The breadth and specificity of 18-month-old's infant-initiated interactions in naturalistic home settings.

Infants actively initiate social interactions aiming to elicit different types of responses from other people. This study aimed to document a variety of communicative interactions initiated by 18-month-old Turkish infants from diverse SES (N = 43) with their caregivers in their natural home settings. The infant-initiated interactions such as use of deictic gestures (e.g., pointing, holdouts), action demonstrations, vocalizations, and non-specific play actions were coded from video recordings and classified into two categories as need-based and non-need-based. Need-based interactions were further classified as a) biological (e.g., feeding); b) socio-emotional (e.g., cuddling), and non-need-based interactions (i.e., communicative intentions) were coded as a) expressive, b) requestive; c) information/help-seeking; d) information-giving. Infant-initiated non-need-based (88%) interactions were more prevalent compared to need-based interactions (12%). Among the non-need-based interactions, 50% aimed at expressing or sharing attention or emotion, 26% aimed at requesting an object or an action, and 12% aimed at seeking information or help. Infant-initiated information-giving events were rare. We further investigated the effects of familial SES and infant sex, finding no effect of either on the number of infant-initiated interactions. These findings suggest that at 18 months, infants actively communicate with their social partners to fulfil their need-based and non-need-based motivations using a wide range of verbal and nonverbal behaviors, regardless of their sex and socio-economic background. This study thoroughly characterizes a wide and detailed range of infant-initiated spontaneous communicative bids in hard-to-access contexts (infants' daily lives at home) and with a traditionally underrepresented non-WEIRD population.

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.

Interactional preludes to infants' affective climax - Mother-infant interaction around infant smiling in two cultures.

Due to limited research on cross-cultural similarities and differences in the development of infant smiling, the main goals of this study were to analyze, first, the development of infants' bouts of intense smiling during their third month and, second, the interactional preludes to infants' affective climax in two cultural contexts, namely Kichwa families from the Ecuadorian Andes region and educated urban middle-class families from Münster, Germany, which differ concerning their cultural models on infant smiling. Based on a longitudinal, naturalistic study design, mother-infant interaction in Kichwa (n = 10) and Münster (n = 10) families was analyzed when infants were 9 and 13 weeks old. Following a mixed methods approach, a quantitative analysis of infant smiling based on a 1-second interval-coding approach showed that there was a significant increase in infants' high-intensity positive affect from 9 to 13 weeks in the Münster, but not the Kichwa sample, leading to significant cross-cultural differences at 13 weeks. Complementarily, the qualitative analysis of the interactional preludes to the 66 infants' affective climaxes at 13 weeks identified two main patterns that characterized the dynamic that resulted in high-intensity positive affect and that were similar across the two cultural contexts: the first was intense and multimodal stimulation with repetition and theme variation, and the second was positively tuned and mutually contingent responsiveness, often in the form of prolonged proto-conversations between mother and infant. Overall, this open approach converged on key mechanisms underlying infant smiling, namely infants' experience of mastery based on effortful assimilation or self-efficacy, which was embedded in episodes of intersubjective coordination. Overall, these results suggest universality without uniformity; that is, similar interactional mechanisms are associated with high-intense positivity in infants, while the episodes are co-constructed differently in different dyads and high-intense positivity varies in significance and frequency across cultures.

The Bidirectional View of Mother-Infant Interaction by Gaze and Facial Affect. / Anne-Bebek Etkilesimine Çift-Yönlü Bakis Açisi: Bakis ve Yüz Duygulanimi.

