Body structure processing and attentional patterns in infancy and adulthood.

Infants are sensitive to distortions to the global configurations of bodies by 3.5 months of age, suggesting an early onset of body knowledge. It is unclear, however, whether such sensitivity indicates knowledge of the location of specific body parts or solely reflects sensitivity to the overall gestalt of bodies. This study addressed this issue by examining whether, like adults, infants attend to specific locations where body parts have been reorganized. Results show that adults and 5-month-olds, but not 3.5-month-olds, allocated more attention to the body joint areas (e.g., where the arm connects to the shoulder) that were reorganized versus ones that were typical. To examine whether this kind of processing is driven by low-level features, 5-month-olds were tested on images in which the head was removed. Infants no longer exhibited differential scanning of typical versus reorganized bodies. Results suggest that 5-month-olds are sensitive to the location of body parts, thereby demonstrating adult-like response patterns consistent with early expertise in body processing. The contrasting failure of 3.5-month-olds to exhibit sensitivity to the reorganization suggests a developmental change between these ages.

Newborn Hearing Screening Results for Infants With Prenatal Opioid Exposure in Southern Appalachia.

PURPOSE: Infants prenatally exposed to opioids exhibit withdrawal symptomology that introduce physiological noise and can impact newborn hearing screening results. This study compared the referral rate and physiological noise interpreted by number of trials rejected due to artifact on initial newborn hearing screenings of infants with prenatal opioid exposure (POE) and infants with no opioid exposure (NOE). Furthermore, within the POE group, it examined the relationship of referral rates with severity of withdrawal symptomology, and with maternal and infant risk factors. METHOD: This study used a retrospective cohort design of electronic medical records from six delivery hospitals in South-Central Appalachia. Newborn hearing screenings were conducted using automated auditory brainstem response (ABR) for 334 infants with POE and 226 infants with NOE. Severity of withdrawal symptomology was measured using the Modified Finnegan Neonatal Abstinence Scoring Tool, which includes observation of behaviors that introduce physiological noise. RESULTS: There was no significant difference in newborn hearing screening referral rate between infants with POE and infants with NOE. Referral rate was not affected by maternal or infant risk factors. Infants with POE had statistically significant higher artifact (defined as rejected ABR sweeps) than infants with NOE. There was a strong positive correlation between Finnegan scores and artifact but not referral rates. Sensitivity and specificity analysis indicated artifact decreased substantially after Day 4 of life. CONCLUSIONS: Referral rates of infants with POE were similar to those of infants with NOE. Nevertheless, the withdrawal symptomology of infants with POE introduces physiological noise reflected as artifact on ABR, which can affect efficiency of newborn hearing screenings.

Adverse Childhood Experiences and Quality of Life: A Mediating Role of Physical Activity.

PURPOSE: Examine whether barriers to physical activity (PA) and PA level serve as serial mediators to the relationship between adverse childhood experiences (ACEs) and perceived quality of physical health. Design: Cross-sectional. Setting: A public university in Southeast United States. SUBJECTS: Seventy-five participants (18- 49 years). Measures: Self-report measures related to ACEs, barriers to PA, amount of PA, and perceived quality of physical health. ANALYSIS: Serial mediation analysis. Barriers to PA was a first-order mediator, and PA level was a second-order mediator between ACEs and perceived quality of physical health. RESULTS: Barriers to PA and PA levels serially mediated the relationship between ACEs and perceived quality of physical health (c = -1.01, SE = .251, P = .0002, 95% CI [-1.50, -.499]). The direct effect of ACEs on perceived quality of physical health was nonsignificant when mediators were controlled (c' = -.383, SE = .252, P = .133, 95% CI [-.886, .120]). Higher ACE scores were associated with more barriers to PA, lower PA levels, and in turn, lower perceived quality of physical health. CONCLUSION: The current study highlights specific pathways that contribute to the relationship between ACEs and perceived quality of physical health. Albeit limited by the sample size, preliminary data support prioritization of interventions that reduce barriers to PA when trying to increase PA in populations that are prone to early adversity.

Can umbilical cord testing add to maternal urine drug screen for evaluation of infants at risk of neonatal opioid withdrawal syndrome?

OBJECTIVE: This study evaluated maternal urine drug screen (UDS) at delivery and umbilical cord drug testing and its association with neonatal opioid withdrawal syndrome (NOWS) diagnosis and severity following opioid exposed pregnancy. METHODS: A retrospective chart review of 770 mother-infant dyads at five birthing hospitals in the United States Appalachian region for a five-year period was performed. Variables of interest included dyad demographics, results of maternal UDS at delivery and umbilical cord drug testing, and three neonatal outcomes: NOWS diagnosis, pharmacologic treatment administered for NOWS, and length of hospital stay (LOS) of the newborn. RESULTS: Opioid-positivity was between 8.5% and 66.3% based on maternal UDS at delivery or umbilical cord testing. Odds of NOWS diagnosis and increased infant LOS was best associated with opioid detection in maternal UDS alone (OR = 5.62, 95% CI [3.06, 10.33] and OR = 8.33, 95% CI [3.67, 18.89], respectively). However, odds of pharmacologic treatment for NOWS was best associated with opioid detection in both maternal UDS and umbilical cord testing on the same dyad (OR = 3.22, 95% CI [1.14, 9.09]). CONCLUSION: Maternal UDS is a better option compared to umbilical cord testing for evaluation of opioid-exposed infants and risk of NOWS diagnosis and increased infant LOS.

