Seven-Year Outcome of the Vermont Intervention Program for Low-Birthweight Infants

We compared 24 low-birthweight subjects of an experimental intervention (LBWE), 32 no-treatment controls (LBWC), and 37 normal birthweight (NBW) subjects. The intervention involved 7 hospital sessions and 4 home sessions in which a nurse helped mothers adapt to their LBW babies. At age 7, LBWE scored significantly higher than LBWC on the Kaufman Mental Processing Composite (p less than .001), Sequential (p = .02), and Simultaneous (p = .001) Scales, after statistical adjustments for socioeconomic status. LBWE did not differ from NBW (F less than 1). These results bear out a divergence between the LBWE and LBWC that first became statistically significant at age 3. The findings suggest that the intervention prevented cognitive lags among LBW children, and that long-term follow-ups are needed to evaluate the developmental effects of efforts to overcome major biological and environmental risks.     

Predicting IQ from mother-infant interactions.

Longitudinal observations of maternal and infant characteristics were used to investigate the consequences of early day-care intervention for infants at high risk for intellectual retardation due to sociocultural factors. High-risk infants and their mothers were compared on social and intellectual characteristics with a control group not enrolled in an intervention program and with a random sample of mother-child dyads from the general population. Results from group comparisons indicated that mothers of high-risk infants in a day-care intervention group interacted with their infants in ways quite similar to mother of high-risk infants who were not enrolled in the intervention program. Both high-risk groups differed from the general population of mothers on interaction and attitudinal measures. Changes across time on the measures taken were roughly parallel from all three groups. Multiple regression analyses using maternal variables and mother-infant interactional variables to predict 36-month Stanford-Binet scores for the high-risk samples indicated that children's intelligence was predictable from previous maternal behaviors and attitudes, particularly for the control group, and that early day-care intervention apparently had altered the predictiveness of some maternal factors.     

The Role of an Early Intervention on Enhancing the Quality of Mother-Infant Interaction

The study examines an intervention designed to influence mothers' sensitive responsiveness toward their infant by presenting information about the newborn's competence to interact and promoting affectionate handling and interaction with the infant. Thirty-six primiparous mothers and their newborn infants participated in the study. On day 2/3 after delivery, mother-infant dyads were assigned to either: (1) an experimental group that received an intervention program designed to enhance mother-infant interaction; or (2) a control group that was presented with an intervention that emphasized basic caregiving skills. One month later an observation was undertaken in the home to assess mother-infant synchronous and asynchronous co-occurrences during free-play and infant bathing. The enhancement group showed a reliably greater frequency of co-occurrences involving vocal exchanges, looking to the partner, and physical contact. There also were differences in mothers' responsiveness to infant crying and involuntary responses. The findings show that even a modest videotaped early intervention can enhance mothers' sensitive responsiveness to the infant.     

Intervention for peer mediation and mother-child interaction: The effects on children’s mediated learning strategies and cognitive modifiability

The effects of intervention for peer mediation and mother-child mediated learning experience (MLE) strategies on children’s MLE strategies and cognitive modifiability (CM) was investigated on a sample of 100 mother–child dyads. CM was examined in domains of executive functions and analogical reasoning. The MLE interactions were analyzed by Observation for Mediated Interaction (OMI) scale. Children of high- and low-mediating mothers were assigned to experimental (n = 49) and control (n = 51) conditions. The experimental group received a peer-mediation program and the control groups received an alternative creativity program. The children (in Grade 3) were assigned as mediators of learners (in Grade 1) and taught them analogical reasoning problems. The peer interaction was videotaped and analyzed by the OMI. All children were given dynamic assessment after the interaction. Children in the experimental group showed higher MLE strategies and CM than did children in the control condition. Mediators of low-MLE mothers in the experimental group showed greater CM than did mediators in the control group. Structural equation modeling analysis showed that mediators’ cognitive modifiability was explained by proximal factors of treatment, mothers’ quality of mediation (QM) and mediators’ QM; learners’ cognitive modifiability was explained by mediators’ QM. The findings were discussed in relation to the MLE theory and earlier findings.     

Interactional Synchrony and the Origins of Infant-Mother Attachment: A Replication Study

This study sought to replicate previous work in testing the hypothesis that interactions of dyads developing secure attachment relationships would be characterized by disproportionately synchronous and those of dyads developing insecure relationships by disproportionately asynchronous exchanges. Additionally, a priori hypotheses were tested regarding expected differences in the interactional histories of dyads developing insecure-avoidant and insecure-resistant attachments. Results supported the study's predictions in all cases. Dyads developing secure attachments were observed at 3 and 9 months to interact in a disproportionately well-timed, reciprocal, and mutually rewarding manner; dyads developing insecure relationships were disproportionately characterized by interactions in which mothers were minimally involved, unresponsive to infant signals, or intrusive. Within the insecure group, as predicted, 3- and 9-month interactions of avoidant dyads were characterized by maternal intrusiveness and overstimulation; resistant dyads were characterized at both ages by poorly coordinated interactions in which mothers were underinvolved and inconsistent. These findings are discussed as they lend to a growing body of evidence concerning associations between differential interactional histories and attachment quality.     

