Caregiver and Child Distress as Predictors of Dyadic Physiological Attunement During Vaccination.

Abstract

Previous research discerned three groups of caregiver-toddler dyads that differed in their physiological co-regulatory patterns, also known as physiological attunement, during routine vaccinations in the second year of life. One group of dyads (80% of sample) displayed an attuned regulatory pattern and two groups of dyads (20% of sample) showed maladaptive attunement patterns (i.e., a lack of attunement or misattunement). The objective of the current study was to examine how well pain-related distress of children and caregivers during vaccination predicted these patterns. Caregiver-toddler dyads (N = 189) were part of a longitudinal cohort observed at either 12-, 18-, or 24-month vaccination appointments. Caregiver self-report of worry was assessed before and after the needle and child behavioural pain-related distress was also measured during the vaccination appointment. Logistic regression was used to determine how well these variables predicted caregiver-child physiological attunement patterns, as indexed by high-frequency heart rate variability. Higher behavioural pain-related distress at various timepoints after the needle were associated with membership in the dyad groups that showed misattunement or lack of attunement. Further, caregivers with higher pre-needle worry and lower post-needle worry had a greater likelihood of belonging to groups that showed a maladaptive attunement pattern. Findings suggest that caregivers who experience distress associated with their toddlers' vaccination experience more difficulty co-regulating with their child during vaccination, and these children are at risk of experiencing higher levels of pain-related distress. This research highlights the need to help caregivers support their children's regulation during vaccination.