Infant Behavior Research Articles

Mother-infant interactive processes and infant behavioral and vagal stress recovery: Associations at 3, 6, and 9 months of age.

Mother-infant interactive processes, including matching social behaviors and repairing interactive ruptures, are proposed to foster infant stress functioning. However, little is known about the extent to which the concurrent relations between these dyadic processes and infant behavioral and vagal stress recovery change over the first year of life. In this study, 116 mother-infant dyads (55 girls) from a midwestern city in the United States completed the still-face paradigm at 3, 6, and 9 months. Using microcoding of infant and maternal behaviors (i.e., facial expressions, vocalizations, and gaze directions), we defined two dyadic states (positive match and mismatch) and measured dyadic matching as a composite of (a) the proportion of positive match and (b) latency to interactive repair (i.e., the average duration of mismatches), for the play and reunion episode, separately, at each time point. Infant behavioral and vagal stress recovery were assessed as the proportion of social engagement during the reunion episode and increases in respiratory sinus arrhythmia from the still-face to reunion episodes, respectively. At 6 and 9 months, higher levels of dyadic matching during the play episode were related to better infant behavioral and vagal stress recovery, controlling for matching during the reunion episode. At 3 months, the relation only emerged for infant behavioral stress recovery. These findings suggest that the dynamics of mother-infant interaction may play a key role in infant stress recovery, particularly during the second half of the first year when infants become more actively engaged in social interactions and their vagal systems become more mature. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prenatal iodine intake and infant temperament in a multiethnic US cohort.

Maternal iodine plays a central role in fetal neurodevelopment. It is recommended that pregnant women consume sufficient levels of iodine to accommodate increased need for mother and fetus. We examined associations among prenatal dietary and supplemental iodine intake and infant temperament. The PRogramming of Intergenerational Stress Mechanisms (PRISM) study is an ongoing longitudinal pregnancy cohort. Data from 2011 to 2020 were used for this study. Women completed the Block98 FFQ ascertaining prenatal dietary and supplemental iodine intake and the Infant Behavior Questionnaire-Revised at infant age 6 months to ascertain infant temperament (Surgency/Extraversion, Negative Affectivity and Orienting/Regulation). USA. Mother-child dyads (n 892). Women were primarily Black/Hispanic Black (44 %) and non-Black Hispanic (35 %) with 46 % reporting household income < $25 000/year. Nearly half had an estimated average requirement (EAR) < 160 µg/d (49 % based on dietary intake; 43 % based on diet and supplements). Girls born to women with an EAR ≥ 160 µg/d compared to girls born to women below this level had higher unadjusted extraversion scores for dietary plus supplemental intake (β = 0·23 (0·13, 0·33)); decreased to β = 0·05 (-0·08, 0·19) after adjusting for covariates. Boys born to women with an EAR ≥ 160 µg/d (based on diet and supplements) as compared to boys born to women below this level had statistically non-significant higher unadjusted negative affective score (β = 0·06 (-0·08, 0·20)) that became significantly lower upon covariate adjustment (β = -1·66 (-1·97, -1·35)). A significant proportion of these women reported suboptimal prenatal iodine intake. Suboptimal prenatal iodine intake may have implications for child neurodevelopment evident as early as infancy.

Early-life temperament: A longitudinal investigation of stability and structure

In this longitudinal study, we investigated the factor structure and stability of early-life temperament in a German sample, using three measures developed within Rothbart’s psychobiological approach. Temperament was measured using the Infant Behavior Questionnaire Revised (IBQ-R) at the ages of 6 and 12 months, the Early Childhood Behavior Questionnaire (ECBQ) at the age of 18 months, and the Child Behavior Questionnaire (CBQ) at the ages of 36 and 48 months. We assessed longitudinal stability on a scale and factor level using data from the 85 participants that took part in each measurement. The latent factor structures were analyzed at each time point using all available data, ranging from 112 to 148 participants. Modest to high degrees of stability for most scales and all three latent factors was found. Stability was highest between measurements employing the same instrument and increased with age, indicating a consolidation of temperament traits over time. Model fit for the proposed factor structure consisting of Surgency, Negative Affect, and Effortful Control/Regulatory Capacity was poor, while exploratory factor analyses revealed similar but not identical structures for each time point. The third factor of Regulatory Capacity was not found at 6 months, but at 12 months and later, as is commonly the case in German samples. These findings further contribute to our understanding of the early development of temperament and its stability from infancy and beyond as well as expand on previous literature regarding its structure in German culture.

