the effect of prematurity and the infant's temperament on the mother-infant behaviors in the Face-to-Face Still-Face Paradigm (FFSF). The study included 75 mothers and their infants (37 preterm and 38 term) between three and four months of age (corrected age for preterm infants). The mothers responded to a perception scale of the infants' temperament and the dyads were observed in a structured condition (FFSF). The FFSF Paradigm, divided into three episodes, made it possible to analyze the behaviors of: Positive Social Orientation, Negative Social Orientation and Self-comfort. The averages recorded for these categories were analyzed in a Multivariate ANOVA (factors: prematurity and temperament). Temperament had more effect on maternal and infant behaviors, suggesting that this factor may influence mother-infant interaction. The results can guide possible interventions with families. (AU)

Resumo Buscou-se avaliar o efeito da prematuridade e do tipo de temperamento do bebê sobre a interação mãe-bebê por meio do Paradigma do Face-to-Face Still-Face (FFSF). Participaram do estudo 75 mães e seus bebês (37 pré-termo e 38 a termo), entre três a quatro meses de vida (idade corrigida para bebês pré-termo). As mães responderam a uma escala de percepção do temperamento dos bebês e as díades foram filmadas em condição estruturada (FFSF). A filmagem, dividida em três episódios, possibilitou a análise de comportamentos de: Orientação Social Positiva, Orientação Social Negativa e Autoconforto. As médias registradas para essas categorias foram submetidas à Anova Multivariada (fatores: prematuridade e temperamento). O temperamento apresentou mais efeito sobre os comportamentos maternos e dos bebês, sugerindo que esse fator pode influenciar a interação diádica. Os resultados podem nortear possíveis intervenções junto às famílias.(AU)

Resumen Se buscó evaluar el efecto de la prematuridad y el tipo de temperamento del bebé en la interacción madre-bebé a través del Paradigma Face-to-Face Still-Face (FFSF). En el estudio participaron 75 madres y sus bebés (37 prematuros y 38 a término), con edades comprendidas entre los tres y los cuatro meses (edad corregida para bebés prematuros). Las madres respondieron a una escala de percepción del temperamento de los bebés y las díadas fueron filmadas en una condición estructurada (FFSF). El rodaje, dividido en tres episodios, permitió analizar los comportamientos de: Orientación Social Positiva, Orientación Social Negativa y Autoconfort. Los promedios registrados para estas categorías fueron sometidos al ANOVA Multivariado (factores: prematuridad y temperamento). El temperamento tuvo más efecto en los comportamientos maternos e infantiles, lo que sugiere que este factor puede influir en la interacción diádica. Los resultados pueden orientar posibles intervenciones con las familias. (AU)

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.

Coconstrução do apego no primeiro semestre de vida: o papel do outro nessa constituição / Co-construction of attachment in the first semester of life: the role of the other in this constitution / Co-construction de l'attachement au premier semestre de la vie: le rôle de l'autre dans cette constitution / Coconstrucción del apego en el primer semestre de vida: el papel del otro en esta constitución

Resumo A sobrevida do bebê humano é possibilitada pelo sistema de apego, na medida em que ele busca proximidade, emitindo comportamentos mediadores em direção a uma figura que lhe proporciona segurança. Reflexões provindas da existência de uma intersubjetividade inata e evidências de habilidades mais refinadas do que se conhecia à época da formulação da teoria de Bowlby levaram à hipótese de que o comportamento de apego pode ser observado antes do proposto por esse autor. Empreendeu-se um estudo de caso, em que se analisaram videogravações do primeiro semestre de vida de Marina. Selecionaram-se e analisaram-se microgeneticamente episódios de comportamento diferencial do bebê com seus cuidadores antes dos seis meses de idade; e mapearam-se os comportamentos mediadores com cada cuidador. O comportamento diferencial com uma figura discriminada foi visualizado já aos três meses de vida. Discutiram-se os processos dialógicos e culturais que repercutiram na seleção da mãe como figura de apego.