OBJECTIVE: The aim of this research was to assess gaze behaviors and facial affect expressions in mother-infant interaction within the frame of self-contingency and interactive contingency, reflecting self-regulation and interactive regulation, respectively. In Model 1, second-by-second changing gaze behaviors (on partner's face/off partner's face) and in Model 2, facial affect expressions (from positive to negative) were examined. Self-contingency reflects the variability or stability in gaze directions and facial affect expressions in each partner. Interactive contingency reflects the degree of mother-infant gaze and facial affect attunement or interactive regulation relative to each other. METHOD: Sample was composed of 56 healthy mother-infant dyads. All infants were 4 months old, and mean maternal age was 29.61 (SD=3.71). Mother-infant interactions were filmed at the lab. Interactions were coded second-by-second for mother-infant gaze behaviors and facial affect expressions with video microanalysis method. The analysis method was multilevel-multivariate time series analysis. RESULTS: According to Model 1-2, mother-infant gaze behaviors and facial affect expressions were neither too stable nor too variable, rather, the change in gaze behaviors and facial affect expressions in each partner showed predictable patterns. Mothers regulated their gaze behaviors and facial affect expressions in relation to that of their infants. Infants regulated their facial affect expressions in relation to their mothers' facial affect expressions, but infant gaze interactive contingency to mother gaze was marginally significant. CONCLUSION: In interactions, infants and mothers regulate the rhythms of their own behavior and at the same time contingently coordinate with that of the partner. This bi-directionally regulating environment is the foundation of infants' relationship expectations and bio-socialbehavioral regulation capacity, which may be related to psychopathology in future.

Stability and structure of infant and toddler temperament in two longitudinal studies in Germany.

The present study investigated the factor structure and longitudinal stability of infant and toddler temperament measured with the Infant Behavior Questionnaire-Revised (IBQ-R) and the Early Childhood Behavior Questionnaire (ECBQ) in two German samples. Since the few studies using the German IBQ-R failed to replicate the commonly assumed three factors of infant temperament, another exploration of its factor structure was necessary. Whereas previous stability measurements are usually based on groups with relatively large age ranges, we investigated stability between concrete ages. In Study 1, the IBQ-R was applied in 9- and 12-month-old infants. In Study 2, both questionnaires were applied in 12-, 18-, and 24-month-olds. Factor analyses of the IBQ-R in both studies revealed a two-factor solution comprising Surgency/ Extraversion and Negative Affectivity, replicating earlier findings with German infants. The Orienting/ Regulation factor was not replicated for the IBQ-R, whereas analysis of the ECBQ revealed a three-factor solution for toddlers. The results showed stability of temperament ratings within infancy (Study 1) and toddlerhood (Study 2) as well as between the developmental periods within the second year of life (Study 2). Taken together, the present findings indicate that temperament stability emerges early in life and can be reliably measured using the IBQ-R and ECBQ, whereas the factor structure of temperament in infancy requires further validation.

Miniaturized wireless, skin-integrated sensor networks for quantifying full-body movement behaviors and vital signs in infants.

Early identification of atypical infant movement behaviors consistent with underlying neuromotor pathologies can expedite timely enrollment in therapeutic interventions that exploit inherent neuroplasticity to promote recovery. Traditional neuromotor assessments rely on qualitative evaluations performed by specially trained personnel, mostly available in tertiary medical centers or specialized facilities. Such approaches are high in cost, require geographic proximity to advanced healthcare resources, and yield mostly qualitative insight. This paper introduces a simple, low-cost alternative in the form of a technology customized for quantitatively capturing continuous, full-body kinematics of infants during free living conditions at home or in clinical settings while simultaneously recording essential vital signs data. The system consists of a wireless network of small, flexible inertial sensors placed at strategic locations across the body and operated in a wide-bandwidth and time-synchronized fashion. The data serve as the basis for reconstructing three-dimensional motions in avatar form without the need for video recordings and associated privacy concerns, for remote visual assessments by experts. These quantitative measurements can also be presented in graphical format and analyzed with machine-learning techniques, with potential to automate and systematize traditional motor assessments. Clinical implementations with infants at low and at elevated risks for atypical neuromotor development illustrates application of this system in quantitative and semiquantitative assessments of patterns of gross motor skills, along with body temperature, heart rate, and respiratory rate, from long-term and follow-up measurements over a 3-mo period following birth. The engineering aspects are compatible for scaled deployment, with the potential to improve health outcomes for children worldwide via early, pragmatic detection methods.

Understanding emerging regulation: The role of frontal electroencephalography asymmetry and negative affectivity.