Association between infant feeding behavior and maternal choice of breastfeeding type

Abstract Introduction Feeding in infants is a fundamental process influenced by the mother-child relationship during the early months of life. The regulation of feeding behavior, and hunger and satiety cues may be interpreted by the mother, potentially relating to the type of feeding chosen. Objectives To determine the association between infant feeding behavior and the type of breastfeeding chosen by the mother. Methods A cross-sectional and prospective study was conducted, including mothers with children aged between 6 and 18 months. Those with medical contraindications for immediate postpartum breastfeeding or with suspension of exclusive breastfeeding during the first 6 months of life due to medical prescription were excluded. The Baby Eating Behavior Questionnaire was used to evaluate the baby’s enjoyment of food, appetite response, eating speed, and satiety response. Results 108 mothers were included, with 87% in agreement with exclusive breastfeeding (EBF), 43.3% using breastfeeding as the primary feeding method, and only 33.3% practicing EBF during the first 6 months. Food response (FR) scored 19.6 (±4.3), enjoyment of food (EF) 17.6 (±2.1), satiety response (SR) 7.1 (±2.0), eating speed (ES) 8.8 (±2.3), and appetite (AP) 4.2 (±0.7). Comparing FR, EF, SR, ES, and AP scores between those who practiced EBF and those who did not showed p &amp;gt; 0.05. sociodemographic characteristics, perinatal factors, stance on EBF, number of hours per day with the child, feeding location, poor technique, breastfeeding pain and lack of medical guidance, all showed p &amp;gt; 0.05 when comparing between those who practiced EBF and those who did not; in contrast to perceiving that the baby wanted to breastfeed (2.5/1.0-6.2), having time to feed (3/1.2-7.2) and having no health problems (10/1.2-78.7) all with p-value &amp;lt;0.05. Conclusions The mother’s perception identifying the baby’s desire to breastfeed, having time to feed the baby and not having health problems favor exclusive breastfeeding. Key messages • Maternal perception plays an important role in deciding to give SCI, so it is the physician’s job to educate the mother so that she has additional arguments for choosing SCI. • The infant’s feeding behavior does not have a significant impact on the mother’s behavior in choosing SCI feeding.

M-Poma: Innovative Technology for Boosting Exclusive Breastfeeding Practices

Background: The Indonesian Health Survey data indicates that exclusive breastfeeding coverage is projected to reach 55.5% in 2023, with Aceh showing a lower rate of 49.9%. In Aceh Besar, the coverage was reported at 55.9% in 2022. Notably, women from low-income backgrounds are less likely to engage in breastfeeding practices by the second day postpartum compared to their higher-income counterparts. To address this disparity, the use of smartphone applications offering educational videos about breastfeeding and infant behavior has emerged as a preferred method, particularly among low-income mothers. Objective: This study aims to develop a mobile application called “POMA” (M-POMA) to enhance exclusive breastfeeding practices among infants in the Kuta Baro District of Aceh Besar. Methodology: A Research and Development (R&amp;D) approach was employed to create the Android-based M-Poma application. The development process spanned two years: the first year focused on application design and functionality, while the second year involved training sessions for 25 midwives and 25 community health cadres. These training sessions were critical for testing the application and gathering user feedback. Results: Based on the first year of research, the M Poma application was developed through a collaborative process, including FGDs and in-depth interviews, to ensure the application meets the needs of the community. Year 2 training was conducted for cadres and midwives to provide their valuable input on the application. The M-Poma application has been developed to support exclusive breastfeeding, which is essential for improving infant health. Feedback from Focus Group Discussions (FGD) highlighted the need for content on exclusive breastfeeding, user profiles, and case examples. Training sessions with midwives and community health cadres confirmed that the application is user-friendly, featuring an attractive interface and clear educational materials. Respondents emphasized the importance of a simple login process, engaging visuals, and easily accessible content. The majority of participants found the application’s features intuitive and appreciated the ease of data management within user profiles. Conclusion: While the M-POMA application has made considerable strides, there are still areas that require revision. We highly value the feedback provided by users and remain dedicated to enhancing the application to ensure it is both appealing and efficient.

