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.

[Mentalization as a factor protecting a human being]. / Mentalisaatio ihmistä suojaavana tekijänä.

Mentalization refers to the ability of an individual to contemplate her/his own or another person's perspective and experience. Good mentalizing ability will help control one's own emotional states, stabilize interpersonal relationships and reduce conflict-induced stress. Mentalizing ability is associated with good interaction with a child, and with a favorable cognitive and emotional development. Although experiences of interaction during childhood are of crucial importance for the development of mentalization, the ability may also be strengthened through later good human relations and precisely targeted therapy.

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.

How mothers interact with children with suspected cow's milk allergy symptoms.

AIM: To characterize mother-child interaction in children with suspected gastrointestinally manifested cow's milk allergy (GI-CMA) and to explore factors associated with the parentally perceived symptoms. METHODS: We invited a randomly selected group of children with suspected GI-CMA and their mothers to take part in a video recording of them playing together. The mother-child interaction was rated using the Emotional Availability Scales (EAS, 4th edition) and compared with national normative data. RESULTS: Video recordings were conducted with 24 patients (15 girls and nine boys) with a median age of 10.1 months (range 2.1-20.5 months) undergoing a double-blind, placebo-controlled food challenge for cow's milk allergy. The EAS profile in the challenge negative group (17/24) was significantly different from the normative data. The scores for maternal sensitivity (p = 0.0049) and nonintrusiveness (p = 0.0192), together with child responsiveness (p = 0.0053) and involvement of mother (p = 0.0085), were all significantly lower when compared to the normative data. The dimensions of maternal nonhostility and structuring, as well as the scores of the challenge positive group, did not differ from the normative data. CONCLUSION: Dysfunctional mother-child emotional interaction was frequent in young children with suspected GI-CMA ruled out by the cow's milk challenge. Appropriate psychological support should be considered.

Bodily-tactile early intervention for a mother and her child with visual impairment and additional disabilities: a case study.

PURPOSE: Congenital visual impairment and additional disabilities (VIAD) may hamper the development of a child's communication skills and the quality of overall emotional availability between a child and his/her parents. This study investigated the effects of bodily-tactile intervention on a Finnish 26-year-old mother's use of the bodily-tactile modality, the gestural and vocal expressions of her one-year-old child with VIAD, and emotional availability between the dyad. MATERIALS AND METHODS: Mixed methods were used in the video analysis. The child's and his mother's bodily-tactile and gestural expressions were analyzed using a coding procedure. Applied conversation analysis was used to further analyse the child's emerging gestural expressions in their sequential interactive context. Emotional availability scales were used to analyze the emotional quality of the interaction. RESULTS: The results showed that the mother increased her use of the bodily-tactile modality during the intervention, especially in play and tactile signing. The child imitated new signs and developed new gestural expressions based on his bodily-tactile experiences during the intervention sessions. His vocalizations did not change. Emotional availability remained stable. CONCLUSIONS: The case study approach allowed the in-depth investigation of the components contributing to the emergence of gestural expressions in children with VIAD.Implications for rehabilitationBodily-tactile modality may compensate for the absence of a child's vision in child-parent interactions.Bodily-tactile early intervention may be effective in guiding caregivers to use bodily-tactile modality in interacting with their child with VIAD.Caregivers' use of bodily-tactile modality in interactions may contribute to the development of gestural expressions in a child with VIAD.The use of bodily-tactile modality in interactions may improve the emotional connection between children with VIAD and their caregivers.

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.

Prenatal Reflective Functioning as a Predictor of Substance-Using Mothers' Treatment Outcome: Comparing Results From Two Different RF Measures.

