Parent-infant Interaction Research Articles

An Integrated Review of Transitional Care for Families of Pre-Term Infants

This study was conducted to identify the key elements of transitional care for families with pre-term infants in South Korea. We used an integrative review methodology proposed by Whittemore and Knafle. During the problem identification step, the review question was constructed via the population, intervention, outcome, and timeframe (PIOT) format. During the literature search step, integrative reviews of the published literature from nine electronic databases were undertaken and a total of 14 studies were reviewed that met our inclusion criteria. During the data evaluation step, the quality of the literature was assessed using the Mixed Methods Appraisal Tool (MMAT) developed by Hong et al. We identified three domains and 10 key attributes of transitional care for families of pre-term infants. The parenting empowerment domain included growth and development, developmental promotion, nutrition, safe environment, general parenting, and parent–infant interaction. The emotional support domain included counseling, advocacy, and community network. The social support domain included professional collaboration. Efforts should continue to further develop programs and policies to enhance transitional care for families of pre-term infants that reflect South Korean nursing practices.

Strategies to support language development in neonatal intensive care unit: a narrative review.

Despite neonatal intensive care advancements and quality improvements, preterm infants often experience delays in speech and language development during early childhood. The etiological pathway of language delays is multifactorial, including younger gestational age at birth, male sex, pregnancy complications including gestational diabetes mellitus and preeclampsia, organic pathology from neonatal morbidities, environmental factors of the neonatal intensive care unit (NICU) and prolonged hospitalization, home environment including socioeconomic status and parental education, and parent-infant interactions. As early language experiences and environments are crucial for the development of language processing, strategies to support language development should be implemented from the NICU onward. This study aimed to summarize evidence-based strategies for language development through an extensive review of nutrition, NICU environment, language and sound exposure, developmental care interventions, and family-centered care. Promoting breastfeeding, increasing parent-infant interactions in a single-family room setting, nurturing the language environment via parental book reading and language interventions, and parent-integrated interventions in the NICU could potentially enhance language development among preterm infants. These supportive strategies can be integrated through family-centered care, which recognizes parents as primary caregivers and collaborative partners.

Paternal and Maternal Speech at 3 Months Postpartum: An Exploratory Study on the Effect of Parental Role and Birth Weight

Recent research highlights a growing interest in early interactions between fathers and their infants, acknowledging the significant influence these interactions have on developmental outcomes. However, there is a limited understanding of the specific characteristics of paternal infant-directed speech (IDS), especially in the context of premature birth. This study aimed to analyze the functional and morpho-syntactic features of paternal IDS to full-term (FT) and preterm (PT) infants at 3 months, comparing it with maternal communicative style. Additionally, the study explored the influence of the severity of preterm birth according to birth weight, further distinguishing between extremely low-birth-weight (ELBW) and very low-birth-weight (VLBW) infants. Seventy-one father–infant and mother–infant dyads (24 FT, 22 ELBW, 25 VLBW) were recruited at 3 months (corrected age for PTs). Parent–infant interactions were video recorded to assess lexical, syntactic, and functional aspects of paternal and maternal speech. Results revealed lower verbosity and lexical variability in paternal IDS compared to the maternal one. No differences were found between parents of the PT and FT groups. Overall, these findings could contribute to better understanding the patterns of parent–infant communications in both FT and PT dyads, confirming the importance of involving both mothers and fathers from the early stages of development.

Exploring predictors of interaction among low-birth-weight infants and their caregivers: a machine learning–based random forest approach

BackgroundQuality caregiver-infant interaction is crucial for infant growth, health, and development. Traditional methods for evaluating the quality of caregiver-infant interaction have predominantly relied on rating scales or observational techniques. However, rating scales are prone to inaccuracies, while observational techniques are resource-intensive. The utilization of easily collected medical records in conjunction with machine learning techniques offers a promising and viable strategy for accurate and efficient assessment of caregiver-infant interaction quality.MethodsThis study was conducted at a follow-up outpatient clinic at two tertiary maternal and infant health centers located in Shanghai, China. 68 caregivers and their 3-15-month-old infants were videotaped for 3–5 min during playing interactions in non-threatening environment. Two trained experts utilized the Infant CARE-Index (ICI) procedure to assess whether the caregivers were sensitive or not in a dyadic context. This served as the gold standard. Predictors were collected through Health Information Systems (HIS) and questionnaires, which included accessible features such as demographic information, parental coping ability, infant neuropsychological development, maternal depression, parent-infant interaction, and infant temperament. Four classification models with fivefold cross-validation and grid search hyperparameter tuning techniques were employed to yield prediction metrics. Interpretable analyses were conducted to explain the results.ResultsThe score of sensitive caregiver-infant interaction was 6.34 ± 2.62. The Random Forest model gave the best accuracy (83.85%±6.93%). Convergent findings identified infant age, care skills of infants, mother age, infant temperament-regulatory capacity, birth weight, positive coping, health-care-knowledge-of-infants, type of caregiver, MABIS-bonding issues, ASQ-Fine Motor as the strongest predictors of interaction sensitivity between infants and their caregiver.ConclusionsThe proposed method presents a promising and efficient approach that synergistically combines rating scales and artificial technology to detect important features of caregiver-infant interactions. This novel approach holds several implications for the development of automatic computational assessment tools in the field of nursing studies.