The present study examined frontal electroencephalography (EEG) asymmetry and negative affectivity (NA) as predictors of infant behaviors during the Still-Face Paradigm (SFP). It was hypothesized that infants with lower NA subscale scores who also demonstrate greater left frontal activation would exhibit more frequent social engagement and self-soothing behaviors during the SFP. Mothers reported infant temperament at 6-12 months of age (N = 62), and EEG was recorded during a baseline task and the SFP. Social engagement, distress, and self-soothing behaviors were coded during the SFP. A three-factor solution emerged based on exploratory factor analysis of eight infant behaviors. After considering bivariate relations, multiple regression analyses predicting the behavior factor labeled social engagement (containing vocalizations and handwaving; average factor loading = .56) were conducted separately for asymmetry and NA subscales, controlling for infant sex and age. The SFP asymmetry predicted social engagement after controlling for covariates and baseline asymmetry; however, NA subscales (falling reactivity and distress to limitations) did not uniquely explain significant variance. These findings highlight the importance of frontal EEG asymmetry in contributing to emerging social engagement and regulation in infancy. Implications include potentially utilizing asymmetry markers as screening and intervention targets in the first year of life.

Infant's Behaviour Checklist for low birth weight infants and later neurodevelopmental outcome.

Assessment of the characteristics of spontaneous movements and behaviour in early infancy helps in estimating developmental outcomes. We introduced the Infant Behaviour Checklist (IBC) and examined the relationship between the behavioural characteristics of low-birth-weight infants and neurodevelopmental outcomes at 6 years of age. The behavioural characteristics during the neonatal (36-43 weeks, adjusted) and early infancy periods (49-60 weeks, adjusted) were assessed in very-low-birth-weight infants. The IBC includes 44 common behaviours. We assessed the appearance of individual behavioural characteristics at each period according to the neurodevelopmental outcome. Of the 143 infants assessed during the neonatal period, 89 had typical development (TD), 30 had intellectual disability (ID), and 24 had autism spectrum disorder (ASD). In 78 infants assessed during early infancy, 40, 21, and 17 had TD, ID, and ASD, respectively. The frequency of appearance of three behaviour-related items was significantly lower in the ID group than in the TD group. The frequency of appearance of three posture- and behaviour-related items was significantly lower, while that of two posture-related items was significantly higher, in the ASD group than in the TD group. Behavioural assessment using the IBC may provide promising clues when considering early intervention for low-birth-weight infants.

Effect of Online 1-Day Cognitive Behavioral Therapy-Based Workshops Plus Usual Care vs Usual Care Alone for Postpartum Depression: A Randomized Clinical Trial.

Importance: Postpartum depression (PPD) affects as many as 20% of mothers, yet just 1 in 10 of these women receives evidence-based treatment. The COVID-19 pandemic has increased PPD risk, reduced treatment access, and shifted preferences toward virtual care. Objective: To determine whether an online 1-day cognitive behavioral therapy (CBT)-based workshop added to treatment as usual improves PPD, anxiety, social support, mother-infant relationship quality, and infant temperament more than treatment as usual alone. Design, Setting, and Participants: This randomized clinical trial included 403 women with PPD who were recruited across Ontario, Canada, during the COVID-19 pandemic (April 20 to October 4, 2020). Women with Edinburgh Postnatal Depression Scale (EPDS) scores of at least 10 who were 18 years or older and had an infant younger than 12 months were eligible. Interventions: Women were randomly assigned to receive a live, interactive online 1-day CBT-based workshop delivered by a registered psychotherapist, psychiatrist, or clinical psychology graduate student in addition to treatment as usual (n = 202) or to receive treatment as usual and wait-listed to receive the workshop 12 weeks later (n = 201). Main Outcomes and Measures: The primary outcome was change in PPD (EPDS scores) in experimental and wait list control groups 12 weeks after baseline. Secondary outcomes included maternal anxiety (7-item Generalized Anxiety Disorder Questionnaire [GAD-7]), social support (Social Provisions Scale), quality of the mother-infant relationship (Postpartum Bonding Questionnaire), and infant temperament (Infant Behavior Questionnaire-Revised Very Short Form). Results: Participants all identified as women with a mean (SD) age of 31.8 (4.4) years. The workshop led to significant mean (SD) reductions in EPDS scores (from 16.47 [4.41] to 11.65 [4.83]; B = -4.82; P < .001) and was associated with a higher odds of exhibiting a clinically significant decrease in EPDS scores (odds ratio, 4.15; 95% CI, 2.66-6.46). The mean (SD) GAD-7 scores decreased from 12.41 (5.12) to 7.97 (5.54) after the workshop (B = -4.44; 95% CI, -5.47 to -3.38; P < .001) and participants were more likely to experience a clinically significant change (odds ratio, 3.09; 95% CI, 1.99-4.81). Mothers also reported improvements in bonding (B = -3.22; 95% CI, -4.72 to -1.71; P < .001), infant-focused anxiety (B = -1.64; 95% CI, -2.25 to 1.00; P < .001), social support (B = 3.31; 95% CI, 1.04 to 5.57; P < .001), and positive affectivity/surgency in infants (B = 0.31; 95% CI, 0.05 to 0.56; P < .001). Conclusions and Relevance: In this randomized clinical trial, an online 1-day CBT-based workshop for PPD provides an effective, brief option for mothers, reducing PPD and anxiety as well as improving social support, the mother-infant relationship, and positive affectivity/surgency in offspring. Trial Registration: ClinicalTrials.gov Identifier: NCT04485000.