Abstract The survival of a human baby is enabled by the attachment behavioral system, as babies seek proximity, directing attachment mediator behaviors toward a figure who provides security. Reflections from the existence of a primary intersubjectivity and evidence of more refined abilities than what was known at the time in which Bowlby formulated this theory conducted us to the hypothesis that attachment is perceived before the period he proposed. We performed a case study in which we analyzed video-recordings from Marina's six months of life. Episodes of differential behavior towards a figure were selected and micro-genetically transcribed. Moreover, mediator behaviors with each of the baby's caregivers were mapped. Results suggested differential behavior towards a discriminated figure since her third month. The dialogical and cultural processes that reverberated in selecting the mother as the attachment figure were discussed.

Résumé La survie du jeune enfant est rendue possible par la relation d'attachement, quand il cherche de la proximité, en émettant des comportements médiateurs vers une figure qui lui fournit sécurité. Réflexions de l'existence d'une intersubjectivité innée et évidences d'habiletés raffinées qu'on connaissait à l'époque de la formulation de la théorie on conduit à l'hypothèse que le comportement d'attachement peut être observé avant la période proposé par Bowlby. On a réalisé une étude de cas où des enregistrements vidéo du premier semestre de Marina ont été analysés. Episodes de comportement différentiel du jeune enfant avec une figure discriminée avant six mois ont été sélectionnés et analysés micro génétiquement; les comportements médiateurs avec chaque soignant ont été enregistrés à intervalles. Le comportement différentiel avec une figure discriminée a été observé déjà à trois mois de vie. L'influence des processus dialogiques et culturels sur le choix de la mère comme figure d'attachement sont discutés.

Resumen La garantía de supervivencia del bebé humano es posibilitada por el sistema de apego, en la medida en que el bebé busca acercamiento, mediante comportamientos mediadores emitidos en dirección de una figura que le proporcione seguridad. Las reflexiones derivadas de la intersubjetividad innata y evidentes habilidades mucho más refinadas de lo que eran conocidas en la época de la formulación de la teoría de Bowlby llevaron a la hipótesis de que el comportamiento de apego puede observarse antes de lo propuesto por él. Se realizó un estudio de caso a partir del análisis de grabaciones en video del primer semestre de vida de Mariana. Para ello, se seleccionaron y se analizaron microgenéticamente episodios de comportamiento diferencial del bebé con cuidadores antes de los seis meses; y se enumeraron los comportamientos mediadores con cada cuidador. Los resultados sugieren que el comportamiento diferencial con una figura discriminada se observó ya a los tres meses de vida. Se discutieron los procesos dialógicos y culturales que repercutirán en la selección de la madre como la figura de apego.

Reading Appetite Cues in Infancy: A Role for Nutrition Education.

Infants communicate complex aspects of appetite through a variety of behaviors. In newborn babies, mouthing and orientation towards odors from breast milk signal preference, whereas in older infants likes and dislikes are signaled via facial expressions. Infants communicate readiness to eat by sucking their hands and eliciting the hunger cry, and indicate satiation through a wide repertoire of behaviors ranging from subtle facial expressions, shifts in gaze through to changes in gesture and bodily movements including turning their head away. Filming mealtime interactions reveals the dynamic nature of infant communication and caregiver response. Optimal responsiveness to infant cues may be influenced by individual characteristics of the mother and the mode of feeding (breastfed or formula). A series of studies has used video capture to characterize the ways in which infants communicate appetite. We have then translated this into an educational resource for healthcare professionals and caregivers on how to identify, interpret, and respond to these cues. There is a potentially important role for nutrition education in promoting both the principles of good nutrition as well as ways to read then respond sensitively to infant appetite cues.

The Impact of Neurobehavior on Feeding Outcomes in Neonates with Congenital Heart Disease.

