Infant-directed communication: Examining the many dimensions of everyday caregiver-infant interactions.

Everyday caregiver-infant interactions are dynamic and multidimensional. However, existing research underestimates the dimensionality of infants' experiences, often focusing on one or two communicative signals (e.g., speech alone, or speech and gesture together). Here, we introduce "infant-directed communication" (IDC): the suite of communicative signals from caregivers to infants including speech, action, gesture, emotion, and touch. We recorded 10 min of at-home play between 44 caregivers and their 18- to 24-month-old infants from predominantly white, middle-class, English-speaking families in the United States. Interactions were coded for five dimensions of IDC as well as infants' gestures and vocalizations. Most caregivers used all five dimensions of IDC throughout the interaction, and these dimensions frequently overlapped. For example, over 60% of the speech that infants heard was accompanied by one or more non-verbal communicative cues. However, we saw marked variation across caregivers in their use of IDC, likely reflecting tailored communication to the behaviors and abilities of their infant. Moreover, caregivers systematically increased the dimensionality of IDC, using more overlapping cues in response to infant gestures and vocalizations, and more IDC with infants who had smaller vocabularies. Understanding how and when caregivers use all five signals-together and separately-in interactions with infants has the potential to redefine how developmental scientists conceive of infants' communicative environments, and enhance our understanding of the relations between caregiver input and early learning. RESEARCH HIGHLIGHTS: Infants' everyday interactions with caregivers are dynamic and multimodal, but existing research has underestimated the multidimensionality (i.e., the diversity of simultaneously occurring communicative cues) inherent in infant-directed communication. Over 60% of the speech that infants encounter during at-home, free play interactions overlap with one or more of a variety of non-speech communicative cues. The multidimensionality of caregivers' communicative cues increases in response to infants' gestures and vocalizations, providing new information about how infants' own behaviors shape their input. These findings emphasize the importance of understanding how caregivers use a diverse set of communicative behaviors-both separately and together-during everyday interactions with infants.

Exploring predictors of interaction among low-birth-weight infants and their caregivers: a machine learning-based random forest approach.

BACKGROUND: Quality caregiver-infant interaction is crucial for infant growth, health, and development. Traditional methods for evaluating the quality of caregiver-infant interaction have predominantly relied on rating scales or observational techniques. However, rating scales are prone to inaccuracies, while observational techniques are resource-intensive. The utilization of easily collected medical records in conjunction with machine learning techniques offers a promising and viable strategy for accurate and efficient assessment of caregiver-infant interaction quality. METHODS: This study was conducted at a follow-up outpatient clinic at two tertiary maternal and infant health centers located in Shanghai, China. 68 caregivers and their 3-15-month-old infants were videotaped for 3-5 min during playing interactions in non-threatening environment. Two trained experts utilized the Infant CARE-Index (ICI) procedure to assess whether the caregivers were sensitive or not in a dyadic context. This served as the gold standard. Predictors were collected through Health Information Systems (HIS) and questionnaires, which included accessible features such as demographic information, parental coping ability, infant neuropsychological development, maternal depression, parent-infant interaction, and infant temperament. Four classification models with fivefold cross-validation and grid search hyperparameter tuning techniques were employed to yield prediction metrics. Interpretable analyses were conducted to explain the results. RESULTS: The score of sensitive caregiver-infant interaction was 6.34 ± 2.62. The Random Forest model gave the best accuracy (83.85%±6.93%). Convergent findings identified infant age, care skills of infants, mother age, infant temperament-regulatory capacity, birth weight, positive coping, health-care-knowledge-of-infants, type of caregiver, MABIS-bonding issues, ASQ-Fine Motor as the strongest predictors of interaction sensitivity between infants and their caregiver. CONCLUSIONS: The proposed method presents a promising and efficient approach that synergistically combines rating scales and artificial technology to detect important features of caregiver-infant interactions. This novel approach holds several implications for the development of automatic computational assessment tools in the field of nursing studies.