Reaching skills in six-month-old infants at environmental and biological risk.

OBJECTIVES: To assess kinematic parameters and proximal and distal reaching adjustments of infants at biological or environmental risk and compare with reaching performance of six-month-old full-term infants without known risk factors. METHODS: This blinded cross-sectional study included 62 infants at six months of age divided into three independent groups: Group with no known risk factor (NRF), 28 full-terms with no risk factors; Low SES group (LSES):19 full-terms classified as low socioeconomic status and no biological risk; Very preterm group (VPT), 15 very preterm infants at six months corrected age and no environmental risk. Infants were placed in a reclined baby chair at 45°, and a malleable and unfamiliar object was presented to the infant at 5-second intervals to elicit reaching movements. RESULTS: Infants from LSES presented reaching duration (p = 0.032, Cohen's f = 0.349) and movement unit (p = 0.033, Cohen's f = 0.351) significantly higher than VPT group. Horizontal hand orientation was moderately associated with infants at environmental risk (p = 0.031; Cramer's V = 0.30). CONCLUSION: Infants of low socioeconomic status perform less functional reaching movements than very preterm infants at six months corrected age. Socioeconomic status may impact more on reaching skills than biological risk. Given the importance of reaching for infant development, low-cost public health strategies are needed to identify possible delays.

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

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

The emergence of a theta social brain network during infancy.

Infants' socio-cognitive ability develops dramatically during the first year of life. From the perspective of ontogeny, the early development of social behavior allows for parent-child attachment, which in turn enhances survival. Thus, it is theorized that the development of social behavior, driven by social brain networks, forms the core of developmental acquisitions during this period. Further, understanding the maturation within the neural networks during social development is crucial to obtain a better grasp of the development of social developmental disorders. Therefore, we performed a longitudinal study in 854 infants measured at around 5 and 10 months to map the development of functional networks in the brain when infants were processing social and non-social videos. Using EEG, we focused on the frequency bands most commonly connected to social behavior: theta and alpha. We found that alpha networks remained relatively stable over the first year of life and showed no selectivity for social versus non-social stimuli, theta networks, showed strong global reconfigurations. The development of the theta networks progressed from a parietal occipital network in early infancy to a frontoparietal network towards the end of the first year of life. This reconfiguration coincided with selectivity for social versus non-social stimuli, with infants approaching the end of their first year of life showing increased synchronicity of theta communication when watching social videos versus non-social videos. Our findings provide strong evidence for the involvement of a frontoparietal theta network in the development of the social brain.

Patterns of regulatory behavior in the still-face paradigm at 3 months: A comparison of Brazilian and Portuguese infants.

