Abstract
Emotional maltreatment (EM) has profound effects on the developing brain but is hardest to identify in infancy. Early observations of parent-infant interactions may provide opportunities to identify babies at risk of neglect and EM. This prospective study tests, in the first fortnight of life, the feasibility of using an observation tool previously validated for use at 2 to 7months of age. Women awaiting induction of labour were recruited in South Wales in July 2016. Women consented to being contacted postnatally and video recordings of mother-infant interaction at two home visits between 7 and 10days (T1) and 8-12weeks old (T2). Demographic details, information on the pregnancy, delivery, and infant condition were obtained at T1. A questionnaire was completed at T2 to capture any significant events affecting the parent-infant relationship. The Parent-Infant Interaction Observation Scale (PIIOS) was used to score the videos. Exclusion criteria included admission to neonatal unit. Recruitment of suitable participants and full research data completion were feasible. Of 60 women who consented to be contacted post-delivery, 30 women (31 infants) participated at T1 and T2. Three babies were excluded. Women accepted being observed in their homes with their babies, with no attrition between T1 and T2. Using the PIIOS 10 of the 13 items could be scored with an awake infant under 2weeks. These encouraging findings can inform exploration of an observation tool to identify high-risk dyads for targeted support. A trial and test of a modified scoring system (based on the PIIOS) should be developed for a future study using a larger sample size. Further research should assess if this approach reliably produces a consistent valid screening tool to assess parental sensitive responsiveness and resilience promoting behaviours at this early stage of life.
Highlights
During childhood, emotional development is largely dependent upon the quality of parent–child interactions
The mother's demographic and pregnancy details are presented in Tables 2A and 2B
Our study provides promising information to pursue further groundbreaking research on the reliability and validity of the screening tool at this age
Summary
Emotional development is largely dependent upon the quality of parent–child interactions. Neglect and emotional abuse represent extreme departures from the average expected caregiving environment; many of the developmental deficits associated with these forms of maltreatment can be explained by a lack of appropriate parent–child interactions. The parent's sensitivity to the infant's feelings—the ability to tune into the baby's internal state and offer appropriate help to keep it modulated within comfortable limits—determines the quality of the attachment relationship (Balbernie, 2013). Observations of parent–infant interactions may provide opportunities to identify babies at risk of neglect and EM. This prospective study tests, in the first fortnight of life, the feasibility of using an observation tool previously validated for use at 2 to 7 months of age. Further research should assess if this approach reliably produces a consistent valid screening tool to assess parental sensitive responsiveness and resilience promoting behaviours at this early stage of life
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