An Ordinal Pattern Analysis of Four Hypotheses Describing the Interactions between Drug-addicted, Chronically Disadvantaged, and Middle-Class Mother-Infant Dyads

This study investigated mother-infant interactions in 18 dyads. All participants were African American and enrolled in an early intervention program because the infants (2–26 months of age) had developmental disabilities or were at high risk for developmental disability. Some mothers had used drugs during their pregnancy, and all mothers were of low or middle socioeconomic status. Dyads were videotaped interacting at 4 different times, separated by at least 5 months in time. Videotapes were rated in terms of infant involvement and maternal responsivity in the interaction. 4 hypotheses concerning the pattern of maternal interaction across time were tested using ordinal pattern analysis. The hypothesis that mothers would become less responsive to infants over time (H_D) as a function of drug addiction, poverty, or serious developmental delay was supported for only 4 of the 18 dyads. There was support for the hypothesis (H_j) that mothers naturally increase their responsivity over time ( N = 6) and support for the hypothesis (H_T) that mothers' interactive sensitivity fluctuates in relation to infants' involvement in the interaction over time ( N = 7). Ordinal pattern analysis has advantages in determining how well competing hypotheses describe individuals within populations relative to approaches that identify differences that apply to entire populations.     

Pilot study of a program delivered within the regular service system in Germany: Effect of a short-term attachment-based intervention on maternal sensitivity in mothers at risk for child abuse and neglect

This pilot study examined the effectiveness of a short-term attachment-based intervention, the Ulm Model, in a German population at risk for child abuse and neglect. The intervention used home visits and video feedback to promote maternal sensitivity, and was implemented by trained staff within the health care and youth welfare systems. Mothers in the control group (n = 33) received standard services only, while those in the intervention group (n = 63) additionally the Ulm Model intervention. The outcomes measured were maternal sensitivity, as assessed by the CARE-Index at pre-intervention, after the last session, and at about 6 and 12 months of age; and infant socio-emotional development, as assessed by the ET6-6 development test at about 6 and 12 months of age. The moderating effects on treatment outcomes of two variables were examined: risk for child abuse (moderate vs. high) and type of maternal attachment representation (secure vs. insecure). Among participants at moderate risk for child abuse, no differences were found between the intervention group and control group in either maternal sensitivity or infant development. Among those considered high risk, mothers in the intervention group showed a significant increase in maternal sensitivity from pre- to post-intervention; however, no group differences were seen at follow-up. There were some indications that infants of mothers in the intervention group showed better emotional development. The variable of maternal attachment representation was not a significant moderator for the intervention effect, but post hoc analysis indicated that the mean sensitivity of secure mothers was significant higher at the 6-month follow-up.     

Dyadic activities and attention in the infant: A developmental study

Infants’ abilities to focus attention on objects are known to be related to mothers’ mobilizing behaviors. As delayed effects of maternal behaviors at 5 months may be observed in 8-month-olds, mothers may be considered as scaffolding their infant’s attention. However, all dyadic activities are probably not equally propitious to attention mobilizing. In a sample of 30 dyads, studied at 5 and 8 months of age, whole observations were split in four broad categories: care, dyadic play with objects, dyadic play without objects and infant alone. The duration of maternal mobilizing and infant attention focussing were studied within categories. Inter-dyads variability is high, while dyads are stable across ages. Even within the dyadic play with objects, mothers differ widely in the duration and way they mobilize attention. Five-month-olds still need their mother’s support, as they explore less when they are alone, while 8-month-olds are more autonomous. The impact and importance of the various types of dyadic activities on cognitive development are discussed.     

Helping mothers discuss sexuality and AIDS with adolescents

The current study was designed to alter experimentally mothers' style when discussing sexuality and AIDS with their adolescent children. Mothers of 11- to 15-year-olds (N = 50) were assigned to an intervention or control group, resulting in 20 dyads in each group. All dyads were assessed twice, on self-reported and observed communication, AIDS knowledge, and perceived vulnerability to AIDS. Intervention group mothers received two training sessions. Observational data revealed that intervention group mothers reduced their amount of speaking, asked more open-ended questions, acted less judgmental, and discussed dating and sexuality more than did control group mothers. Intervention group adolescents reported increased discussions of birth control and increased daily comfort talking to their mothers. There was some evidence that intervention group girls increased in AIDS knowledge. There was no change in AIDS-related beliefs.     