Three infant regulatory behavior patterns have been identified during the Face-to-Face Still-Face paradigm (FFSF) in prior research samples: a Social-Positive Oriented pattern (i.e., infants exhibit predominantly positive social engagement), a Distressed-Inconsolable pattern (i.e., infants display conspicuous negative affect that persists or increases across FFSF episodes), and a Self-Comfort Oriented pattern (e.g., infants primarily engage in self-comforting behaviors such as thumb-sucking). However, few studies have examined these patterns outside US and European countries or evaluated potential cross-country differences in these patterns. In this study, we compared the regulatory behavior patterns of 74 Brazilian and 124 Portuguese infants in the FFSF at 3 months of age, and evaluated their links to demographic and birth variables. The prevalence of the three regulatory patterns varied by country. The most frequent pattern in the Portuguese sample was the Social-Positive Oriented, followed by the Distressed-Inconsolable and the Self-Comfort Oriented. However, in the Brazilian sample, the Distressed-Inconsolable pattern was the most prevalent, followed by the Social-Positive Oriented and the Self-Comfort Oriented. Moreover, in the Brazilian sample, familial SES was higher among infants with a Social-Positive pattern whereas 1st-minute Apgar scores were lower among Portuguese infants with a Distressed-Inconsolable Oriented pattern of regulatory behavior. In each sample, Social Positive pattern of regulatory behavior was associated with maternal sensitivity, Self-Comfort Oriented pattern of regulatory behavior with maternal control, and Distressed-Inconsolable pattern with maternal unresponsivity.

Infant Regulation: Associations with Child Language Development in a Longitudinal Cohort.

OBJECTIVE: To determine whether infants who have regulatory problems (eg, sleeping, crying, and feeding problems) at 1 year of age are at increased risk of experiencing language difficulties at ages 5 and 11 years, compared with settled infants. STUDY DESIGN: Parent survey and child assessment data (n = 1131) were drawn from a longitudinal community cohort study. Latent Class Analysis identified 5 profiles of infant regulation including those who were settled (37%), had tantrums (21%), had sleep problems (25%), were moderately unsettled (13%), and severely unsettled (3%) at 12 months of age. Adjusted regression analyses examined associations between infant regulatory profiles and language ability (Clinical Evaluation of Language Fundamentals-fourth edition) at ages 5 and 11 years. RESULTS: Infants who were moderately unsettled had lower language scores at age 5 (adjusted mean difference, -3.89; 95% CI, -6.92 to -0.86) and were more likely to have language difficulties (aOR, 2.71; 95% CI, 1.28-5.75), than infants who were settled. Infants who were severely unsettled at 12 months of age, had lower language scores at ages 5 (adjusted mean difference, -7.71; 95% CI, -13.07 to -2.36) and 11 (adjusted mean difference, -6.50; 95% CI, -11.60 to -1.39), than infants who were settled. Severely unsettled infants were 5 times more likely to have language difficulties at age 5 than their settled counterparts (aOR, 5.01; 95% CI, 1.72-14.63). CONCLUSIONS: Children at 1 year of age with multiple regulatory problems are at an increased risk for poorer language skills at ages 5 and 11 years.

The General Movements Assessment in Neonates With Hypoxic Ischemic Encephalopathy.

BACKGROUND: Clinical measures after birth and studies such as electroencephalogram (EEG) and brain imaging do not fully predict neurodevelopmental outcomes of infants with hypoxic-ischemic encephalopathy. Early detection of adverse neurologic outcomes, and cerebral palsy in particular, in high-risk infants is essential for ensuring timely management. The General Movements Assessment is a tool that can be used in the early detection of cerebral palsy in infants with brain injury. The majority of studies on the General Movements Assessment in the late preterm and term population were performed prior to the introduction of therapeutic hypothermia. AIMS: To apply the General Movements Assessment in late preterm and term infants with hypoxic-ischemic encephalopathy (including those who received therapeutic hypothermia), to determine if clinical markers of hypoxic-ischemic encephalopathy predict abnormal General Movements Assessment findings, and to evaluate interrater reliability of the General Movements Assessment in this population. Study design: Pilot prospective cohort study Subjects: We assessed 29 late preterm and full-term infants with mild, moderate, and severe hypoxic-ischemic encephalopathy in Philadelphia, PA. RESULTS: Most infants' general movements normalized by the fidgety age. Only infants with moderate or severe hypoxic-ischemic encephalopathy had abnormal general movements in both the writhing and the fidgety ages (n = 6). Seizure at any point during the initial hospitalization was the clinical sign most predictive of abnormal general movements in the fidgety age (sensitivity 100%, specificity 55%, positive predictive value 40%, negative predictive value 100%). Interrater reliability was greatest during the fidgety age (κ = 0.67). CONCLUSIONS: Seizures were the clinical predictor most closely associated with abnormal findings on the General Movements Assessment. However, clinical markers of hypoxic-ischemic encephalopathy are not fully predictive of abnormal General Movements Assessment findings. Larger future studies are needed to evaluate the associations between the General Movements Assessment and childhood neurologic outcomes in patients with hypoxic-ischemic encephalopathy who received therapeutic hypothermia.