MOMENTS OF MEETING: THE RELEVANCE OF LOU SANDER'S AND DAN STERN'S CONCEPTUAL FRAMEWORK FOR UNDERSTANDING THE DEVELOPMENT OF PATHOLOGICAL SOCIAL RELATEDNESS.

Lou Sander and Dan Stern made seminal contributions to our understanding of early child development, particularly in regard to the moment-to-moment intersubjective exchanges and mutual sensitivity that are at the core of the caregiver-infant relationship. Although their own studies focused primarily on the ways in which children's intersubjective experiences of mutual attunement lead to adaptive social relatedness and validate a healthy sense of self, this article focuses on the applicability of their theoretical conceptions to the development of pathological social relations. It explores the premise that the emotional validation derived from recurrent intersubjective experiences of mutual attunement involving negative affects can be as emotionally compelling from the child's standpoint as that derived from positive exchanges. Children's needs to recreate unhealthy, but affectively meaningful, moments with their caregivers can lead to ingrained, automatically operating pathological patterns of social behavior and affective expression that can take on a life of their own and strongly shape the child's subsequent socioemotional functioning. Following an overview of Sander's and Stern's conceptual thinking, developmental research and clinical case material will be utilized to illustrate how their work can enrich our understanding of developmental processes that can contribute to a number of emotion-specific, early relational disturbances.

Building language learning: Relations between infant attention and social contingency in the first year of life.

In Western societies, social contingency, or prompt and meaningful back-and-forth exchanges between infant and caregiver, is a powerful feature of the early language environment. Research suggests that infants with better attentional skills engage in more social contingency during interactions with adults and, in turn, social contingency supports infant attention. This reciprocity is theorized to build infant language skills as the adult capitalizes on and extends the infant's attention during socially contingent interactions. Using data from 104 infants and caregivers, this paper tests reciprocal relations between infant attention and social contingency at 6- and 12-months and the implications for infant vocabulary at 18-months. Infant attentional skills to social (women speaking) and nonsocial (objects dropping) events were assessed, and social contingency was examined during an 8-minute toy play interaction with a caregiver. Child receptive and expressive vocabulary was measured by caregiver-report. Both social and nonsocial attentional skills related to engagement in social contingency during caregiver-infant interaction, though only models that included social attention and social contingency predicted vocabulary. These findings provide empirical evidence for the proposed reciprocal relations between infant attention and social contingency as well as how they relate to later language.

Developmental cascades of vocal turn-taking connect prelinguistic vocalizing with early language.

Conversational turn-taking is ubiquitously found in caregiver-infant interactions, and robustly predictive of infant communicative development. Over the first year, infants take quick adult-like vocal turns with caregivers. Many studies have documented the consistency of caregiver responsiveness and its influence on infant rapid language growth. However, few have examined how caregiver responsiveness facilitates extended vocal turn-taking in real-time with infants over the first year. The influence of prelinguistic vocal turn-taking on the emergence of language has also been under-investigated. We analyzed free-play sessions of 30 caregivers and their infants at both 5 and 10 months, and obtained infant language outcomes at 18 months. We examined the developmental consistency (group-level continuity and dyad-order stability) and change of infant volubility, caregiver responses to babbling in vocal, non-vocal and multimodal modalities, and the influence of modality on caregiver-infant vocal turn-taking. Caregiver contingent responsiveness to infant babbling at 5 months predicted vocal turn-taking at 10 months. Developmental increases in prelinguistic vocalizing and vocal turn-taking from 5 to 10 months predicted infant language outcomes at 18 months. At both 5 and 10 months, caregiver vocal responses were more effective in extending turn-taking than non-vocal or multimodal responses. In summary, prelinguistic vocal turn-taking, facilitated by caregiver vocal responsiveness, is positively related to the emergence of early language.

Hush, little baby: The role of C-tactile afferents in babywearing infants with neonatal opioid withdrawal.

