Maternal Attention Research Articles

The Effect of Previous Child Death on Infant and Child Mortality in Rural Nepal

Data from the Nepal Fertility Survey 1976, which was carried out by the Nepal Family Planning and Maternal-Child Health Project in collaboration with the World Fertility Survey, is used to explore the interrelationships of sibling mortality. Even when demographic variables are considered, the risk of infant and child death is considerably higher among children of mothers whose previous child died than among those whose previous child survived. An attempt is also made to examine whether it is because of close birth spacing or because of the family environment that the previous child loss puts the subsequent children at an excessive risk of dying during infancy and childhood.

ENHANCED BONDING IN THE HIGH RISK NEONATE

An intervention program designed to enhance maternal infant bonding in high risk dyads significantly improved maternal child behavior and interaction. The preterm neonate, whose appearance, behavior and prognosis violate maternal expectations, has disrupted mother-infant relationship because of diminished contact, erratic responsivity and stressed maternal emotions.Thirty four mothers of high risk infants (BW 1630±330g, GA 32+2 wks, Parmalee risk factor 77.5±12.3) comprised the study group, and were exposed to videotapes designed to reduce emotional crises, increase confidence, and enhance ability to interact with the infant. Mother infant contact, discussion, and demonstrations followed each session. Controls consisted of mothers of 35 infants (BW 1590±380g, GA 32±2, Parmalee risk factor 72.5±15.3), exposed to conventional communication.Evaluation with a behavioral rating scale was performed one month post discharge (GA 40±lwk). The results demonstrated increased maternal attention (P 0.01), maternal responsivity (P 0.05) and maternal infant mutuality (P 0.05) in the study group. Repeat examination at 8 months post discharge showed increased smiling behavior (P 0.01) in study infants. Significant inverse correlations were noted between the effects of intervention and socioeconomic status. In these mother-infant dyads improved relationships were achieved by a specifically designed program.

64 NEONATAL ABSTINENCE SYNDROME (NAS) AND INTERACTIVE BEHAVIORS AT 1 AND 30 DAYS OF LIFE

Several studies have investigated differences in the behavior of newborns with NAS and non-addicted infants, using the Brazelton Neonatal Behavioral Assessment Scale (BNBAS). However, the most consistent differences found are for those items reflected in the clinical assessment of the abstinence syndrome, i.e. irritability, tremulousness, jerkiness of motor movement and increased muscle tone. In this study 25 infants born to drug dependent women were evaluated. The BNBAS was used but was scored using the a priori cluster method so that the infants' interactive organization could be evaluated. Scores given for Interaction Dimension were: 1=superior; 2=adequate; 3=deficient. At 1 day of age all infants who later would require pharmacotherapy for NAS had deficient interaction scores (x=3). Infants who never required treatment had a x of 2.1. At 30 days of age, infants who never required treatment had a x of 2.2 and infants who required treatment but were drug free by 30 days had a x of 1.7. Infants still receiving treatment at 30 days had a x of 2.2. There appear to be differences within the latter group. Infants whose mothers rarely came to visit had a x of 2.6 whereas infants whose mothers visited on a regular basis had a x of 1.8. Poor interaction of the infants may have caused avoidance by the mothers or maternal attention may have improved the infants' interaction. These data indicate the possibility that NAS has a deleterious and complex effect on infant-caregiver interaction.

The arrival of sibling: changes in patterns of interaction between mother and first-born child.

SUMMARYInteraction between mother and firstborn child before and after the birth of a second child was studied in 41 families, using home observations and interview techniques. Decreases in maternal attention and play, increases in confrontation, and changes in the balance of responsibility for initiating interaction were found. Changes in patterns of association between maternal and child variables after the birth of the sibling were primarily the result of changes in individual differences in child behaviour.

Some effects of strain differences in the maternal behavior of inbred mice.

The frequencies of occurrence of a variety of activities were recorded for inbred female mice of 3 strains in the presence of their own offspring, in the presence of isogenic fostered offspring, and in the presence of nonisogenic fostered offspring. Differences in the frequency of nursing, of grooming and handling the offspring, and of the absence of the female from the nest were related to differences in the rate of early postnatal development of 2 of these strains: in general, those pups receiving less maternal attention developed more rapidly. The effective stimulus for accelerated maturation may lie in the sequential organization of the manipulation of the offspring by the foster mother, rather than in the overall quantity of manipulation received.