OBJECTIVE: To evaluate the association between neonatal neurobehavioral state and oral feeding outcomes following congenital heart disease (CHD) surgery. STUDY DESIGN: This single center retrospective cohort study described neonates undergoing cardiac surgery evaluated perioperatively with the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS). We compared NNNS attention scores, which evaluates neonates' ability to orient and fixate on stimuli, with the feeding outcomes percentage of feeds taken orally at discharge and time to reach full oral feeds using regression analyses. Models were constructed for both preoperative and postoperative NNNS evaluations. RESULTS: Between August 2015 and October 2017, 124 neonates underwent 89 preoperative and 97 postoperative NNNS evaluations. In multivariable Cox regression, higher preoperative NNNS attention scores were associated with a shorter time to achieve full oral feeds (hazard ratio 1.4; 95% CI 1.0‒2.0; P = .047). This relationship was not seen for post-operative NNNS attention scores or percentage of oral feeds at discharge. Depending on the model, younger age at surgery, increased ventilator days, increased length of stay, and single or 2-ventricle anatomy with aortic arch obstruction were associated with lower percentage of oral feeds at discharge and/or delay in full oral feeds. CONCLUSIONS: Higher neonatal attention before cardiac surgery is associated with improved feeding outcomes. Prospective assessment of neonatal neurobehavioral state may be a novel approach to predict and target interventions to improve feeding outcomes in CHD. Future studies should examine the impact of intrinsic neurodevelopmental delay vs environmental adaptation on the neurobehavioral state of neonates with CHD.

Breastfeeding and behavioural problems: Propensity score matching with a national cohort of infants in Chile.

IMPORTANCE: Potential effects of breast feeding on children's behaviour remains an elusive debate given inherent methodological challenges. Propensity score matching affords benefits by ensuring greater equivalence on observable social and health determinants, helping to reduce bias between groups. OBJECTIVES: We examined whether the duration of breast feeding had an impact on children's externalising and internalising behaviours. STUDY DESIGN: A cohort study (Encuesta Longitudinal de la Primera Infancia cohort) that included 3037 Chilean families who were enrolled in 2010. Follow-up data was collected in 2012. SETTING: General community. PARTICIPANTS: Population-based sample. Eligibility criteria: children born full-term with complete data on matching variables. Matching variables included: healthcare system as a proxy of income, presence of a partner/spouse in the household, maternal age, educational level, IQ, working status, type of work, diagnosis of prenatal depression by a healthcare professional, smoking during pregnancy, delivery type, child sex, weight at birth, incubation following delivery, and child age. EXPOSURE: Duration of breast feeding. MAIN OUTCOMES AND MEASURES: Externalising and internalising problems assessed using the Child Behaviour Checklist. RESULTS: Matched results revealed benefits of any breast feeding, up to 6 months, on emotional reactivity and somatic complaints (mean difference of -1.00, 95% CI, -1.84 to -0.16 and -1.02, 95% CI, -1.76 to -0.28, respectively). Children breast fed between 7 and 12 months also had reduced scores on emotional reactivity, in addition to attention problems (mean difference of -0.86, 95% CI, -1.66 to -0.06 and -0.50, 95% CI, -0.93 to -0.07, respectively). No benefits were observed for children breast fed 13 months or more. CONCLUSION: Reduced internalising difficulties and inattention were found in children breast fed up to a year, suggesting that breast feeding may have beneficial impacts on these areas of development. The magnitude of effect was modest. Extended durations of breast feeding did not appear to offer any benefits.

Impact of maternal prenatal smoking on fetal to infant neurobehavioral development.

Despite recent emphasis on the profound importance of the fetal environment in "programming" postnatal development, measurement of offspring development typically begins after birth. Using a novel coding strategy combining direct fetal observation via ultrasound and actocardiography, we investigated the impact of maternal smoking during pregnancy (MSDP) on fetal neurobehavior; we also investigated links between fetal and infant neurobehavior. Participants were 90 pregnant mothers and their infants (52 MSDP-exposed; 51% minorities; ages 18-40). Fetal neurobehavior at baseline and in response to vibro-acoustic stimulus was assessed via ultrasound and actocardiography at M = 35 weeks gestation and coded via the Fetal Neurobehavioral Assessment System (FENS). After delivery, the NICU Network Neurobehavioral Scale was administered up to seven times over the first postnatal month. MSDP was associated with increased fetal activity and fetal limb movements. Fetal activity, complex body movements, and cardiac-somatic coupling were associated with infants' ability to attend to stimuli and to self-regulate over the first postnatal month. Furthermore, differential associations emerged by MSDP group between fetal activity, complex body movements, quality of movement, and coupling, and infant attention and self-regulation. The present study adds to a growing literature establishing the validity of fetal neurobehavioral measures in elucidating fetal programming pathways.