Social touch through infant holding, skin-to-skin contact, and infant carrying (babywearing) decreases infant distress and promotes secure attachment. Unknown is the extent to which these effects are the result of the activation of C-Tactile afferents (CTs), the constellation of nerve fibers associated with affective touch, primarily located in the head and trunk of the body. The purpose of the present study was to compare dynamic touch (CTs activated) to static touch (CTs less activated) during a babywearing procedure among infants experiencing Neonatal Opioid Withdrawal Syndrome (NOWS). NOWS is a spectrum of clinical symptoms, including elevated heart rate (HR), associated with withdrawal from intrauterine opioid exposure. We hypothesized that stroking an infant's head during babywearing would amplify the pleasurable effect of babywearing as measured by changes in infant HR. Twenty-nine infants in a Neonatal Intensive Care Unit (NICU) in the Southwestern USA were worn in an infant carrier starting at five days old (M = 5.4, SD = 2.6; 46.2 % White, 26.9 % Latinx, 11.5 % Native American) and physiological readings were conducted daily; heart rates of infants and caregivers were taken every 15-seconds for 5-minutes, before, during, and after babywearing (30 min per phase). Each day infants alternated (randomly) in a static touch (hands-free babywearing) or dynamic touch condition (stroking the top of the infants' head at a velocity of 3 cm/s while babywearing). On average, infants completed 3 dynamic and 3 static babywearing sessions. Hospital and research staff participated in babywearing when a parent was not available (31.0 % of infants were exclusively worn by volunteers, 27.6 % were exclusively worn by parents). We analyzed the data using Hierarchical Linear Models due to the 3-level nested design (N = 29 infants, N = 191 readings, N = 11,974 heart rates). Compared to baseline (infant calm/asleep and without contact), infant's HRs significantly declined during and after babywearing, controlling for pharmacological treatment. These effects were significantly stronger during the dynamic touch condition (reduction in HR of 11.17 bpm) compared to the static touch condition (reduction in HR of 3.74 bpm). These effects did not significantly vary by wearer (mother, father, volunteer). However, differences between the dynamic and static conditions were significantly stronger in earlier babywearing sessions, potentially indicating a learning effect. There was evidence for a calming effect among caregivers as well, particularly in the dynamic touch condition, when caregivers were engaged in active touch. Activation of CTs appears to be an important mechanism in the physiological benefits of babywearing and in the symbiotic role of caregiver-infant attachment.

The cultural specificity of parent-infant interaction: Perspectives of urban middle-class and rural indigenous families in Costa Rica.

Caregiver-infant interactions in Western middle class often take place in dyadic play settings, engaged in infant-initiated object stimulation, and surrounded by a positive emotional tone, reflecting a distal parenting style. With this study we aim to investigate whether the same conception of caregiver-infant interaction is embodied in the proximal parenting style. For this purpose, we compare the context and pattern of caregiver-infant interactions in two cultural groups in Costa Rica: Urban middle-class families in San José and rural indigenous Bribri families. Naturalistic observations and caregiver interviews revealed significant differences between the groups, with San José families resembling the Western middle-class interaction pattern. Among the Bribris, adult-child play is uncommon so that children interact with adults in primary care settings and with older siblings in play settings. Bribri interactions are further characterized by emotional neutrality. The groups did not differ in terms of body contact. Also, caregivers in both samples took the lead in interactions more often than infants. The results are discussed in the context of an autonomous-relational style as combining psychological autonomy and hierarchical relatedness. We argue that early childhood theories and intervention programs need to abandon the assumption that Western middle-class strategies are universal and recognize locally relevant patterns of caregiver-infant interaction.

Eating in Synch: An investigation of parent-infant behaviour coordination during feeding interactions.