Shaping linguistic input in parent-infant interactions: The influence of the Infant's temperament.

Parent-infant interactions highlight the role of parental input, considering both the quality, infant-directed speech, and quantity of interactions, adult words and communicative turns, in these interactions. However, communication is bidirectional, yet little is known about the infant's role in these interactions. This study (n=35 4-month-old infants) explores how infant-directed speech, the number of adult words and turn-taking (both measured by the LENA system) are correlated with infants' temperament. Our findings reveal that, while mothers use the typical characteristics of infant-directed speech, they are not correlated with the infant's temperament. However, we observe more adult-infant turn-taking in both introverted infants (with lower Surgency scores) and infants with lower attention regulation (with lower Regulatory/Orienting scores). The number of adult words was not correlated with infants' temperament. We suggest that infants with an introverted temperament prefer quieter exchanges that may lead to more turns and that infants with lower attention regulation might create more opportunities for interactions due to their lower level of self-regulation. These findings suggest that infants' temperament is associated with how adults talk with infants (communicative turns) rather than how adults talk to infants (infant-directed speech, number of adult words). Our results underscore the infant's role in parent-infant communication.

Associations between shared book reading, daily screen time and infants’ vocabulary size

Abstract In the current pre-registered study, we examined the associations between shared book reading, daily screen time, and vocabulary size in 1,442 12- and 24-month-old Norwegian infants. Our results demonstrate a positive association between shared reading and vocabulary in both age groups, and a negative association between screen time and vocabulary in 24-month-olds. Exploratory analyses revealed that the positive relationship between shared reading and expressive vocabulary in 12-month-olds was stronger in lower SES groups, suggesting that shared reading may act as a compensatory mechanism attenuating potentially impoverished learning environment and parent-infant interactions in low-SES families.

Estimation of human body 3D pose for parent-infant interaction settings using azure Kinect and OpenPose

Automatic pose estimation has become a valuable tool for the study of human behavior, including dyadic interactions. It allows researchers to analyze the nuanced dynamics of interactions more effectively, and facilitates the integration of behavioral data with other modalities (EEG, etc.). However, many technical difficulties remain. Particularly, for parent-infant interactions, automatic pose estimation for infants is unpredictable; the immature proportions and smaller bodies of children may cause misdetections. OpenPose is one tool that has shown high performance in pose tracking from video, even in infants. However, OpenPose is limited to 2D (i.e., coordinates relative to the image space). This may be undesirable in a multitude of paradigms (e.g., naturalistic settings). We developed a method for expanding the functionality of OpenPose to 3D, tailored to parent-infant interaction paradigms. This method merges the estimations from OpenPose with the depth information from a depth camera to obtain a 3D pose that works even for young infants.•Video recordings of interactions of parents and infants are taken using a dual color-depth camera.•2D-positions of parents and their infants are estimated from the color video.•Using the depth camera, we transform the 2D estimations into real-world 3D positions, allowing movement analysis in full-3D space.

The effects of telepresence with real-time video and audio communication on parent-infant interaction and staff experience in neonatal intensive care unit

ObjectiveWe implemented an online visitation system named “telepresence” in the neonatal intensive care unit (NICU) for family members at home to communicate with their babies in real-time using video and audio. This study evaluated the impact of this system on families and medical staff. MethodsNineteen families of babies admitted to the NICU between 2022 and 2023 and 65 medical staff participated. Each family experienced two weeks of virtual visits. Changes in parental depression and attachment were assessed. ResultBefore and after telepresence, the median Edinburgh Postnatal Depression Scale score reduced from 6 to 4 (p = 0.026), and the Mother-to-Infant Bonding Scale score showed a decreasing trend, with both medians at 2 (p = 0.057). Eighty-nine percent of the parents and 97% of staff reported that telepresence did not increase parental stress, and 88% of parents felt positive changes in their baby's siblings. All parents wanted to visit their babies in person after seeing them on camera. ConclusionTelepresence improved parental mental health, reduced family distress, and supported connection with their infants, making them eager to visit in person. InnovationsThis technology potentially make parents want to visit more by helping them feel more connected to their infants.

