Maternal childhood trauma and observed maternal care behaviors with 4-month-old infants.

OBJECTIVE: To examine the relationship between maternal childhood trauma and early maternal caregiving behaviors (MCB). METHOD: Participants included 74 mother-infant dyads (maternal age 20-45 years; ethnicity 64.9% Latina) from a longitudinal pregnancy cohort study. Maternal childhood trauma was assessed during pregnancy with the childhood trauma questionnaire (CTQ). Observed mother-infant interactions at infant age 4 months were coded utilizing modified Ainsworth's MCB rating scales that assessed a range of behaviors (e.g., acceptance, soothing, and delight) which we analyze grouped together and will summarize using the term "maternal sensitivity." Linear regressions tested the associations between maternal childhood trauma and MCB. Primary analyses examined the relationships of MCB with (a) any maternal childhood trauma (moderate or greater exposure to physical abuse, sexual abuse, emotional abuse, physical neglect, and/or emotional neglect) and (b) cumulative childhood trauma. Secondary analyses examined the relationships between each type of childhood trauma and MCB. RESULTS: Exposure to childhood trauma was not associated with MCB (p = .88). Cumulative childhood trauma score was associated with lower scores on MCB (ß = -1.88, p < .05). Emotional abuse and emotional neglect were individually associated with lower scores on MCB (ß = -1.78, p = .04; ß = -1.55, p = .04, respectively). Physical abuse, sexual abuse, and physical neglect were not associated with MCB. CONCLUSIONS: Many mothers exposed to childhood trauma may be resilient to negative effects on parenting behaviors, while specific experiences of childhood trauma (emotional abuse, emotional neglect, and cumulative childhood trauma) may predict less sensitive early parenting behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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.

Family nurture intervention increases term age forebrain EEG activity: A multicenter replication trial.

OBJECTIVE: This trial (RCT-2) sought to replicate the EEG findings of a randomized controlled trial of Family Nurture Intervention in the NICU (FNI-NICU) (RCT-1) comparing infants receiving standard care (SC) with infants receiving SC plus FNI . METHODS: RCT-2 (NCT02710474) was conducted at two NICUs. Subjects were randomly assigned to receive SC or FNI during their NICU stay. The primary outcome was EEG power in the frontal polar region at 39-41 weeks gestational age (GA). Sixty preterm infants (26-34 weeks GA; 33 SC, 27 FNI) were assessed. FNI-NICU consisted of repeated calming sessions (∼4 times/week) facilitated by Nurture Specialists during which mothers engaged in emotional expression during clothed or skin-to-skin holding, vocal soothing, and eye contact. EEGs were collected from 128 leads. EEG power was computed using Fast Fourier Transforms. RESULTS: RCT-2 replicated RCT-1 results; FNI-NICU led to significantly increased frontal polar power at frequencies > 12 Hz. Effects were spatially more widespread than in RCT-1, with substantial effect sizes (∼0.50) in frontal and parietal regions. CONCLUSIONS: RCT-2 results provide further evidence that FNI-NICU increases term age brain activity. SIGNIFICANCE: FNI-NICU is designed to facilitate autonomic emotional connection and coregulation between mothers and infants in the NICU resulting in profound effects on early brain development.

Preterm infant heart rate is lowered after Family Nurture Intervention in the NICU: Evidence in support of autonomic conditioning.

BACKGROUND: Cardiac complications after premature birth are associated with negative long-term consequences to health. The Family Nurture Intervention (FNI) has been designed to support mother-infant parasympathetic calming sessions in the neonatal intensive care unit (NICU). FNI has shown neurodevelopmental and autonomic benefit across infant development. AIMS: We tested the hypothesis that heart rate (HR) will decrease after FNI over the course of the NICU stay, compared to matched controls. STUDY DESIGN: We used a case-matched design. The intervention included on average four ~1-hour facilitated mother-infant 'calming' sessions per week. We collected 24/7 real time heart rate data from a central monitoring system and analyzed data from two time-periods. SUBJECTS: The intervention group comprised 37 infants born ~30 weeks gestational age (GA) in a level IV NICU, treated with FNI. From the same NICU and time-period, we created a contemporaneous comparison group of 32 infants who were case-matched to each intervention infant for sex, age-at-birth, singleton or twin status, month of admission and length of stay. OUTCOME MEASURES: Using generalized estimating equation (GEE) modeling, we analyzed 24/7 HR data during a 1-hour period between 4:30 and 5:30 am each day in the NICU, when all infants were least disturbed. Using repeated measures ANOVA, we analyzed 24/7 HR data during a 6-week period starting 1 week prior to the start of FNI and ending 5 weeks after start. RESULTS: GEE modeling of the 1-hour data from all subjects showed significant lower HR in the FNI group, compared with controls. ANOVA modeling on a subset of subjects over the five-week period showed that FNI infant HR decreased in a dose-response manner relative to SC HR. CONCLUSION: This study suggests FNI may condition lower infant HR in a dose-response manner during the NICU stay.