Infants' visual sustained attention is higher during joint play than solo play: is this due to increased endogenous attention control or exogenous stimulus capture?

Previous research has suggested that when a social partner, such as a parent, pays attention to an object, this increases the attention that infants pay to that object during spontaneous, naturalistic play. There are two contrasting reasons why this might be: first, social context may influence increases in infants' endogenous (voluntary) attention control; second, social settings may offer increased opportunities for exogenous attentional capture. To differentiate these possibilities, we compared 12-month-old infants' naturalistic attention patterns in two settings: Solo Play and Joint Play with a social partner (the parent). Consistent with previous research, we found that infants' look durations toward play objects were longer during Joint Play, and that moments of inattentiveness were fewer, and shorter. Follow-up analyses, conducted to differentiate the two above-proposed hypotheses, were more consistent with the latter hypothesis. We found that infants' rate of change of attentiveness was faster during Joint Play than Solo Play, suggesting that internal attention factors, such as attentional inertia, may influence looking behaviour less during Joint Play. We also found that adults' attention forwards-predicted infants' subsequent attention more than vice versa, suggesting that adults' behaviour may drive infants' behaviour. Finally, we found that mutual gaze did not directly facilitate infant attentiveness. Overall, our results suggest that infants spend more time attending to objects during Joint Play than Solo Play, but that these differences are more likely attributable to increased exogenous attentional scaffolding from the parent during social play, rather than to increased endogenous attention control from the infant.

Concepções parentais sobre intencionalidade comunicativa em bebês aos 3 e 6 meses / Parental conceptions of communicative intentionality in infants at 3 and 6 months / Concepciones de los padres de la intencionalidad comunicativa en los bebés a los 3 y 6 meses

O presente estudo objetivou conhecer e analisar as concepções parentais acerca da intencionalidade comunicativa de bebês aos 3 e 6 meses do primeiro ano de vida. Foi utilizado um delineamento longitudinal, com a participação de 20 mães e de 20 pais, entrevistados em duas etapas. As entrevistas foram transcritas de forma literal e, em seguida, analisadas qualitativamente. Foram identificadas mais semelhanças do que diferenças entre os discursos maternos e paternos. Constatou-se que os relatos parentais apresentaram concepções que comportamentos infantis específicos podem ser indícios da habilidade de comunicação intencional. Especialmente na segunda etapa, quando os bebês tinham 6 meses de idade, os pais referiram comportamentos infantis que seriam exibidos para expressar vontades e indicar intenção. O conhecimento dessas concepções é importante para a compreensão das relações iniciais estabelecidas entre pais e seus filhos. (AU)

This study aimed to identify and analyze parental conceptions of the communicative intent of infants at 3 and 6 months in the first year of life. A longitudinal design was used, including 20 mothers and 20 fathers who were interviewed in two stages. The interviews were literally transcribed and then qualitatively analyzed. It was identified more similarities than differences between maternal and paternal speeches. It was found that parental reports presented conceptions that specific child behavior may be evidence of intentional communication skills. Especially in the second stage, when infants were 6 months old, parents mentioned child behavior that seemed to express wishes and indicate intention. Knowledge of these concepts is important for understanding the early relations between parents and their children. (AU)

Este estudio tuvo como objetivo conocer y analizar las concepciones de los padres sobre la intención comunicativa de los bebés a los 3 y 6 meses en su primer año de vida. Se utilizó un delineamiento longitudinal, y participaron 20 madres y 20 padres entrevistados en dos etapas. Las entrevistas fueron transcriptas literalmente y analizadas cualitativamente. Fueron identificadas más semejanzas que diferencias entre los discursos maternos y paternos. Se constató que los informes de los padres presentan concepciones sobre el hecho de que, comportamientos infantiles específicos, pueden ser indicios de la habilidad de comunicación intencional. Especialmente en la segunda etapa, cuando los bebés tenían 6 meses de edad, los padres indicaron que comportamientos infantiles fueron exibidos para expresar deseos e indicar la intención. El conocimiento de esas concepciones es importante para la comprensión de las relaciones iniciales estabelecidas entre padres y sus hijos. (AU)

Related visual impairment to mother-infant interaction and development in infants with bilateral retinoblastoma.