Development of the Baby Behaviors when Satiated (BABES) behavioral coding scheme

Current infant feeding recommendations promote responsive feeding, wherein caregivers respond to infants' cues to determine feeding pace and duration, to support infant self-regulation and healthy weight outcomes. A central tenet of responsive feeding is that infants will effectively signal hunger, receptiveness to feeding, needs to disengage from feeding, and satiation, yet there is a lack of research available to support this assumption. Rather, previous research illustrates substantial variability exists for the extent to which infants exhibit behavioral cues during feeding and that many mothers feel their infants do not clearly communicate satiation, suggesting certain caregivers need tailored support to understand their infants' needs during feeding interactions. As a first step toward addressing this research gap, we developed the Baby Behaviors when Satiated (BABES) coding scheme, a comprehensive tool that assesses infants' disengagement/satiation behaviors and mothers' responses to infant behaviors and feeding practices during mother-infant feeding interactions. The BABES was applied to 876 videos of bottle-feeding interactions from a prospective, longitudinal study of dyads observed when infants were 1, 2, 4, 6, 9, and 12 months old. Coders achieved moderate to strong inter-rater reliability. Descriptive analyses illustrated that the percentages of infants and mothers exhibiting different behaviors at each age were consistent with developmental trends noted in previous research. Application of this tool within future research holds the potential to create rich datasets allowing for description of intra- and inter-individual variability in infant and mother behaviors and how infants' and mothers' behaviors co-develop across the first year.

Delay of Gratification in Preschoolers with Autism and Concerns for ADHD.

Self-regulation abilities in childhood are predictive of a range of challenges later in life, making it important to identify difficulties in this area as early as possible. Autistic children and those with attention-deficit/hyperactivity disorder (ADHD) often have difficulties with self-regulation, but little is known about the similarities and differences in such abilities across neurodevelopmental conditions. We examined self-regulation using a delay of gratification task in 36-month-old autistic children (n = 20), those showing clinically relevant concerns for ADHD (i.e. ADHD Concerns; n = 24), and Comparison children without these conditions (n = 130); early predictors of self-regulation were also assessed. Both the Autism and ADHD Concerns groups had greater difficulty waiting for a desired snack than the Comparison group. At the longest delay trial (30 seconds), a substantial percentage of autistic children (50%) and those with ADHD Concerns (35%) consumed the snack prematurely, in contrast to only 16% of the Comparison group. Parent-reported temperament-based impulsivity at 18 months and examiner-observed ADHD-like traits at 24 months were associated with increased self-regulation challenges at 36 months, regardless of group. Adjusting for verbal abilities attenuated some of these differences and associations, suggesting that language may be an important mechanism undergirding early self-regulatory abilities. Given possible links between preschool self-regulation and a range of critical functional outcomes, future studies may explore the efficacy of early interventions targeting impulsivity and regulatory behaviors in infants and toddlers at elevated likelihood for developing self-regulation challenges to potentially reduce the impact of these difficulties later in life.

Practical resources for effective postpartum parenting (PREPP): a randomized controlled trial of a novel parent-infant dyadic intervention to reduce symptoms of postpartum depression