The Welch Emotional Connection Screen: Adapting observational methods to pediatric primary care via resident training.

The Welch Emotional Connection Screen (WECS) is a novel instrument that is a brief, practicable, evidenced-based observational screening tool for assessing relationship health between parent and child. The WECS requires observing 2-3 min of face-to-face interactions between parent and child, without toys, prompts, paradigms or technology. Here, we describe a translational project from the coding lab to the primary care provider via a residency training program conducted with 50 residents during a 30-day developmental and behavioral pediatrics medical resident education rotation. The aims of this study were to evaluate the efficacy of WECS pediatric resident training: 1) to improve residents' accuracy in recognizing the dyadic behaviors of emotional connection (EC) via WECS training; and 2) to improve residents' attitudes, self-efficacy, and perceived professional norms (ASPPN) pertaining to Early Relational Health in Pediatrics. Results indicate that using a rapid prototyping approach to training, residents improved in their identification of dyads showing low to midrange levels of emotional connection. As well, resident attitudes about the importance of relationship health in pediatrics and their self-efficacy in identifying emotional connection improved significantly after this brief resident training.

Family nurture intervention in the NICU increases autonomic regulation in mothers and children at 4-5 years of age: Follow-up results from a randomized controlled trial.

BACKGROUND: Maturation of multiple neurobehavioral systems, including autonomic regulation, is altered by preterm birth. The purpose of this study was to determine the long-term effects of Family Nurture Intervention (FNI) in the NICU on autonomic regulation of preterm infants and their mothers. METHOD: A subset of infants and mothers (48% of infants, 51% of mothers) randomly assigned to either standard are (SC), or SC plus the FNI in the NICU in a prior RCT (ClincalTrials.gov; NCT01439269) returned for follow-up assessments when the children were 4 to 5 years corrected age (CA). ECGs were collected for 10 minutes in mothers and their children while children were in their mothers' laps. Heart rate, standard deviation for heart rate, respiratory sinus arrhythmia (RSA)-an index of parasympathetic regulation, and a measure of vagal efficiency were quantified. RESULTS: Both children and mothers in the FNI group had significantly greater levels of RSA compared to the SC group (child: mean difference = 0.60, 95% CI 0.17 to 1.03, p = 0.008; mother: mean difference = 0.64, 95% CI 0.07 to 1.21, p = 0.031). In addition, RSA increased more rapidly in FNI children between infancy and the 4 to 5-year follow-up time point (SC = +3.11±0.16 loge msec2, +3.67±0.19 loge msec2 for FNI, p<0.05). These results show that the rate of increase in RSA from infancy to childhood is more rapid in FNI subjects. CONCLUSION: Although these preliminary follow-up results are based on approximately half of subjects originally enrolled in the RCT, they suggest that FNI-NICU led to healthier autonomic regulation in both mother and child, when measured during a brief face-to-face socioemotional interaction. A Pavlovian autonomic co-conditioning mechanism may underly these findings that can be exploited therapeutically.

Autonomic regulation of preterm infants is enhanced by Family Nurture Intervention.

Preterm infants have maturational delays in several neurobehavioral systems. This study assesses the impact of the Family Nurture Intervention (FNI) in the neonatal intensive care unit (NICU) on the maturation of autonomic regulation of preterm infants. Preterm infants born at 26-34 weeks postmenstrual age (PMA) were assigned to groups receiving either standard care (SC) or SC plus FNI, using a randomized controlled trial design. At two collection time points, approximately 35 weeks and 41 weeks PMA, electrocardiograms (ECG) were monitored for approximately 1 hour during sleep. Heart rate and respiratory sinus arrhythmia (RSA) were quantified from the ECG. Across the two time points, the FNI group exhibited greater increases in RSA (Cohen's d = 0.35) and slope between RSA and heart rate, as a measure of vagal efficiency (Cohen's d = 0.62). These results document that FNI resulted in enhanced autonomic regulation consistent with greater maturation of cardiac function. These and previous findings strongly suggest that facilitating early nurturing interactions and emotional connection between preterm infants and their mothers is a practicable and effective means of optimizing postnatal development in preterm infants. Interpretation of these autonomic function results also enriches our understanding of the potential long-term beneficial outcomes of FNI by drawing upon polyvagal theory, which explains how autonomic state provides a neurophysiological platform for optimal co-regulation between infant and caregiver, and by drawing upon calming cycle theory, which provides a model for understanding how repeated mother/infant calming interactions positively condition autonomic state and reinforce approach, prosocial behaviors.