Effect of a reliability observer on the frequency of positive parent behavior recorded during naturalistic parent-child interactions

The purpose of the present study was to examine the effect of the presence of a reliability observer on the number of positive parent behaviors recorded by a primary observer during naturalistic parent-child interactions. Thirty parents and their young clinic-referred children served as subjects. After two initial home observations, a reliability observer was present to record data in observation session 3, but not session 4, for one-half the subjects. For the remaining subjects the reliability observer was present in session 4 but not session 3. The results of a 2 × 2 analysis of variance indicated a group by session interaction which resulted from an increase in maternal attention to the child in the presence of a reliability observer. Hypotheses to explain the finding are presented and implications of the results are discussed.

Perceived infant temperament, locus of control, and maternal physiological response to infant gaze

Maternal physiologic response was used as an index of maternal attention to infant eye contact. Thirty-six women, each of whom had a 3-month-old infant, were shown 10-sec silent images of a 3-month-old infant on a videotape monitor. In one condition the en face position offered eye contact, in the other condition eye contact was not possible. Each woman viewed a sequence of six identical episodes of one condition followed by six episodes of the other condition. Heart rate and skin conductance were recorded continuously during the session. Skin conductance response did not differentiate between reciprocated and unreciprocated gaze. Cardiac response elicited by reciprocated gaze viewed first shifted from a predominately orienting response on early trials to an acceleratory response on Trial 6. The acceleratory response was most pronounced in those women identified as Externals by the Locus of Control Inventory ( Rotter, J. B. Psychological Monographs, 1966 , 80, [No. 609]). Initial viewing of the infant looking away elicited a predominantly deceleratory heart-rate response that did not habituate. Mothers who described their infants as being difficult as assessed by the questionnaire method ( Carey, W. B. Journal of Pediatrics, 1970 , 77, 188–194) were physiologically less sensitive to the change from the infant's averted gaze to its direct gaze. Results are discussed in terms of the role of direct and averted gaze during social transactions.

Effects of birth order and spacing on mother–infant interactions.

Early differences in mother-infant interaction were examined as a function of infant birth order and birth spacing. One hundred ninety-three 3-monthold infants and their mothers were observed in the home for a 2-hour period during which a wide variety of mother and infant behaviors were recorded. Birth-order effects were significant, with firstborns generally receiving and emitting behavior more frequently than later borns. Birth-spacing effects were significant for maternal behavior, such that very closely and widely spaced infants received more maternal attention than middle-spaced groups. Both biological and environmental interpretations of these data are offered. The data are related to the theoretical model of the reciprocal nature of the infant-caregiver relationship. The status of the infant in the family constellation was chosen as the context in which to observe mother-infant interaction. The birth order and birth spacing of infants were considered because these family status variables are hypothesized to have an impact on infant and caregiver behavior. In the case of the caregiver, the amount of available time and energy that can be devoted to a given child may be affected by the number of children in the family and the spacing between a given child and the next older and younger siblings. For example, a mother's time and energy might, by necessity, be more divided between two children spaced 2 years apart than two children spaced 6 years apart, especially when the younger child is an infant. In the 2-year spacing, the older child would not yet be self-sufficient and would need consistent care and attention, which might take the mother away from the infant, whereas in the 6-year spacing, the older child would be in school, developing a social network

Maternal physiological response to infant signals.

ABSTRACTThe present study reports the use of maternal physiologic responses as an index of maternal attention to infant signals. Thirty‐two women, each of whom had a 3‐month‐old infant, were shown 10‐sec silent images on a videotape monitor of a 3‐month‐old infant, en face, exhibiting either a smiling or a crying facial expression. Heart rate and skin conductance were recorded continuously while each woman viewed a sequence of 6 identical episodes of one expression followed by 6 episodes of the other expression. Both cardiac and skin conductance responses to the smile expression decreased following repeated presentations of the cry stimulus. Cardiac deceleration to the cry was prolonged following the viewing of the smiling infant. Mothers' perception of their own infants' temperament assessed by the Carey Infant Temperament Questionnaire (1970) was systematically related to maternal heart rate response. Mothers who described their infants as more difficult were physiologically less sensitive to changes in infant expressions. Results are discussed in terms of the impact of infant signals upon developing mother‐infant reciprocity.