PURPOSE: This study was conducted with infants diagnosed with bilateral retinoblastoma (RB) and their mothers. It explored characteristics of the mother-infant interaction, the infants' developmental characteristics and related risk factors. METHOD: Cross-sectional statistical analysis was performed with 18 dyads of one-year-old infants with bilateral RB and their mothers. RESULTS: Using the Japanese Nursing Child Assessment Teaching Scale (JNCATS) results showed that infants with RB had significantly lower scores compared to normative Japanese scores on all of the infants' subscales and "Child's contingency" (p < 0.01). Five infants with visual impairment at high risk of developmental problems had a pass rate of 0% on six JNCATS items. There were positive correlations between Developmental quotients (DQ) and JNCATS score of "Responsiveness to caregiver" (ρ = 0.50, p < 0.05) and DQ and "Child's contingency" (ρ = 0.47, p < 0.05). CONCLUSIONS: Infants with visual impairment were characterized by high likelihood of developmental delays and problematic behaviors; they tended not to turn their face or eyes toward their mothers, smile in response to their mothers' talking to them or the latter's changing body language or facial expressions, or react in a contingent manner in their interactions. These infant behaviors noted by their mothers shared similarities with developmental characteristics of children with visual impairments. These findings indicated a need to provide support promoting mother-infant interactions consistent with the developmental characteristics of RB infants with visual impairment.

Behavioral and neural correlates of emotional development: typically developing infants and infants of depressed and/or anxious mothers / Bases neurais e comportamentais do desenvolvimento emocional: lactentes com desenvolvimento típico e lactentes filhos de mães deprimidas e/ou ansiosas

ABSTRACT Objectives: To describe the main findings of studies of behavioral and neural correlates regarding the development of facial emotion processing during the first year of life in typically developing infants and infants of depressed and/or anxious mothers. Sources: Comprehensive, non-systematic review of the literature on studies about individual differences in facial emotion processing by newborns and infants over the first year of life. Summary of the findings: Maternal stress related to depression and anxiety has been associated to atypical emotional processing and attentional behaviors in the offspring. Recent neurophysiological studies using electroencephalogram and event-related potentials have begun to shed light on the possible mechanisms underlying such behaviors. Conclusions: Infants of depressed and/or anxious mothers have increased risk for several adverse outcomes across the lifespan. Further neurobehavioral investigations and the promotion of clinical and developmental research integration might eventually contribute to refining screening tools, improving treatment, and enabling primary prevention interventions for children at risk.

RESUMO Objetivos: Descrever os principais achados de estudos de correlação entre o comportamento e as bases neurais em relação ao processamento de emoções faciais durante o primeiro ano de vida de lactentes com desenvolvimento típico e lactentes de mães deprimidas e/ou ansiosas. Fontes: Análise abrangente e não sistemática da literatura de estudos sobre diferenças individuais no processamento de emoções faciais de neonatos e lactentes ao longo do primeiro ano de vida. Resumo dos achados: O estresse materno relacionado à depressão e ansiedade tem sido associado a alterações no processamento emocional e na alocação da atenção da prole. Estudos neurofisiológicos recentes utilizando electroencefalograma e potenciais relacionados a eventos começam a esclarecer os possíveis mecanismos inerentes a esses comportamentos. Conclusões: Lactentes filhos de mães deprimidas e/ou ansiosas têm maior risco de problemas de saúde física e mental durante toda vida. O avanço de estudos neurocomportamentais e a promoção de integração entre a pesquisa clínica e de desenvolvimento poderão contribuir para refinar as ferramentas de triagem, melhorar o tratamento e permitir intervenções de prevenção primária para crianças em risco.