Mothers with prenatal substance use disorder (SUD) often show broad deficits in their reflective functioning (RF), implying severe risk for the relationship with their baby. Two different types of prenatal maternal RF may be important for parenting: adult attachment-focused-RF (AAI-RF), regarding parent's own childhood experiences, and parenting-focused RF (PRF) regarding their own current process of becoming a parent. However, their inter-relations and potentially different roles for parenting intervention outcomes are not clear. This study examined the associations between mothers' prenatal AAI-RF and pre- and post-natal PRF, and their role in mother-infant interaction and substance use as treatment outcomes. The participants were 57 treatment-enrolled pregnant mothers with SUD and 50 low-risk comparison mothers. AAI-RF was measured with the Adult Attachment Interview. For a subsample of 30 mothers with SUD, PRF was measured with Pregnancy Interview (during pregnancy/pre-intervention), and with Parent Development Interview at 4 months (during intervention). Mother-infant interaction was measured with Emotional Availability Scales at 4 and 12 months (post-intervention), and maternal substance use by post-natal substance relapses. Prenatal AAI-RF and pre- and post-natal PRF were highly associated with each other. Only higher prenatal PRF predicted better mother-infant interaction quality at 4 months and less substance use during the child's first year. Interestingly, prenatal PRF and AAI-RF predicted opposite changes in mother-infant interaction: lower prenatal PRF, but higher AAI-RF predicting more positive change. AAI-RF was especially associated with a change in maternal intrusiveness and hostility, indicating that it represents a more general regulatory tendency. Further studies are needed in larger and lower-risk samples. Our results suggest, however, that AAI-RF and PRF are partially distinct and should be uniquely targeted in perinatal interventions.

Parental relationship satisfaction, reflective functioning, and toddler behavioral problems: A longitudinal study from pregnancy to 2 years postpartum.

Parent relationship satisfaction and parental reflective functioning (PRF) are significant factors in the transition to first-time parenting and are likely to affect a child's later wellbeing. However, little is known about their joint longitudinal effects from pregnancy onward. Starting in the prenatal period, this follow-up study of 1016 Finnish first-time parents (358 fathers and 658 mothers at baseline) examined the stability and the reciprocal associations between relationship satisfaction and PRF in predicting child behavioral problems (CBCL) at age 2. First, the results of the random-intercept cross-lagged panel models showed that both relationship satisfaction and PRF were stable from pregnancy onward for both mothers and fathers, with the exception of mothers' prenatal PRF. Second, there were significant reciprocal associations between low prenatal PRF and low relationship satisfaction at age 1, and vice versa. Third, for both mothers and fathers, a low level of relationship satisfaction, but not PRF, predicted consistently higher levels of child behavioral problems at age 2. These results suggest that parent relationship satisfaction and PRF are stable but largely independent parental factors during the transition to parenthood. In addition, our results highlight the significant role of parent relationship satisfaction in predicting toddler behavior problems, which indicates the relevance of early relationship-orientated help for first-time parents.

[Theraplay--interactive therapy between parent and child in juvenile mental problems]. / Theraplay--vanhemman ja lapsen välinen vuorovaikutus- hoito lasten mielenterveysongelmissa.

Parent-child interaction therapy is an effective means to prevent and correct children's mental problems. Interactive interventions shown to be effective share common features: the focus is on the support of the parent's sensitivity, positive guiding ability and reflective capability. Simultaneous participation of both parents in the therapy, application of video observation and affirmation of positive collaborative relationship with the parents seem to increase the efficacy of the intervention. The above-mentioned elements are utilized in an interactive therapy method called Theraplay.

Effect of Tactile Imitation Guidance on Imitation and Emotional Availability. A Case Report of a Mother and Her Child With Congenital Deafblindness.

Interaction between parents and children with congenital deafblindness (CDB) is easily hampered due to dual sensory loss. This case report examines imitation and emotional availability in interaction between a mother and her 3-year-old child with CDB first in unguided play and then in three play sessions with tactile imitation guidance. The video recorded play sessions were analyzed for frequency, length, and modality of imitation. Emotional Availability Scales were used to code the emotional quality of interaction. The results showed that before the guidance the mother imitated the child mainly vocally. After the guidance, the use of tactility in imitations increased. Imitation exchanges lasted longest in the last session. The emotional availability between the mother and the child was higher after the guidance. Further research is needed to confirm the positive outcomes of this case study.