Maternal self-efficacy and infant attachment: integrating physiology, perceptions, and behavior

48 mothers of 5-month-old infants were asked to estimate their control over the termination of an infant cry in a laboratory-simulated child-care task. Mothers who greatly overestimated their control differed from low or moderate "illusion-of-control" mothers by exhibiting a depression-prone attributional style, a depressed mood state, perceiving the father as participating less in child care, and responding to impending infant cries with heart-rate acceleration characteristic of aversive conditioning. At age 16 months, 40 of the mother-infant pairs participated in the Ainsworth Strange Situation. Insecure infant attachment at 16 months was associated with maternal perception of overcontrol, depressed mood state, and aversive conditioning to the impending cry in the laboratory task at the 5-month period.     

Enhancing the Development of Low-Birthweight, Premature Infants: Changes in Cognition and Behavior over the First Three Years

The Infant Health and Development Program is a randomized clinical trial to test the efficacy of educational and family support services and pediatric follow-up offered in the first 3 years of life on reducing the incidence of developmental delay in low-birthweight (LBW), preterm infants in 8 clinical sites ( N = 985). Effects of the intervention on cognitive and behavior problem scores over the 3 years are examined. Significant intervention effects were seen on cognitive scores at 24 and 36 but not 12 months of age; effect sizes were similar at both ages. These effects persist when controlling for earlier cognitive scores. At 24 and 36 months, behavior problem scores for the intervention group were significantly lower than for the follow-up group; the intervention was more efficacious for children with higher initial behavior problem scores. Results are discussed in terms of timing and targeting of services for LBW and disadvantaged children.     

The rhythmic structure of mother-infant interaction in term and preterm infants

The purpose of this study was to quantify social interaction rhythms in 3- and 5-month-old term and preterm infants and their mothers. Infant-mother dyads were videotaped in a 3-min face-to-face paradigm. For each second of the interaction, separate scores were assigned to infant and mother indicating levels of affective involvement, creating 2 180-sec time series. Spectral and cross-spectral techniques were used to quantify periodicities in each member of the dyad and to estimate the synchrony or coherence of interactional rhythms between each infant and mother. Results showed the existence of periodicities in the behavior of each infant and mother at 3 and 5 months, with most subjects showing spectral peaks between .022 and .10 Hz. Increases from 3 to 5 months in behavioral periodicities were found for infants and mothers as well as for the coherence between infant-mother dyads. Term dyads showed higher coherence than preterm dyads at both 3 and 5 months. Term infants more often led the interaction at both ages. These results were taken as evidence that behavioral periodicities, which may be biologically based, underlie early mother-infant interaction and provide a temporal structure for the organization of cognitive and affective experience. Differences in synchrony between term and preterm infants may explain later reported differences in language between these groups.     

Children and mothers in war: an outcome study of a psychosocial intervention program

The present study was designed to evaluate the effects on children (age: M = 5.5 years) in war-torn Bosnia and Herzegovina of a psychosocial intervention program consisting of weekly group meetings for mothers for 5 months. An additional aim was to investigate the children's psychosocial functioning and the mental health of their mothers. Internally displaced mother-child dyads were randomly assigned to an intervention group receiving psychosocial support and basic medical care (n = 42) or to a control group receiving medical care only (n = 45). Participants took part in interviews and tests to provide information about war exposure, mental health, psychosocial functioning, intellectual abilities, and physical health. Results showed that although all participants were exposed to severe trauma, their manifestations of distress varied considerably. The intervention program had a positive effect on mothers' mental health, children's weight gain, and several measures of children's psychosocial functioning and mental health, whereas there was no difference between the two groups on other measures. The findings have implications for policy.     

Supporting fathering through infant massage

Fathers may feel dissatisfied with their ability to form a close attachment with their infants in the early postpartum period, which, in turn, may increase their parent-related stress. Our study sought to determine if an infant massage intervention assisted fathers with decreasing stress and increasing bonding with their infants during this time. To address the complex father-infant relationship, we conducted a pilot study using a mixed methodology approach. Twelve infant-father dyads participated in the intervention, and 12 infant-father dyads populated a wait-list control group. Paternal stress was measured using the Parenting Stress Index at baseline and at postintervention. We found infant massage instruction significantly decreased paternal stress. Our findings were also supported by the qualitative data and suggest fathers may benefit from applied postnatal education.     