Early Identification of Atypical Motor Performance of Infants With Prenatal Opioid Exposure.

PURPOSE: To investigate the association between prenatal opioid exposure (POE) and newborn infants' motor performance to aid in the early identification of developmental delays. METHODS: Nineteen infants with POE requiring pharmacological treatment, 27 infants with POE without pharmacological treatment, and 25 infants without POE were assessed via the Test of Infant Motor Performance (TIMP). RESULTS: Infants in both groups with POE had lower TIMP scores than infants without POE. There was no difference between the TIMP scores of infants with POE who required pharmacological treatment and infants with POE who did not require pharmacological treatment. CONCLUSIONS: The TIMP can detect differences in motor performance of infants with POE. Regardless of whether infants required pharmacological treatment, POE was associated with lower motor performance. Those working in hospital or early intervention settings can use the TIMP to identify early delays in infants with POE and refer for intervention.

Average fixation duration in infancy: Stability and predictive utility.

The current study examined the stability, consistency, and predictive utility of average fixation durations in infancy. In Study 1, infants' (N = 80) average fixation duration when viewing social stimuli was found to show strong relative stability from 3.5 to 9 months of age. In Study 2, strong within-infant consistency was found in 3.5-month-old infants' (N = 73) average fixation durations to social and nonsocial stimuli. In Study 3, 3.5- to 9-month-old infants' (N = 89) average fixation duration was found to systematically vary with parent-reported symptoms of attention deficit hyperactivity disorder (ADHD) at 4-6 years of age. These results suggest that average fixation duration serves as a stable and systematic measure of individual differences in cognitive development beginning early in life.

Marijuana use in opioid exposed pregnancy increases risk of preterm birth.

BACKGROUND: The prevalence of opioid use disorder has increased across the United States, but the rural population of Appalachia has been disproportionately impacted. Concurrently, the slow, but steady progress in the legalization of marijuana may be affecting perception of marijuana use in pregnancy. However, marijuana use in pregnancy has been associated with adverse perinatal outcomes. Concomitant use of opioids and marijuana in pregnancy has not been evaluated. OBJECTIVE: The primary aim of the study was to evaluate the association between confirmed marijuana use in late pregnancy and preterm birth in opioid-exposed pregnancies. METHODOLOGY: A retrospective chart review was conducted that included all births from July 2011 to June 2016 from 6 delivery hospitals in South-Central Appalachia. Out of 18,732 births, 2368 singleton pregnancies indicated opioid use and met remaining inclusion criteria, with 108 of these mothers testing positive for marijuana at delivery. Independent sample t-test and Chi-Square analyses compared marijuana and non-marijuana exposed groups on maternal and neonatal outcomes. Regression analyses controlled for confounding variables in predicting neonatal abstinence syndrome (NAS), NICU admission, preterm birth, small for gestational age, and low birth weight outcomes as shown in Table 1. RESULTS: Neonates born to marijuana-positive women in opioid-exposed pregnancy were more likely to be born preterm, small for gestational age, have low birth weight, and be admitted to NICU. After statistically controlling for parity, marital status, tobacco and benzodiazepine use, preterm birth and low birth weight remained statistically significant with aOR of 2.35 (1.30-4.24) and 2.01 (1.18-3.44), respectively. CONCLUSIONS: Maternal use of marijuana in any opioid-exposed pregnancy may increase risk of preterm birth and low-birth weight infants. Prospective studies need to examine the dose and timing of marijuana and opioid use in pregnancy to better delineate perinatal effects. Nonetheless, pregnant women using opioids, including recommended medication assisted treatment for opioid use disorder, should be educated about the risks of concurrent marijuana use during pregnancy and may need to be counseled to abstain from marijuana use during pregnancy for an optimal outcome.

Waist-to-Hip Ratio Sensitivity in Early Infancy.

The waist-to-hip ratio (WHR) is correlated with health and associated with sex, attractiveness, and age judgments by adults. We examined the development of sensitivity to the WHR by testing 3.5-month-old infants' (N = 71) preference between images depicting different WHRs. Female 3.5-month-olds exhibited a preference for the WHR associated with attractiveness and mate value by adults (0.7) over a larger WHR (0.9). This preference was exhibited when infants were tested on upright stimuli but not when they were tested on inverted stimuli, indicating that low-level differences (e.g., curviness) were not driving performance. This sensitivity to WHR may lay the foundation for more explicit preferences and categorical associations later in life. In contrast to females, male infants failed to exhibit a significant preference for the 0.7 WHR in either orientation, replicating previous findings of female infants' superior processing of social stimuli. Implications for theories of the development of body knowledge and sex differences in social information processing are discussed.