BackgroundThere is little known about the effectiveness of psychological interventions to prevent postpartum depression that focus on the birthing parent and infant dyad. Risk factors for PPD include depression during pregnancy, low parenting self-efficacy, and disrupted parental nocturnal sleep. The brief Practical Resources for Effective Postpartum Parenting (PREPP) intervention is designed for pregnant individuals at-risk for postpartum depression, providing them with 1) caregiving strategies aimed at reducing infant fuss and cry behavior and increasing infant sleep, 2) self-reflection and mindfulness skills and 3) psychoeducation about the postpartum period and infant behavior. The aims are to set more realistic postpartum expectations, enhance parenting confidence and sleep via supporting infant regulatory behavior, improve parental affect regulation and ultimately reduce the risk of postpartum depression. ObjectiveAssess the effectiveness of PREPP compared to enhanced treatment as usual in reducing symptoms of depression and anxiety and episodes of infant fuss and cry behavior and improving parental and infant sleep in the early postpartum. Study designA randomized controlled trial was conducted of 175 pregnant individuals. Inclusion criteria were standard prenatal care for a singleton pregnancy, aged 18 to 45 and at increased risk of PPD as determined by a score of ≥19 on the Predictive Index of Postnatal Depression or ≥7 on the Edinburgh Postnatal Depression Scale. Participants assigned to the PREPP group (n=88) received 3 coaching sessions and 2 phone check-ins. Participants assigned to the enhanced treatment as usual group (n=87) received 3 sessions which included psychoeducation, mood assessments, and clinical referral and follow-up as indicated. Assessments were conducted at 28 to 32 weeks and 34 to 39 weeks gestation, and at 6, 12 and 16 weeks postpartum and included measures of parental depression, anxiety and sleep (Edinburgh Postnatal Depression Scale, Patient Health Questionnaire (PHQ-9), Hamilton Rating Scales of Depression and Anxiety and Pittsburgh Sleep Quality Index) and infant sleep and fuss and cry behavior (Baby Day Diary). ResultsCompared to enhanced treatment as usual, PREPP significantly reduced depressive symptoms at 6, 12 and 16 weeks postpartum with medium to large effect sizes (d=0.7-0.98). Compared to enhanced treatment as usual, participants receiving PREPP reported less of a decline in sleep quality at 6 weeks postpartum (p=0.035) and the effect size was large (d=0.83). Moreover, parents receiving the PREPP intervention reported less infant fussing and crying, with the largest effect for morning crying (p<.001; d=-1.48). ConclusionThe results provide evidence that PREPP, initiated during pregnancy, reduced symptoms of parental depression and infant fuss and cry behavior in the early postpartum, compared to enhanced treatment as usual, in a sample at-risk for postpartum depression.

The Impact of Mothers’ Smartphone Use, eHealth Literacy, Maternal Role Performance Confidence, and Online Social Support on Health Promotion Behavior for Infants and Toddlers

Background: This study aimed to identify the factors influencing health promotion behaviors for infants and toddler, focusing on the time spent by mothers using smartphone, eHealth literacy, maternal role performance confidence, and online social support.Methods: This study surveyed 136 women who gave birth to a child in 2023. For this study, recruitment announcements were made on popular parenting websites. Multiple regression analysis was performed to identify the factors affecting health promotion behaviors.Results: The mean age of the participants was 33.8 years, and the mean age of the children was 13.3 months old. Mothers spent 20.2 hours weekly on smartphone to access health information. A total of 86.7% of the respondents indicated that they primarily used the Internet to make health decisions. Factors that influenced health promotion behaviors were role performance confidence (β=0.54, P&lt;0.001), eHealth literacy (β=0.18, P=0.015), online social support (β=0.16, P=0.022), and time spent on smartphone (β=-0.17, P=0.006), with an explanatory power of 51.3% (F=29.43, P&lt;0.001).Conclusions: To improve the health promotion behaviors of mothers for their infants and young children, it is believed that interventions that increase confidence in their roles, online social support, and eHealth literacy are required, and that smartphone screen time should be limited. These baseline data can guide the development of effective intervention programs to improve healthcare for infants and toddlers.

Commercial milk formula marketing entry points: setting the course of infant and young child feeding trajectories

BackgroundThere is a limited understanding of the dynamic influences that shape infant and young child feeding (IYCF) decisions over time. We conducted an innovative qualitative study to reconstruct IYCF trajectories across early life course phases, in the context of the socioecological model (SEM) and the commercial determinants of IYCF.MethodsWomen of different socioeconomic status were interviewed in two large metropolitan areas in Mexico. Our specific goal was to allow us to better understand if and how the commercial milk formula (CMF) marketing influenced breastfeeding decisions in a complex dynamic way involving the individual, relational, community and societal levels.ResultsHospitals, health professionals, and interactions with social media were key category entry points throughout the prenatal, perinatal, early infancy period and beyond. The CMF industry interfered by engaging a wide array of actors across the different layers of the SEM, most prominently the health care system and the workplace. Through its marketing strategies the CMF operates subconsciously and its messages are most effective when health institutions, health care providers, workplace spaces and social norms are weak in their support for breastfeeding.ConclusionsThe cases in our study highlight how, together with a weak breastfeeding counseling system, and health professionals who lack training in breastfeeding and normal infant behavior, lead to the opportunity for CMF marketing to shape infant feeding, and ultimately to the decision to feed formulas that some mothers were not planning to use and cannot afford.