Signs of deterioration in infants discharged home following congenital heart surgery in the first year of life: a qualitative study.

AIMS: To describe the ways in which parents recognise and make decisions about their child's symptoms following discharge home after congenital heart interventions in the first year of life and their experiences of seeking help. METHODS: This was a qualitative study involving semistructured interviews with parents. Twenty-one parents were recruited to the study. Parents all had a child who had congenital heart surgery in their first year of life between September 2009 and October 2013 at one of three UK cardiac centres; the children had either died or were readmitted as an emergency following initial discharge. RESULTS: Some parents were unable to identify any early warning signs. Others described symptoms of deterioration including changes in feeding and appearance, respiratory distress and subtle behavioural changes that may not be routinely highlighted to parents at discharge. Several barriers to accessing prompt medical assistance were identified including parents feeling that their concerns were not taken seriously, long wait times and lack of protocols at A&E. CONCLUSIONS: Our study highlights behavioural symptoms as being a potentially underemphasised sign of deterioration and identifies a number of barriers to parents accessing support when they are concerned. It is important that parents are encouraged to seek advice at the earliest opportunity and that those health professionals at the front line have access to the information they need in order to respond in an appropriate and timely way. A role for home monitoring was also noted as potentially useful in identifying at risk children who appear clinically well.

Maternal postpartum depressive symptoms and infant externalizing and internalizing behaviors.

Maternal postpartum depression has been shown to be one of the main predictors of externalizing and internalizing behaviors in toddlers and adolescents. Research suggests that presence of such behaviors can be observed as early as infancy. The current study uses longitudinal data from 247 mothers to examine the relationship between postpartum depressive symptoms at 8 weeks and the infant's externalizing and internalizing behaviors at 12 months. In unadjusted linear regression models, there were associations between postpartum depressive symptoms and infant externalizing behaviors (ß=0.082, SE=0.032, p=0.012) and internalizing behaviors (ß=0.111, SE=0.037, p=0.003). After controlling for potential confounding factors, including maternal age, race, education, home ownership, smoking status in the postpartum period, marital status, parenting stress, and happiness from becoming a parent, the associations between postpartum depressive symptoms and infant externalizing (ß=0.051, SE=0.034, p=0.138) and internalizing behaviors (ß=0.077, SE=0.040, p=0.057) were reduced and became non-significant. Furthermore, in these models the total amount of variance explained was 17.2% (p<0.0001) for externalizing behaviors and 10.5% (p<0.01) for internalizing behaviors; the only significant predictor of externalizing behaviors was maternal age (ß=-0.074, SE=0.030, p=0.014), and of internalizing behaviors was white non-Hispanic ethnicity (ß=-1.33, SE=0.378, p=0.0005). A combined effect of the confounding factors seems to explain the finding of no significant independent association between postpartum depressive symptoms and infant externalizing and internalizing behaviors.

O brincar precoce do bebê como indicador de riscos de sofrimento psíquico / The early play of the baby as an indicator of risk of psychical distress / El juego precoz del bebé como indicador del riesgo de sufrimiento psíquico

Ao partirmos da noção de que os primeiros gestos espontâneos e criativos do bebê revelam aspectos importantes da qualidade de suas primeiras relações precoces com o objeto materno, bem como de seu processo de adaptação ao ambiente dito suficientemente bom, podemos presumir que o brincar primitivo do bebê possui um importante papel de sinalizador de sofrimento psíquico. Por meio de um estudo longitudinal de bebês com risco de autismo acompanhados entre os 6 meses e 3 anos, pôde-se constatar que a maneira como esses bebês exploram, interagem e respondem a um brincar compartilhado com o outro se diferencia significativamente da de bebês que apresentam um atraso do desenvolvimento psicomotor, sem traços de risco de autismo, e de bebês saudáveis (normais).