Investigation of a developmental pathway from infant anger reactivity to childhood inhibitory control and ADHD symptoms: interactive effects of early maternal caregiving.

BACKGROUND: ADHD is a neurodevelopmental disorder with a complex pathogenesis. Individual differences in temperamental reactivity - in particular, anger reactivity - are predictive of ADHD. The goal of this study was to examine the moderating (maternal caregiving behaviors; MCB) and mediating (inhibitory control) variables of reactivity using a 9-year multimethod prospective longitudinal design. METHODS: Participants included 291 children (135 male; 156 female) who participated in a larger study of temperament and social-emotional development. Anger reactivity was assessed by observation of facial anger during an arm restraint task, and MCB were observed during a series of semi-structured mother-infant tasks, both at 9 months of age. Inhibitory control was assessed by performance on a go/no-go task at 5 years of age. ADHD symptoms were assessed by parent and teacher report questionnaires at 7 and 9 years, respectively. RESULTS: Anger reactivity and poor inhibitory control were predictive of later ADHD symptoms. Results supported a moderated mediation model, in which the indirect effects of anger reactivity on ADHD symptoms through inhibitory control were conditional on quality of early MCB. Inhibitory control mediated the effect of anger reactivity on ADHD symptoms, but only among children exposed to lower-quality MCB. CONCLUSIONS: Infant anger reactivity exerts a direct effect on later ADHD from infancy, suggesting anger reactivity as a very early indicator of ADHD risk. Higher-quality caregiving did not buffer against the direct risk of anger reactivity on ADHD but did buffer against the indirect risk by reducing the negative effect of anger reactivity on inhibitory control. Thus, in the developmental pathway from anger reactivity to ADHD, more sensitive, less intrusive parenting supports the development of protective mechanisms (i.e. inhibitory control) to remediate ADHD risk.

Validation study showed that ratings on the Welch Emotional Connection Screen at infant age six months are associated with child behavioural problems at age three years.

AIM: The emotional connection between mothers and infants born preterm has been associated with positive behaviour. The aim of this study was to examine the longitudinal association between emotional connection at six months of age and behavioural problems at three years. METHODS: This study was carried out by the University of North Texas, USA and comprised 49 mothers and infants from a longitudinal investigation of family interaction and infant development conducted in 1994-1997. Face-to-face interaction and toy-based play were videotaped and coded at six months of age using the Welch Emotional Connection Screen (WECS), a brief screening tool for relational health. When the children were three years of age, the mothers reported on child behavioural problems. RESULTS: The children from dyads that were rated as emotionally connected at six months of age had fewer externalising and internalising behavioural problems at the age of three. No links were found between emotional connection during toy-based play at six months and later child behavioural problems. CONCLUSION: We showed that when the WECS was used at six months of age it was a promising and valid relational screening tool for infants at risk of adverse behavioural outcomes at the age of three.

The Welch Emotional Connection Screen: validation of a brief mother-infant relational health screen.

AIM: The Welch Emotional Connection Screen (WECS), assesses mother-infant Emotional Connection in clinical settings. It includes: Attraction, Vocal Communication, Facial Communication, Sensitivity/Reciprocity and clinical decision of Emotional Connection (yes/no). We tested concurrent and construct validity of the WECS and associations with behavioural and physiological measures in preterm infants. METHODS: Videos from 76 mothers-infants (gestational age 36 weeks) during an in-NICU caregiving paradigm were coded for maternal caregiving behaviour. Videos of mothers-infants were also obtained at 4 months during 10 minutes of face-to-face play (coded with WECS and for maternal positivity and infant social engagement) and the still-face paradigm (coded for infant behavioural approach towards mother; infant electrocardiogram acquired in vivo). RESULTS: WECS maternal scores were positively associated with maternal sensitivity and quality of vocal contact at 36 weeks (caregiving) and maternal positivity at 4 months (face-to-face). WECS infant scores positively correlated with infant social engagement and maternal positivity during face-to-face interactions at 4 months. Infants from emotionally not connected dyads (vs. emotionally connected dyads) displayed autonomic dysregulation and less approach-seeking behaviour towards mother during interactive/play sessions of the still-face paradigm. CONCLUSION: This preliminary evidence supports the WECS as a valid screen for rating mother-preterm infant emotional connection associated with healthier infant biobehavioural stress responding.