Maternal high BMI: Sex-dimorphic alterations in maternal and offspring stress indices

Maternal body mass index (BMI) influences pregnancy and birth outcomes along with child metabolic and neurodevelopmental health and fetal sex may be a moderating factor in these effects. Alternations in autonomic nervous system (ANS) functioning, identified in heart rate (HR) measurements, could present early markers of these prenatal programming effects in both the mother and the developing fetus. This study examines the associations between pre-pregnancy BMI and maternal and fetal ANS functioning and infant postnatal behavioral outcomes stratified by fetal sex. Pregnant women (N=176) were recruited at gestational week (GW) T1: 12–22 and categorized into Normal (BMI< 25) or High BMI (BMI > 25). Women attended laboratory sessions at T2: GW 23–28, and T3: GW 34–36 to assess maternal and fetal HR and HR variability (HRV) at baseline and after a stressor at T3. Infant behavior was assessed at 4 months using the Infant Behavior Questionnaire-Revised. Women with high BMI bearing female fetuses had higher HR and lower HRV at both gestational time points. Later in the third trimester, female fetuses of high BMI women exhibited lower HRV when challenged with a stressor. At 4 months, female infants were rated as having lower scores on the Orienting/Regulatory scale. Our findings provide evidence of female sex-specific programming of maternal pre-pregnancy BMI on maternal ANS regulation and neurodevelopment identified in-utero and continuing into early infancy.

Childhood anaesthesia and autism risk: population and murine study.

Early childhood exposure to general anaesthesia has been linked to potential changes in infant brain morphology and behaviour in preclinical studies, contributing to long-term behaviours associated with autism spectrum disorder. This study investigates the association between early childhood exposure to general anaesthesia and the risk of autism, using a population-based cohort study with matching for baseline characteristics and evaluates the effect of sevoflurane exposure on autism-like behaviour in mice, using the Taiwan Maternal and Child Health Database. Children aged 0-3 who received at least one exposure to general anaesthesia between 2004 and 2014 were matched 1:1 with children who were not exposed. Risk ratios and confidence intervals were used to assess the relationship between general anaesthesia and the occurrence of autism. Additionally, mice were exposed to sevoflurane for 2 h on postnatal days 5-7, and changes in behaviour related to autism were evaluated. Propensity score matching resulted in 7530 children in each group. The incidence rates (IRs) of autism were 11.26 and 6.05 per 100 000 person-years in the exposed and unexposed groups, respectively. The incidence ratio for autism following exposure to general anaesthesia was 1.86 (95% confidence interval, 1.34-2.59). In mice, sevoflurane exposure induced autism-like behaviours and led to the downregulation of high-risk autism genes, including ARID1B, GABRA5, GABRB3, GRIN2B, SHANK3 and SUV420H1. Early childhood exposure to general anaesthesia is associated with an increased risk of autism. Repeated exposure to sevoflurane in mice induces autism-like behaviours, suggesting a potential link between anaesthesia and the development of autism.

Infant Temperament Is Associated With Milk Cortisol but Not With Maternal Childhood Trauma.

Previous studies have suggested that maternal childhood trauma (MCT) may influence infant temperament, but the underlying physiological mechanisms remain unclear. This study sought to confirm the involvement of breast milk cortisol in the link between MCT and infant temperament. The study sample included 90 mother-infant dyads recruited from the urban Polish population. MCT was assessed based on the Early Life Stress Questionnaire (ELSQ) and infant temperamental factors (surgency/extraversion, negative affectivity, and orienting/regulation) using the Infant Behavior Questionnaire-Revised at 12 months of life. Cortisol was assayed in milk samples collected at 5 months of life using the ELISA method. Based on the ELSQ median, the sample was divided into low and high MCT groups. The ANCOVA models with milk cortisol as a covariant were run to check the effect of low versus high MCT on infant temperament. We found a positive association between milk cortisol and orienting/regulation. Surprisingly, the low and high MCT groups did not significantly differ in milk cortisol. Furthermore, we found that MCT was unrelated to any infant temperamental factor. While recent literature on the association between milk cortisol and infant temperament is inconsistent, our results suggest that high orienting/regulation might be an adaptation to adverse environments such as stress. Moreover, the infant's temperament appears to be more responsive to the current exposition to maternal stress than her experience of traumatic stress.

Infant sensitivity to social contingency moderates the predictive link between early maternal reciprocity and infants' emerging social behavior.