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.

Experience with research paradigms relates to infants' direction of preference.

Interpreting and predicting direction of preference in infant research has been a thorny issue for decades. Several factors have been proposed to account for familiarity versus novelty preferences, including age, length of exposure, and task complexity. The current study explores an additional dimension: experience with the experimental paradigm. We reanalyzed the data from 4 experiments on artificial grammar learning in 12-month-old infants run using the head-turn preference procedure (HPP). Participants in these studies varied substantially in their number of laboratory visits. Results show that the number of HPP studies is related to direction of preference: Infants with limited experience with the HPP setting were more likely to show familiarity preferences than infants who had amassed more experience with this paradigm. This evidence has important implications for the interpretation of experimental results: Experience with a given method or, more broadly, with the laboratory environment may affect infants' patterns of preferences.

Discharge planning considerations for the neonatal intensive care unit.

Neonatal intensive care unit (NICU) discharge readiness is the primary caregivers' masterful attainment of technical care skills and knowledge, emotional comfort and confidence with infant care by the time of discharge. NICU discharge preparation is the process of facilitating discharge readiness. Discharge preparation is the process with discharge readiness as the goal. Our previous work described the importance of NICU discharge readiness and strategies for discharge preparation from an American medical system perspective. NICU discharge planning is, however, of international relevance as challenges in relation to hospital discharge are a recurring global theme. In this manuscript, we conceptualise NICU discharge preparation with international perspective.

Infant Cardiac Orienting Responses Predict Later FASD in the Preschool Period.

BACKGROUND: Prenatal alcohol exposure (PAE) has been identified as one of the leading preventable causes of developmental disabilities, but early identification of those impacted has been challenging. This study evaluated the use of infant cardiac orienting responses (CORs), which assess neurophysiological encoding of environmental events and are sensitive to the impact of PAE, to predict later fetal alcohol spectrum disorder (FASD) status. METHODS: Mother-infant dyads from Ukraine were recruited during pregnancy based on the mother's use of alcohol. Participants (n = 120) were then seen at 6 and 12 months when CORs were collected and in the preschool period when they were categorized as having (i) fetal alcohol syndrome (FAS), (ii) partial FAS (pFAS), (iii) alcohol-related neurodevelopmental disorder (ARND), (iv) PAE and no diagnosis, or (v) no PAE and no diagnosis. To assess CORs, stimuli (auditory tones and pictures) were presented using a fixed-trial habituation/dishabituation paradigm. Heart rate (HR) responses were aggregated across the first 3 habituation and dishabituation trials and converted to z-scores relative to the sample's mean response at each second by stimuli. Z-scores greater than 1 were then counted by condition (habituation or dishabituation) to compute a total risk index. RESULTS: Significant group differences were found on total deviation scores of the CORs elicited from visual but not auditory stimuli. Those categorized as pFAS/FAS had significantly higher total deviation scores than did those categorized as ARND or as having no alcohol-related diagnosis with or without a history of PAE. Receiver operating characteristic curve analysis of the visual response yielded an area under the curve value of 0.765 for predicting to pFAS/FAS status. CONCLUSIONS: A score reflecting total deviation from typical HR during CORs elicited using visual stimuli in infancy may be useful in identifying individuals who need early intervention as a result of their PAE.

State-Dependent Memory in Infants.

Why do infants remember some things and not others? Human infants frequently cycle through different states such as calm attentiveness, wakeful activity, and crying. Given that cognitive processes do not occur in isolation, such fluctuations in internal state might influence memory processing. In the present experiment, declarative memory in 9-month-old infants (N = 96) was heavily state dependent. Infants exhibited excellent retention of a deferred imitation task after a 15-min delay if their state at encoding was identical to their state at retrieval (e.g., calm). Infants failed to exhibit retention if their state at encoding was different from their state at retrieval (e.g., calm vs. animated). Infant memory processing depends on internal cues.