Using the notion that the first spontaneous and creative gestures of babies reveal important aspects of the quality of their first early relationships with the maternal object, as well as their process of adaptation to an environment considered as good enough, we can assume that the primitive play of babies has an important role to identify psychical distress. Through a longitudinal study of infants showing risk of autism, followed between 6 months and 3 years, we could find that the way these babies explore, interact and respond to a shared play with others significantly differ from babies who have a developmental delay without autistic traits, and healthy (normal) babies.

Si tomamos la noción de que los primeros gestos espontáneos y creativos del bebé aparecen aspectos importantes de la calidad de sus relaciones precoces con el objeto materno, así como el proceso de adaptación a un medio considerado suficientemente bueno, podemos suponer que estos juegos primitivos del bebé tienen un rol importante en la identificación del sufrimiento psíquico. A través de un estudio longitudinal con bebés que presentaban evidencias de riesgos autistas, seguidos entre los 6 meses hasta los 3 años de edad, mostró una diferencia significativa en la manera como estos exploran, interactúan y responden al juego con otros, en comparación con los que presentan un retardo en el desarrollo psicomotor, sin rasgos autistas, y con los de desarrollo normal.

Intervenções precoces na infância: observando a relação mãe-bebê em um serviço de saúde / Early intervention in childhood: watching the mother-baby relationship in a health service / Intervenciones precoces en la infancia: observando la relación madre-bebé en un servicio de salud

Este artigo tem como objetivo apresentar as atividades desenvolvidas em um projeto de extensão. Tal projeto visa a observar a relação entre crianças de 0 a 2 anos e suas mães nos atendimentos realizados pelo Programa da Criança em uma Unidade Básica de Saúde, com o intuito de detectar possíveis riscos ao desenvolvimento infantil de modo precoce. Utiliza-se da técnica de observação, tendo por base os Indicadores Clínicos de Risco ao Desenvolvimento Infantil (IRDI). Caso se identifiquem riscos ao desenvolvimento, são utilizados outros recursos técnicos que podem incluir entrevistas de orientações aos familiares e encaminhamentos à rede de atendimentos especializados. Os resultados alcançados indicam a importância do vínculo entre a equipe e os usuários, a maior atenção às díades e suas relações afetivas e a possibilidade de detecção precoce das problemáticas envolvendo os aspectos emocionais. Por fim, destaca-se a ação interdisciplinar e a atuação da Psicologia na promoção de saúde.

This article aims to present the activities developed in an extension Project. Such a project aims to observe the relationship between children, from zero to two years old, and their mothers, in the assistance carried out in the Child Program in a Basic Health Unit, targeting to detect possible early risks to child development. Observation techniques are used, based on the Clinical Risk Indicators in Child Development (CRICD). If risks to development are identified, other technical resources are used, that may include orientation interviews of family members and redirections to specialized services network. Results indicate the importance of the bond between the health care team and the users, the need of greater care regarding dyads and their relationships and the possibility of early detection of problems involving emotional aspects. Finally, the interdisciplinary actions and the role of Psychology concerning health promotion are highlighted.

Este artículo tiene como objetivo presentar las actividades desarrolladas en un proyecto de extensión. Este proyecto pretende observar la relación entre niños de cero a dos años y sus madres en la atención realizada por el Programa Infantil de una Unidad Básica de Salud, con el fin de detectar precozmente los posibles riesgos para el desarrollo del niño. Se utiliza la técnica de observación basada en los Indicadores Clínicos de Riesgo al Desarrollo Infantil (IRDI). Cuando se identifican riesgos para el desarrollo, otros recursos técnicos son utilizados, que pueden incluir entrevistas de orientación a los familiares y derivaciones a la red de atención especializada. Los resultados obtenidos indican la importancia del vínculo entre el equipo y los usuarios, una mayor atención a las duplas y sus relaciones afectivas y la posibilidad de detección precoz de los problemas que afectan a los aspectos emocionales. Por último, se destaca la acción interdisciplinaria y la actuación de la Psicología en la promoción de la salud.

The effect of maternal presence on premature infant response to recorded music.