Experimental Evidence of Structural Representation of Hands in Early Infancy.

Hands convey important social information, such as an individual's emotions, goals, and desires, are used to direct attention through pointing, and are a major organ for haptic perception. However, very little is known about infants' representation of human hands. In Experiment 1, infants tested in a familiarization/novelty preference task discriminated between images of intact hands and ones that contained first-order structure distortions (i.e., with locations of fingers altered to result in an unnatural configuration). In Experiment 2, infants tested in a spontaneous preference task exhibited a preference for scrambled hand images over intact images, indicating that 3.5-month-olds have gained sufficient sensitivity to the configural properties of hands to discriminate between intact versus scrambled images without any training in the laboratory. In both procedures, infants' performance was disrupted by inversion of images, suggesting that infants' performance in the upright conditions was not based on low-level features. These results indicate that sensitivity to the structure of hands develops early in life. This early development may lay the foundation for the development of the functional use of hand information for social communication.

Sex-specific scanning in infancy: Developmental changes in the use of face/head and body information.

The current investigation sought to differentiate between contrasting perspectives of body knowledge development by determining whether infants' adult-like scanning of male and female bodies is dependent on relevant information from the face/head alone, the body alone, or a combination of both sources. Scanning patterns of 3.5-, 6.5-, and 9-month-olds (N = 80) in response to images that contained information relevant to sex classification in either the face/head or the body were examined. The results indicate that sex-specific scanning in the presence of only one source of relevant information (i.e., face/head or body) is present only at 9 months. Thus, although sex-specific scanning of bodies emerges as early as 3.5 months, information from both faces/heads and bodies is required until sometime between 6.5 and 9 months of age. These findings constrain theories of the development of social perception by documenting the complex interplay between body and face/head processing early in life.

Categorical Perception of Facial Emotions in Infancy.

Categorical perception, indicated by superior discrimination between stimuli that cross categorical boundaries than between stimuli within a category, is an efficient manner of classification. The current study examined the development of categorical perception of emotional stimuli in infancy. We used morphed facial images to investigate whether infants find contrasts between emotional facial images that cross categorical boundaries to be more salient than those that do not, while matching the degree of differences in the two contrasts. Five-month-olds exhibited sensitivity to the categorical boundary between sadness and disgust, between happiness and surprise, as well as between sadness and anger but not between anger and disgust. Even 9-month-olds failed to exhibit evidence of a definitive category boundary between anger and disgust. These findings indicate the presence of discrete boundaries between some, but not all, of the basic emotions early in life. Implications of these findings for the major theories of emotion representation are discussed.

The role of shape recognition in figure/ground perception in infancy.

In this study we sought to determine whether infants, like adults, utilize previous experience to guide figure/ground processing. After familiarization to a shape, 5-month-olds preferentially attended to the side of an ambiguous figure/ground test stimulus corresponding to that shape, suggesting that they were viewing that portion as the figure. Infants' failure to exhibit this preference in a control condition in which both sides of the test stimulus were displayed as figures indicated that the results in the experimental condition were not due to a preference between two figure shapes. These findings demonstrate for the first time that figure/ground processing in infancy is sensitive to top-down influence. Thus, a critical aspect of figure/ground processing is functional early in life.

Dichotomous Perception of Animal Categories in Infancy.

Although there is a wealth of knowledge on categorization early in life, there are still many unanswered questions about the nature of category representation in infancy. For example, it is unclear whether infants are sensitive to boundaries between complex categories, such as types of animals, or whether young infants exhibit such sensitivity without explicit experience in the lab. Using a morphing technique, we linearly altered the category composition of images and measured 6.5-month-olds' attention to pairs of animal faces that either did or did not cross the categorical boundary, with the stimuli in each pair being equally dissimilar from one another across the two types of image pairs. Results indicated that infants dichotomize the continua between cats and dogs and between cows and otters, but only when the images are presented in their canonical, upright orientations. These findings demonstrate a propensity to dichotomize early in life that could have implications for social categorizations, such as race and gender.

Development of body emotion perception in infancy: From discrimination to recognition.

Research suggests that infants progress from discrimination to recognition of emotions in faces during the first half year of life. It is unknown whether the perception of emotions from bodies develops in a similar manner. In the current study, when presented with happy and angry body videos and voices, 5-month-olds looked longer at the matching video when they were presented upright but not when they were inverted. In contrast, 3.5-month-olds failed to match even with upright videos. Thus, 5-month-olds but not 3.5-month-olds exhibited evidence of recognition of emotions from bodies by demonstrating intermodal matching. In a subsequent experiment, younger infants did discriminate between body emotion videos but failed to exhibit an inversion effect, suggesting that discrimination may be based on low-level stimulus features. These results document a developmental change from discrimination based on non-emotional information at 3.5 months to recognition of body emotions at 5 months. This pattern of development is similar to face emotion knowledge development and suggests that both the face and body emotion perception systems develop rapidly during the first half year of life.