Infant temperament reactivity and early maternal caregiving: independent and interactive links to later childhood attention-deficit/hyperactivity disorder symptoms.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with origins early in life. There is growing evidence that individual differences in temperament reactivity are predictive of ADHD symptoms, yet little is known about the relations between temperament reactivity in early infancy and later ADHD symptoms or the combined effect of reactivity with early environmental factors on ADHD symptom development. Using a 9-year prospective longitudinal design, this study tested the independent and interactive contributions of infant reactivity and maternal caregiving behaviors (MCB) on parent- and teacher-reported childhood ADHD symptoms. METHODS: Participants included 291 children (135 male; 156 female) who participated in a larger study of temperament and social-emotional development. Reactivity was assessed by behavioral observation of negative affect, positive affect, and motor activity during novel stimuli presentations at 4 months of age. MCB were observed during a series of semistructured mother-infant tasks at 9 months of age. Finally, ADHD symptoms were assessed by parent- and teacher-report questionnaires at 7 and 9 years, respectively. RESULTS: Reactivity was predictive of ADHD symptoms, but results were sex specific. For boys, infant motor activity was positively predictive of later ADHD symptoms, but only at lower quality MCB. For girls, infant positive affect was positively predictive of later ADHD symptoms at lower quality MCB, and-unexpectedly-infant positive affect and motor activity were negatively predictive of later ADHD symptoms at higher quality MCB. CONCLUSIONS: These results point to early parenting as a moderating factor to mitigate temperament-related risk for later ADHD, suggesting this as a potential intervention target to mitigate risk for ADHD among reactive infants.

The practical utility of the Welch Emotional Connection Screen for rating parent-infant relational health.

Emotional Connection (EC) measured by the Welch Emotional Connection Screen (WECS) was related to the Parent-Infant Interaction Rating System (PIIRS), a 5-point adaptation of the rating system developed for the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (e.g., NICHD Early Child Care Research Network, 1999, Developmental Psychology, 35, 1399). Parent-infant dyads (n = 49 mothers; 43 fathers) were videotaped during face-to-face interaction at infant age 6 months; interactions were coded with both the WECS and PIIRS. At age 3, mothers completed the Child Behavior Checklist. WECS ratings of EC were associated with PIIRS rating items for both mother-infant and father-infant dyads. Mother-infant EC related positively to maternal sensitivity and positive regard for child, child positive mood and sustained attention, and dyadic mutuality, and negatively with maternal intrusiveness. Father-infant EC related positively to fathers' positive regard for child, child positive mood and sustained attention, and dyadic mutuality. Mother-infant EC predicted child behavior problems at age 3 better than mother-infant PIIRS ratings of dyadic mutuality. With fathers, neither EC nor dyadic mutuality ratings predicted mother-reported child behavior problems. Findings highlight the practical utility of the WECS for identifying potentially at-risk dyads and supporting early relational health.

Family nurture intervention for preterm infants facilitates positive mother-infant face-to-face engagement at 4 months.

Although preterm infants are at risk for social deficits, interventions to improve mother-infant interaction in the neonatal intensive care unit (NICU) are not part of standard care (SC). Study participants were a subset from a randomized controlled trial of a new intervention for premature infants, the Family Nurture Intervention (FNI), designed to help mothers and infants establish an emotional connection. At infants' 4 months corrected age, mother-infant face-to-face interaction was filmed and coded on a 1-s time base for mother touch, infant vocal affect, mother gaze, and infant gaze. Time-series models assessed self- and interactive contingency. Comparing FNI to SC dyads, FNI mothers showed more touch and calmer touch patterns, and FNI infants showed more angry-protest but less cry. In maternal touch self-contingency, FNI mothers were more likely to sustain positive touch and to repair moments of negative touch by transitioning to positive touch. In maternal touch interactive contingency, when infants looked at mothers, FNI mothers were likely to respond with more positive touch. In infant vocal affect self-contingency, FNI infants were more likely to sustain positive vocal affect and to transition from negative to positive vocal affect. In maternal gaze interactive contingency, following infants' looking at mother, FNI mothers of male infants were more likely to look at their sons. In maternal gaze self-contingency, following mothers' looking away, FNI mothers of male infants were more likely to look at their sons. Documentation of positive effects of the FNI for 4-month mother-infant face-to-face communication is useful clinically and has important implications for an improved developmental trajectory of these infants. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Early Caregiving and Human Biobehavioral Development: A Comparative Physiology Approach.