The scientific study of love underscores the importance of dyadic reciprocity in laying the foundation for infants' social development. While research establishes links between early reciprocity and children's social capacities, some infants appear to benefit from reciprocity more than others. A central feature of reciprocity is its contingent structure, that is, the extent to which maternal behaviors are temporally associated with and contingent upon infants' dynamically changing cues. As such, infants' sensitivity to social contingencies may define the extent to which an infant benefits from maternal reciprocity. The current study examined the role of infants' sensitivity to social contingency (SC) in moderating associations between early maternal reciprocity and subsequent infants' social behavior. The study followed 157 children (47% females), across the first year of life (4, 10, and 12 months) and at preschool age (48 months). Infants' SC at 4 and 10 months moderated the link between early maternal reciprocity and infants' prosocial behavior observed at 12 months. SC at 10 months moderated the link between early reciprocity and reported peer problems at 48 months. Maternal reciprocity predicted more helping behavior in infancy and fewer peer problems at preschool, but only for infants who displayed high SC. Findings highlight the contingent nature of reciprocal mother-infant interactions revealing that an infant's sensitivity to breaks in social-contingency moderates the developmental benefit of reciprocity. Future research is necessary to directly test the underlying mechanisms of these processes and better understand the individual characteristics of infants' sensitivity to social contingency and its' role in typical and atypical development. RESEARCH HIGHLIGHTS: Individual differences in infants' sensitivity to breaks in social contingencies may moderate the extent to which infants benefit from contingent reciprocal maternal behavior (i.e., maternal reciprocity). Maternal reciprocity predicted more helping behavior in infancy and fewer peer problems at preschool, but only for infants who displayed high sensitivity to breaks in social contingency. Findings highlight the contingent nature of reciprocal mother-infant interactions revealing that infants' sensitivity to breaks in social-contingency moderates the developmental benefit of reciprocity. Findings emphasize the need to develop measurement methods and direct empirical attention to the important yet understudied individual characteristic of infants' sensitivity to social contingency and its role in shaping social development.

Oral feeding challenges of infants of diabetic mothers.

The presence of diabetes before or during pregnancy can increase perinatal mortality and morbidities. It is well known an infant of a diabetic mother (IDM) may experience complications such as macrosomia, hypoglycemia, respiratory distress syndrome, cardiac anomalies, and other abnormalities of organogenesis. Medical providers including physicians, nurses, and speech therapists have experienced challenges with helping IDMs orally feed. Challenges with oral feeding can lead to prolonged hospital stays and placement of supplemental feeding devices. The etiology of an IDM's oral feeding delays is not well understood and does not necessarily affect all infants. This descriptive review explores what is known about potential contributing factors to feeding difficulty in IDMs, including differences in infant behavior and swallowing mechanics. Some IDMs are unable to maintain active alert states and have decreased autonomic regulation and motor control. Studies of sucking and swallowing demonstrate reduced sucking pressure, fewer sucking bursts, and slowing of esophageal sphincter function. The increasing prevalence of diabetes during pregnancy makes further investigations into the characteristics and trajectories of state, behavior, and oral feeding of IDMs imperative.

35 - Integrating health literacy and cultural considerations into a web-based program promoting healthy behaviours in infants

35 - Integrating health literacy and cultural considerations into a web-based program promoting healthy behaviours in infants

Impaired motor and social skill development in infancy predict high autistic traits in toddlerhood

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder. Early diagnosis in the critical period is important for ASD children. Recent studies of neurodevelopmental behavioral features and joint attention in high-risk infants showed there are some special cues which can distinguish ASD from typical development infant. But the findings of high-risk population may not be applicable to the general population. It is necessary to “analogically” study the potential warning traits of ASD in infancy in the general population. We did a nested case-control study from June 2019 to November 2022 in Tianjin, China, including 76 general infants whom completed the neurodevelopmental evaluation, the Checklist for Autism in Toddlers-23 (CHAT-23) screening, and eye tracking task. Social behavior quotient in infancy was negatively correlated to CHAT-23 total scores in toddlerhood. Social behavior quotient in infancy was positively correlated to initiating joint attention in toddlerhood. Regression model showed that high fine motor scale and social behaviour scale quotient in infancy were associated with an decreased risk of the total score of CHAT-23 ≥ 2 in toddlerhood. The Receiver operating characteristic curve showed the social behaviour in infancy alone and the combination of fine motor and social behaviour in infancy contributed to auxiliary diagnosis of higher level of autistic traits in toddlerhood. These findings suggest that Impaired development of fine motor and social behavior in infancy are potential warning features of high autistic traits in general population.