Effects of Neurological Training on Psychomotor Abilities of Kindergarten Children

That neurological dysfunction accounts for many cases of academic failure is well documented, but specific research on programs designed to overcome this dysfunction is sparse. In this study fifty kindergarten children having perceptuomotor and/or psychomotor deficits as identified by several well-known scales were assigned to an experimental or control group. The experimental group was then given a program of cross-patterning exercises for 3 minutes a day over a 3-month period. The obtained results suggest that a neurological training program does not significantly improve the psychomotor functioning of kindergarten children.     

Linking Assessment and Intervention for Developmental/Functional Outcomes of Premature,Low-birth-weight Children

Prematurity and low birth weight (LBW) are two major biological factors that put infants and young children at high risk for developmental delays or disabilities. While survival rates for premature and LBW children have improved, incidence figures have changed little over the past 20 years; in fact, the incidence of LBW has increased. Although the vast majority of LBW children have normal outcomes, as a group, they have higher risk for subnormal growth, illnesses, and neurodevelopmental problems. The purpose of this article is to examine the factors that influence the effectiveness of early intervention for premature, LBW children and to describe a strategy for linking assessment and early intervention. Linking assessment and intervention involves comprehensive assessment; a team approach to both assessment and intervention; empowering and enabling families; and the development of functional goals and objectives.     

A randomized controlled trial of a home-visiting intervention aimed at preventing relationship problems in depressed mothers and their infants

This study examined the effect of a mother–baby intervention on the quality of mother–child interaction, infant–mother attachment security, and infant socioemotional functioning in a group of depressed mothers with infants aged 1–12 months. A randomized controlled trial compared an experimental group ( n = 35) receiving the intervention (8–10 home visits) with a control group ( n = 36) receiving parenting support by telephone. There were assessments pre, post, and follow-up after 6 months. The intervention had positive effects on the quality of mother–infant interaction. Infants in the experimental group had higher scores for attachment security and for one aspect of socioemotional functioning, namely, competence. The intervention proved successful in preventing deterioration of the quality of mother–child interaction.     

A Longitudinal Study of Two Early Intervention Strategies: Project CARE

65 families with children at risk for cognitive difficulties were randomly assigned at the time of the child's birth to 1 of 3 groups, 2 intervention and 1 control. For the most intensive intervention group, family education was combined with a center-based educational day-care program; the less intensive intervention group received the home-based family education program only. To assess the cognitive performance of children, The Bayley Scales of Infant Development were administered at 6, 12, and 18 months; the Stanford-Binet Intelligence Test at 24, 36, and 48 months; and the McCarthy Scales of Children's Abilities at 30, 42, and 54 months. On each test after the 6-month assessment, scores of children in the educational day-care plus family support group were greater than those in the other 2 groups. No cognitive intervention effects were obtained for the family education group. Group effects were not obtained for measures of either the quality of the home environment or parent attention.     

EFFECTIVENESS OF THE FRIENDS FOR LIFE PROGRAM IN PORTUGUESE SCHOOLS: STUDY WITH A SAMPLE OF HIGHLY ANXIOUS CHILDREN

The FRIENDS for Life program is a cognitive–behavioral group program that targets anxiety in children. The main purpose of this study was to analyze the effectiveness of the Portuguese version of the FRIENDS for Life Program, which was implemented in schools to reduce anxiety problems in a group of highly anxious children. The study used a quasi‐experimental research design with two groups of children, an intervention (n = 17) and a wait‐list control group (n = 21), aged 8 to 12 years old. The impact of the program in reducing anxiety symptoms as assessed by children and mothers was analyzed through the Screen for Child Anxiety Related Emotional Disorders‐Revised (SCARED‐R). The results show a statistically significant post intervention effect on anxiety symptoms evaluated by the child, but not by the mother. The implications of these results for the prevention of anxiety disorders in Portuguese schools are discussed.     

The Social Competence of Children Born Prematurely: Effects of Medical Complications and Parent Behaviors

36-month-old, full-term children (n = 21) and low-birthweight (LBW) children of high (n = 25) and low (n = 23) medical risk status were observed in interactions with mothers in teaching and social context. Child compliance, self-directed behaviors, and problem behaviors were evaluated as well as associations among aspects of children's social competence, mothers' behaviors, and context factors. Degree of medical risk was associated with impairments in children's self-directed behavior and quality of response to maternal directives. Mothers of LBW children showed a smaller proportion of behaviors that provided choices compared to mothers of full-term children. Medical complications, children's cognitive status, and mothers' interactive behaviors were significantly associated with LBW children's social competence. Results of regression analyses suggested that mothers and LBW children influence each others' behavior in ways similar to mothers and full-term children in both teaching and social contexts.