A large and growing body of evidence demonstrates associations between quality of the early caregiving environment and risk for stress-related illness across the lifespan. The recent research examining associations between early caregiving environments and subsequent development is reviewed, with particular attention to early programming and subsequent malleability of systems underlying stress responsivity. A developmental comparative physiology model is suggested; one in which postnatal programming and phenotypic plasticity act in concert as mechanisms underlying the persisting effects of early care environments for biobehavioral outcomes.

Depression and anxiety symptoms of mothers of preterm infants are decreased at 4 months corrected age with Family Nurture Intervention in the NICU.

Preterm delivery can precipitate maternal psychological morbidities. Family Nurture Intervention (FNI) was designed to minimize these by facilitating the emotional connection between mother and infant, beginning early in the infant's neonatal intensive care unit (NICU) stay. We examined depression and anxiety symptoms of mothers of preterm infants at 4 months infant corrected age (CA). One hundred fifteen mothers who delivered between 26 and 34 weeks gestational age were randomized to receive standard care (SC) or standard care plus FNI. Mothers' self-reported depressive symptoms (Center for Epidemiologic Studies Depression Scale: CES-D) and state anxiety (Spielberger State-Trait Anxiety Inventory: STAI) symptoms were assessed at enrollment, near to term age, and 4 months (CA). At 4 months CA, mean CES-D and STAI scores were significantly lower in FNI mothers compared to SC mothers. Effectiveness of FNI can only be evaluated as an integrated intervention strategy as it was not possible to control all aspects of FNI activities. Although there was considerable loss to follow-up, analyses suggest that resulting biases could have masked rather than inflated the measured effect size for depressive symptoms. FNI may be a feasible and practicable way to diminish the impact of premature delivery on maternal depressive and anxiety symptoms.

Emergent patterns of risk for psychopathology: The influence of infant avoidance and maternal caregiving on trajectories of social reticence.

The current study investigated the influential role of infant avoidance on links between maternal caregiving behavior and trajectories at risk for psychopathology. A sample of 153 children, selected for temperamental reactivity to novelty, was followed from infancy through early childhood. At 9 months, infant avoidance of fear-eliciting stimuli in the laboratory and maternal sensitivity at home were assessed. At 36 months, maternal gentle discipline was assessed at home. Children were repeatedly observed in the lab with an unfamiliar peer across early childhood. A latent class growth analysis yielded three longitudinal risk trajectories of social reticence behavior: a high-stable trajectory, a high-decreasing trajectory, and a low-increasing trajectory. For infants displaying greater avoidance, 9-month maternal sensitivity and 36-month maternal gentle discipline were both positively associated with membership in the high-stable social reticence trajectory, compared to the high-decreasing social reticence trajectory. For infants displaying lower avoidance, maternal sensitivity was positively associated with membership in the high-decreasing social reticence trajectory, compared to the low-increasing trajectory. Maternal sensitivity was positively associated with the high-stable social reticence trajectory when maternal gentle discipline was lower. These results illustrate the complex interplay of infant and maternal behavior in early childhood trajectories at risk for emerging psychopathology.

Family nurture intervention improves the quality of maternal caregiving in the neonatal intensive care unit: evidence from a randomized controlled trial.

OBJECTIVE: This study assessed the impact of Family Nurture Intervention (FNI) on the quality of maternal caregiving behavior (MCB) while in the neonatal intensive care unit (NICU). FNI is a randomized controlled trial conducted in a high-acuity NICU to facilitate an emotional connection between mothers and their premature infants. FNI begins shortly after birth, continues until discharge, and involves mother/infant calming sessions that include scent cloth exchange, vocal soothing and emotion expression, eye contact, skin-to-skin and clothed holding, and family-based support sessions. METHODS: Maternal caregiving behavior was coded during a single holding and feeding session (∼30 min) in the NICU before discharge at approximately 36 weeks gestational age (GA). Sixty-five mothers and their premature infants (34 male, 31 female; 26-34 wk GA) were included in these analyses (FNI, n = 35; standard care [SC], n = 30). RESULTS: Relative to mothers in the SC condition, those in the FNI group showed significantly higher quality MCB, which remained significant when controlling for birth order, twin status, maternal depression, and maternal anxiety. CONCLUSION: This is the first study to demonstrate that in-unit MCB can be enhanced by a hospital-based intervention. FNI provides a new rationale for integrating nurture-based interventions into standard NICU care.