OBJECTIVE: To determine the effect of maternal presence on the physiological and behavioral status of the preterm infant when exposed to recorded music versus ambient sound. DESIGN: Repeated-measures randomized controlled trial. SETTING: Special care nursery (SCN) in a tertiary perinatal center. PARTICIPANTS: Clinically stable preterm infants (22) born at > 28 weeks gestation and enrolled at > 32 weeks gestation and their mothers. METHODS: Infants were exposed to lullaby music (6 minutes of ambient sound alternating with 2x 6 minutes recorded lullaby music) at a volume within the recommended sound level for the SCN. The mothers in the experimental group were present for the first 12 minutes (baseline and first music period) whereas the mothers in the control group were absent overall. RESULTS: There was no discernible infant response to music and therefore no significant impact of maternal presence on infant's response to music over time. However during the mothers' presence (first 12 minutes), the infants exhibited significantly higher oxygen saturation than during their absence p = .024) and less time spent in quiet sleep after their departure, though this was not significant. CONCLUSION: Infants may have been unable to detect the music against the ambient soundscape. Regardless of exposure to music, the infants' physiological and behavioral regulation were affected by the presence and departure of the mothers.

Early markers of autism spectrum disorders in infants and toddlers prospectively identified in the Social Attention and Communication Study.

The Social Attention and Communication Study involved the successful implementation of developmental surveillance of the early markers of autism spectrum disorders in a community-based setting. The objective in the current study was to determine the most discriminating and predictive markers of autism spectrum disorders used in the Social Attention and Communication Study at 12, 18 and 24 months of age, so that these could be used to identify children with autism spectrum disorders with greater accuracy. The percentage of 'yes/no' responses for each behavioural marker was compared between children with autistic disorder (n = 39), autism spectrum disorder (n = 50) and developmental and/or language delay (n = 20) from 12 to 24 months, with a logistic regression also conducted at 24 months. Across all ages, the recurring key markers of both autistic disorder and autism spectrum disorder were deficits in eye contact and pointing, and from 18 months, deficits in showing became an important marker. In combination, these behaviours, along with pretend play, were found to be the best group of predictors for a best estimate diagnostic classification of autistic disorder/autism spectrum disorder at 24 months. It is argued that the identified markers should be monitored repeatedly during the second year of life by community health-care professionals.

The psychosocial impact of an infantile haemangioma on children and their parents.

Infantile haemangiomas (IHs) are common, benign vascular tumours in children that appear soon after birth and regress before the age of 12 years. Physicians have always been concerned about the considerable psychosocial impact these lesions might have on children and their parents. This is the first critical review of studies on the psychosocial impact of IHs on children and their families. Future directions for research are suggested. As propranolol is becoming the most common first choice treatment for IHs, this article discusses its use in the light of this review.

A longitudinal study on the effects of maternal smoking and secondhand smoke exposure during pregnancy on neonatal neurobehavior.

Maternal smoking during pregnancy is one of the most modifiable causes of morbidity and mortality for both pregnant women and their fetuses. The long-term effects of prenatal exposure to smoke on child behavior and development have been the subject of more extensive research than have the short-term effects. Therefore, the aim of this work is to examine the effects of smoke exposure during pregnancy on neonatal behavior, including in our study a group of mothers exposed to secondhand smoke. The behavior of 282 healthy full-term newborns was assessed using the Neonatal Behavior Assessment Scale (NBAS) at 48-72 h of life. Sixty-two mothers smoked during pregnancy (no mother smoked more than 15 cig/day) and 17 were exposed to secondhand smoke. After adjusting for socio-demographic and obstetric factors, both newborns whose mothers smoked and those whose mothers were exposed to secondhand smoke showed significantly lower scores in the habituation cluster than non-smoking mothers. Exposure to secondhand smoke was also related to lower motor system cluster scores as well as some supplementary items and the newborns of smoking mothers showed significantly lower scores in the state regulation cluster and in some items of the state organization cluster than the newborns of non-smoking mothers. We conclude that active and passive smoking during pregnancy affects several aspects of neurobehavioral development, regardless of socio-demographic, obstetric and pediatric factors.