A controlled demonstration of the effectiveness of electric shock in the elimination of chronic infant rumination.

An aversive therapy program was used to eliminate chronic ruminative vomiting in a nine‐month‐old infant, hospitalized with severe weight loss, malnutrition, and secondary medical complications judged potentially fatal by the pediatric staff. A trial of thickened feedings and continuous maternal attention conducted on the pediatric ward before this intervention proved ineffective. In contrast to previous uncontrolled case reports, the present study included an extended pretreatment baseline and a treatment reversal, in which potentially relevant variables such as ward routines, observers, and apparatus remained constant. During treatment, a series of 0.5‐sec shocks were delivered at 0.5‐sec intervals when a ruminating sequence was observed and then terminated when it ceased. Shock intensity was set at a level that resulted in a startle response and produced fussing but failed to elicit crying. Treatment location and the individuals present were systematically varied to facilitate generalization. Ruminating dropped from a five‐day baseline mean of 114 to a single instance on treatment Day 3. During the three‐day treatment reversal, in which the shock source was disconnected, ruminating increased from four instances on the first day to 10 by the third day. Because of clinical considerations, however, shock was re‐introduced before ruminating reached pretreatment baseline levels. Reductions in ruminating were accompanied by significant weight gains, a decrease in crying, and an increase in interactions with staff and parents. The infant was discharged on the tenth day of the second treatment period. Followup evaluations conducted nine months after discharge showed that, despite several instances in the immediate two‐week posttreatment period, rumination no longer occurred and developmental progress was within normal limits. This article presents detailed procedural descriptions, discusses the problem of determining when to terminate treatment, considers nutritional management, and compares the relative effectiveness of an alternative aversive stimulus, concentrated lemon juice.

Diagnóstico da situação de assistência pré-natal em uma divisão regional de saúde do Estado de São Paulo, Brasil

Tomando por base a importância do diagnóstico da situação de Saúde de uma área, para qualquer planejamento e avaliação de programas, foi feito um diagnóstico da área de pré-natal da Divisão Regional de Saúde-5, da Secretaria de Saúde do Estado de São Paulo, utilizando modelo de "acreditação" e alguns itens de avaliação quantitativa. Foi diagnosticada a situação como sofrível, mostrando aumento da relação custo/benefício. Os itens que envolvem investimentos em dinheiro estavam razoavelmente preenchidos, porém, os serviços não funcionavam adequadamente por falta de programação e coordenação.

TRAINING PARENTS AS BEHAVIOR MODIFIERS: SELF‐RECORDING OF CONTINGENT ATTENTION1

Two mothers of deviant young children were instructed to count their episodes of attention to appropriate child behavior in their homes, using wrist counters. Attention and appropriate child behavior were defined before counting began. Independent observations of parent-child interactions showed that, for each mother-child pair, the percentage of maternal attention given following appropriate child behavior increased, as did the child's appropriate behavior. Removal of the counters did not produce a reversal of the behaviors; instead the increased level stabilized. One mother was then instructed to count her attention to inappropriate child behavior and to decrease it. This instruction had little effect on her attention, and her child's behavior did not change. When both parents were again instructed to count their episodes of attention to appropriate behavior, further improvements in both mothers, and in their children resulted. These results were obtained despite inaccurate parent self-recording. Follow-up observations made over the next five months showed these behavioral gains to be durable. A third parent and his child were unaffected by this training procedure. Thus, there are instances in which self-recording may function as an effective and economical parent-training technique for effecting improvements in child behavior.

Style of adaptation to perceived aversive maternal stimulation and selective attention to evaluative cues.

Style of adaptation to perceived aversive maternal stimulation and selective attention to evaluative cues.

The treatment of encopresis by the management of social consequences

It was hypothesized that long-lasting soiling behavior in a 9-year-old physically healthy encopretic boy, otherwise normal apart from a mild stuttering problem and minor physical ailments, was being maintained by the attentions of his mother. Despite the total lack of understanding of the rationale involved, the mother agreed to cooperate in the psychologist's rearrangement of social consequences to insure that soiling behavior was no longer being reinforced by maternal attention. Rapid extinction of the soiling behavior occurred with no apparent relapse, symptom substitution, or other adverse sequelae over a 3-month follow-up period.