Family Nurture Intervention in the Neonatal Intensive Care Unit improves social-relatedness, attention, and neurodevelopment of preterm infants at 18 months in a randomized controlled trial.

BACKGROUND: Preterm infants are at high risk for adverse neurodevelopmental and behavioral outcomes. Family Nurture Intervention (FNI) in the Neonatal Intensive Care Unit (NICU) is designed to counteract adverse effects of separation of mothers and their preterm infants. Here, we evaluate effects of FNI on neurobehavioral outcomes. METHODS: Data were collected at 18 months corrected age from preterm infants. Infants were assigned at birth to FNI or standard care (SC). Bayley Scales of Infant Development III (Bayley-III) were assessed for 76 infants (SC, n = 31; FNI, n = 45); the Child Behavior Checklist (CBCL) for 57 infants (SC, n = 31; FNI, n = 26); and the Modified Checklist for Autism in Toddlers (M-CHAT) was obtained for 59 infants (SC, n = 33; FNI, n = 26). RESULTS: Family Nurture Intervention significantly improved Bayley-III cognitive (p = .039) and language (p = .008) scores for infants whose scores were greater than 85. FNI infants had fewer attention problems on the CBCL (p < .02). FNI improved total M-CHAT scores (p < .02). Seventy-six percent of SC infants failed at least one of the M-CHAT items, compared to 27% of FNI infants (p < .001). In addition, 36% of SC infants versus 0% of FNI infants failed at least one social-relatedness M-CHAT item (p < .001). CONCLUSIONS: Family Nurture Intervention is the first NICU intervention to show significant improvements in preterm infants across multiple domains of neurodevelopment, social-relatedness, and attention problems. These gains suggest that an intervention that facilitates emotional interactions between mothers and infants in the NICU may be key to altering developmental trajectories of preterm infants.

Longitudinal trajectories of social reticence with unfamiliar peers across early childhood.

Behavioral inhibition is a temperament assessed in the toddler period via children's responses to novel contexts, objects, and unfamiliar adults. Social reticence is observed as onlooking, unoccupied behavior in the presence of unfamiliar peers and is linked to earlier behavioral inhibition. In the current study, we assessed behavioral inhibition in a sample of 262 children at ages 2 and 3, and then assessed social reticence in these same children as they interacted with an unfamiliar, same-age, same-sex peer at 2, 3, 4, and 5 years of age. As expected, early behavioral inhibition was related to social reticence at each age. However, multiple trajectories of social reticence were observed including High-Stable, High-Decreasing, and Low-Increasing, with the High-Stable and High-Decreasing trajectories associated with greater behavioral inhibition compared to the Low-Increasing trajectory. In addition, children in the High-Stable social reticence trajectory were rated higher than all others on 60-month Internalizing problems. Children in the Low-Increasing trajectory were rated higher on 60-month Externalizing problems than children in the High-Decreasing trajectory. These results illustrate the multiple developmental pathways for behaviorally inhibited toddlers and suggest patterns across early childhood associated with heightened risk for psychopathology.

Anger and Positive Reactivity in Infancy: Effects on Maternal Report of Surgency and Attention Focusing in Early Childhood.

We examined two aspects of temperamental approach in early infancy, positive reactivity and anger, and their unique and combined influences on maternal reports of child surgency and attention focusing at 4 years of age. One hundred and fourteen infants were observed for their positive reactions to novel stimuli at 4 months, and their anger expressions during arm restraint at 9 months. Child surgency and attention focusing at age 4 years were assessed by maternal report. Infants who expressed more anger to restraint were rated higher in surgency during early childhood relative to infants who expressed less anger. The effects of positive reactivity to novelty on attention focusing were moderated by anger to restraint. These findings suggest that infant temperamental approach tendencies are multifaceted and have both unique and combined influences on later maternal report of attention and social behavior.