Protocol for an intervention for new parents experiencing moderate psychosocial adversity: pilot feasibility randomised trial

ABSTRACT Background Parents exposed to psychosocial adversities often experience challenges which, combined with the needs of a new-born infant, can be difficult to manage and increase the risk of poor outcomes for both parents and infants. Psychosocial adversity can disrupt the development of parental-foetal attachment to the baby during pregnancy, which can have a negative effect on parental care and quality of interaction during the postnatal period. This intervention is based on the proposition that enhanced parental capacity to mentalise and emotionally connect to unborn children during pregnancy, and better understanding about how to manage distressing infant behaviour (i.e., persistent crying and sleep problems) will: (i) promote the development of secure parent-infant attachment; (ii) improve antenatal bonding and postnatal parenting; and, (ii) reduce parental distress. Method This protocol is for a pilot randomised control trial evaluating a new intervention, which makes use of innovative technologies to support parents experiencing moderate psychosocial adversity (Australian New Zealand Clinical Trials Registry: ACTRN12622000287730). The New Technology for New Parents (NTNP) intervention provides support using antenatal ultrasound scans and ‘virtual home visits’ during the perinatal period. Quantitative outcomes include mentalising capacity, parental-foetal/infant attachment, and parental competence. Conclusion To the best of our knowledge, no study has evaluated the combined effectiveness of two novel technologies (3D/4D ultrasound scans and virtual home visits) to support parents across the antenatal and postnatal periods. This protocol, which includes the rationale for this innovative intervention, addresses a gap in services for parents experiencing moderate psychosocial adversity.

Mothers' experience seeking healthcare advice for their unsettled infants in Victoria, Australia.

Unsettled infant behaviours are highly prevalent in the postnatal period and constitute a significant proportion of visits to healthcare services. Unsettled infant behaviours can be highly distressing for parents and are identified as a significant risk factor for postnatal depression. Understanding parents' experiences is paramount to reducing the gap between consumer expectations and service delivery. This study employed a qualitative descriptive approach to explore parents' experiences seeking healthcare advice for their infant with unsettled behaviours. Semi-structured interviews were conducted with 20 mothers. Inductive thematic analysis yielded two overarching themes: (1) 'the journey for answers', consisting of five sub-themes, and (2) 'parents' knowledge and behaviours', consisting of six sub-themes. Despite some positive interactions with healthcare services, mothers generally spoke negatively of their overall experience seeking answers and receiving care for their infant, and they felt the healthcare services they attended were not equipped to meet their needs. To address the gap between service delivery and consumer expectations, mothers relied on online communities for advice and emotional support. The findings of this study highlight several discrepancies between mothers' expectations and service delivery in the context of unsettled infant behaviours, and this paper makes recommendations to address identified shortcomings in approaches to care.

Impact of a Brief Parenting Intervention on Parent and Infant Imitation

Research examining the effect of behavioral parenting interventions, such as parent–child interaction therapy (PCIT), on parent and child imitation is limited despite known benefits to early child development. We examined the effect of a brief, home-based adaptation of PCIT, the Infant Behavior Program (IBP), on changes in observed frequency of parent and infant imitation, moderating effects of parent language (English, Spanish), and mediational effects of parent and infant imitation on the effect of intervention on infant behavior problems. Participants were 60 12- to 15-month-olds with elevated behavior problems and their primary caregiver, all of which were mothers. Parent–infant dyads were randomly assigned to receive either the IBP or standard pediatric primary care. Parents receiving the IBP demonstrated significantly higher rates of observed imitation at postintervention and at the 3-month follow-up compared to those receiving standard care, and the effect at postintervention was stronger for English-speaking than for Spanish-speaking families. Although the IBP did not directly affect changes in infant imitation at postintervention or the 3-month follow-up, rates of infant imitation increased significantly for those who received the IBP at the 6-month follow-up. Additionally, moderation results suggested that the IBP led to improvements in infant imitation at post for Spanish-speaking families but not for English-speaking families. There were no significant mediational effects of parent or infant imitation. Future research is needed to examine the impact of increases in imitation on other aspects of child development, such as social–cognitive and language abilities, and to examine how cultural factors may play a role in individual differences in imitation.