Parent-infant interaction trajectories in infants with an elevated likelihood for autism in relation to 3-year clinical outcome.

Developmental antecedents of autism may affect parent-infant interactions (PII), altering the context in which core social skills develop. While studies have identified differences in PII between infants with and without elevated likelihood (EL) for autism, samples have been small. Here, we examined whether previously reported differences are replicable. From a longitudinal study of 113 EL and 27 typical likelihood infants (TL), 6-min videotaped unstructured PII was blind rated at 8 and 14 months on eight interactional qualities. Autism outcome was assessed at 36 months. Linear mixed-effects models found higher parent sensitive responsiveness, nondirectiveness, and mutuality ratings in TL than EL infants with and without later autism. PII qualities at 8 (infant positive affect, parent directiveness) and 14 months (infant attentiveness to parent, mutuality) predicted 3-year autism. Attentiveness to parent decreased between 8 and 14 months in EL infants with later autism. This larger study supports previous findings of emerging alterations in PII in this group and extends on this by detecting earlier (8-month) predictive effects of PII for autism outcome and a more marked trajectory of decreased social attentiveness. The findings strengthen the evidence base to support the implementation of early preemptive interventions to support PII in infants with early autism signs.

Adaptation of SafeCare, an evidence-based parenting program, for caregivers of infants in the neonatal intensive care unit

BackgroundWhile there are several parenting programs for NICU caregivers, no studies, to our knowledge, have developed parenting programs aimed at preventing child maltreatment that specifically address these parental factors: parental stress, parental self-efficacy, and positive parent-infant interaction. ObjectivesThe objectives of this study were to: 1) Identify adaptations and/or augmentations needed to optimize SafeCare® for NICU caregivers, and 2) Examine the acceptability and preliminary effects of the adapted SafeCare NICU (SCNC) program with NICU caregivers. MethodsThis study consisted of two phases: formative (phase one) and pilot (phase two). For phase one, 5 NICU former caregivers and 5 NICU staff were interviewed to make relevant, NICU-specific adaptations for SCNC. Phase two consisted of a pilot study, where 13 current NICU caregivers were enrolled in the adapted SCNC program. Outcomes included acceptability and preliminary effects of parental stress, parental self-efficacy, and parent-infant interaction. ResultsAdaptations to SafeCare consisted of adding a pre-session to discuss individualized experiences, incorporation of adjusted developmental milestones, a NICU-specific resource sheet, and individualized adaptations to activities based on relevant medical concerns. Out of the 13 participants, 8 completed SCNC (61.5 % retention rate). Participants indicated significant reductions in stress after SCNC (Parental stress index score = 61.7) compared to baseline (79.2, p = 0.02). Among participants who completed SCNC (n = 8), all stated they supported this program for implementation among NICU caregivers. DiscussionThe adapted SCNC demonstrated acceptability among NICU caregivers.

Identifying vulnerable mother-infant dyads: a psychometric evaluation of two observational coding systems using varying interaction periods.

Clinical services require feasible assessments of parent-infant interaction in order to identify dyads requiring parenting intervention. We assessed the reliability and predictive validity of two observational tools and tested whether briefer forms could be identified which retain acceptable psychometric properties over short observation periods. A stratified high-risk community sample of 250 mother-infant dyads from The Wirral Child Health and Development Study completed 7-min play-based interaction at 6-8 months. Film-footage was independently coded by two trained raters using PIIOS and NICHD-SECCYD systems. Incremental predictive validity was assessed from 3, 5 and 7 min observation to attachment outcomes (Strange Situation; 14 months) and infant mental health (BITSEA; 14 and 30 months). Excellent inter-rater reliability was evident at code and subscale level for each tool and observation period. Stability of within-rater agreement was optimal after 5 min observation. ROC analysis confirmed predictive (discriminant) validity (AUCs >0.70) to top decile age 2 mental health outcomes for PIIOS total score and a brief 3-item composite from NICHD-SECCYD (sensitivity, intrusiveness, positive regard; NICHD-3), but not to attachment outcomes. Logistic regression showed dyads rated at-risk for externalizing problems using NICHD-3 were also at significantly higher risk for insecurity at 14 months (OR = 2.7, p = 0.004). PIIOS total and NICHD-3 ratings from 5 min observation are both reliable and valid tools for use in clinical practice. Findings suggest NICHD-3 may have greater utility due to its comparative brevity to train and code, with suitability for use over a broader developmental time frame (3-24 months).

Factors affecting parental role adaptation in parents of preterm infants after discharge: a cross-sectional study.