During feeding, parents have been described to move their mouth as if they were eating themselves. Such matching of behaviours between parents and their infants during face-to-face interactions represents an example of behavioural synchrony. To date, however, the function of these synchronous eating-like mouth movements by the caregiver remains unexplored. To address this question, two competing hypotheses were tested: 1) the instructional hypothesis proposing that parents make eating-like mouth movements, such as opening and closing their mouth, to demonstrate to their infants what they need to do; 2) the mimicry hypothesis suggesting that parents imitate their infant's mouth actions to enhance affiliation. To test these hypotheses, we examined the temporal dependencies between parents' and infants' mouth movements. We reasoned that parents' mouth movements would occur before their infants' if they serve an instructional purpose, but that they would happen after, if parents mimic their infants. Additionally, we expected that parents' matching mouth movements would be more likely when their infants looked at them in both cases. To examine these hypotheses, fifteen caregivers were observed as they were feeding their six-month-old infants. Time-window sequential analysis was conducted to quantify how likely parents were to display mouth opening and closing before or after their infants did. The results revealed that parents' mouth movements were more likely to follow infants' movements and are thus in line with the mimicry hypothesis. Interestingly, these mouth movements of parents were independent of infant's gaze.

Co-regulation of movements during infant feeding.

The process by which infants move from liquid feeding to caregiver-assisted spoon feeding of semi-solid food is quite a dramatic transition. In previous studies, we observed that in the weeks after the introduction to solid food, mother-infant dyads showed increased co-regulation and synchronization of their respective feeding behaviors (e.g. offering food, accepting/refusing, timing). Learning this new way of feeding and eating requires that infants coordinate their position and movements with the complementary position and movements of the caregiver. The present study augments the category-based analysis of this co-regulation by the analysis of coupling in the dyads based on automatically extracted movement data. Previously collected video data from 10 mother-infant dyads were re-analyzed for the purpose of this study. Movement trajectories of mother's hand and infant's face were obtained by applying an automatic movement detection algorithm (TLD, Kalal et al., 2012; for applications to mother-infant interactions see López Pérez et al., 2017). Coordination was assessed by the method of Diagonal Cross Recurrence Profiles (DCRP), which expresses the degree of synchronization at different time lags. Profiles for each dyad from two different occasions --with one visit in the first week of solid feeding and one approximately 4-5 weeks later-- were compared. The results showed that, on average, most synchronization occurred in the first visit at lag 0. In the second visit there was an average delay in synchronization of about 1 s, with leading behavior starting from the infant. This suggests that the coordination was initially closely synchronized and became somewhat looser over time. Possibly, infants have begun to anticipate and guide the feeding movements enacted by the mother. However, our findings underline the idiosyncratic and complex nature of co-regulation of movements during the introduction of solid food. Whereas some dyads showed signs of increased organization, others seemed to disorganize, re-organize, or showed no organization at all. Many (interacting) factors --both individual and contextual-- may be responsible for the observed differences between dyads. Further research is needed to understand why specific synchronization pathways emerge and whether and how these might relate both to later feeding and eating and to the emergent patterns of participation.

A novel two-body sensor system to study spontaneous movements in infants during caregiver physical contact.

Spontaneous movements, which refer to repetitive limb movements in the absence of any external stimulus, have been found to be reflective of neurodevelopmental status during infancy. These movements are modulated by both individual and environmental factors, including physical contact (holding) with the caregiver. However, it is a challenge to measure spontaneous movements during physical contact because infant-generated movements become coupled with caregiver-generated movements in such contexts. Here, we propose the use of a novel two-body sensor system to distinguish infant-generated movements in the presence of physical contact with the caregiver. Data from seven typically developing infants and their caregivers were recorded during different simulated home activities, which involved different combinations of physical interaction, caregiver's movement and infant positions. The two-body sensor system consisted of two wearable accelerometers - one placed on the infant's arm and one on the caregiver's arm, and we developed a Kalman-filter based algorithm to isolate the infant-generated movements. In addition, video was recorded for qualitative analysis. Results indicated that spontaneous movement activity was higher when there was no physical contact with caregiver. When there was physical contact, spontaneous movements were increased when the caregiver was still and when the infant was held horizontally. These results show that the novel two-body sensor system and the associated algorithms were able to isolate infant-generated movements during physical contact with the caregiver. This approach holds promise for the automated long-term tracking of spontaneous movements in infants, which may provide critical insight into developmental disorders.