Parenting a preterm infant can be incredibly challenging and stressful, particularly in the first year after discharge. Desirable parental role adaptation leads to appropriate parenting behaviors and parent-infant interaction, which are essential to child health and development. To investigate the level of parental role adaptation and its influencing factors among parents of preterm infants in the first year after hospital discharge according to Belsky's parenting process model among parents of preterm infants in the first year after hospital discharge. A cross-sectional study design was adopted using convenience sampling. Data were collected using the Parental Role Adaptation Scale (PRAS) in parents with preterm infants, the Perceived Social Support Scale (PSSS), the Coping Adaptation Processing Scale (CAPS-15), and a sociodemographic questionnaire. Descriptive statistics, non-parametric tests, Spearman correlation analyses, and multivariate linear regression were used to analyze the data. In total, 300 Chinese parents were included in the analysis. In the multivariate analysis, first-time parent (p = 0.003), master's degree and above (p = 0.042), coping adaptation processing (p = 0.000), residence location (towns: p = 0.019, city: p = 0.028), monthly family income (6000-10,000: p = 0.000, >10,000: p = 0.000), and perceived social support (p = 0.001) were all significant predictors of parental role adaptation and collectively accounted for 56.8% of the variation in parental role adaptation of parents with preterm infants (F = 16.473, p < 0.001). Coping adaptation processing mediated the relationship between perceived social support and parental role adaptation (95% bootstrap CI = 0.022, 0.130). Chinese parents of preterm infants experience a moderate level of parental role adaptation when their child is discharged from the hospital to home. Parents who are not first-time parents, have master's degrees or above, live in towns or cities, have higher coping and adaptation abilities, have high monthly family income, and greater perceived social support have a higher level of parental role adaptation. Healthcare providers should pay more attention to parents with low socioeconomic status and encourage them to improve their coping and adaptation abilities and to utilize their formal and informal social support networks.

Less frequent face looking in infancy is related to autism likelihood status but not diagnosis: A study of parent-infant interaction

BackgroundPrevious research suggest that autistic children look less at faces than neurotypically developing children, but this finding is based predominantly on screen-based eye tracking studies, with unfamiliar faces used as stimuli. The aim of the current study was to assess 10-month-olds’ gaze to faces in a more naturalistic context - during free play with a parent - in relation to later autism diagnosis. MethodParents were asked to play with their infant ‘as they usually would’ with a set of toys on the floor. During the first 5 min of play, infant gaze to parent’s face was video coded. ResultsInfants at elevated likelihood of autism (N = 18 with later diagnosis; 46 without later diagnosis), regardless of later diagnostic status, produced fewer gaze shifts towards their parents’ faces than infants at low likelihood of autism (N = 18). Infants in all groups spent only ∼3 % of their time looking at parents’ faces, and there was no group difference in terms of the proportion of time spent looking at faces. There was neither a correlation between infant face looking and scores on the Autism Diagnostic Observation Schedule-2, nor between infant face looking and autistic traits in the parent. ConclusionsDuring toy play, all infants – irrespective of later diagnosis – spent very little time looking at parents’ faces. Infants at elevated likelihood of autism made fewer gazes to their parents’ faces than neurotypically developing infants, which could potentially affect opportunities for social learning. The effect was not specifically linked to later autism diagnosis.

Socioeconomic inequalities in the uptake of postpartum care at home across Dutch neighbourhoods.

Postpartum care focuses on prevention of health problems by performing medical check-ups and through enhancing maternal empowerment, the parent-infant interaction and knowledge about mother's own health and that of her newborn. We aimed to investigate whether there was significant clustering within neighbourhoods regarding the uptake of postpartum care and to what extent neighbourhood-level differences are explained by individual socio-demographic factors, pregnancy-related factors and neighbourhood-level determinants (i.e. deprivation and urbanization). A nationwide population-based observational study was carried out using linked routinely collected healthcare data from appropriate-for-gestational-age weight live-born term singleton deliveries (2015-18) in the Netherlands. We performed two-level multivariable logistic regression analyses, using three different models. Model 1 contained no explanatory variables and was used to assess clustering of postpartum care uptake within neighbourhoods. In model 2, individual-level determinants were added one by one and in model 3, neighbourhood-level determinants were added. About 520818 births were included. Multilevel modelling showed that 11% of the total variance in postpartum care uptake could be attributed to the neighbourhood of residence. Individual characteristics explained 38% of the neighbourhood variance, of which income and migration background were the most important contributors. An additional 6% of the variation could be explained by neighbourhood-level determinants. We found substantial neighbourhood differences in postpartum care uptake. These differences are influenced by a complex interplay between individual-level and neighbourhood-level determinants, highlighting the importance of addressing both individual and neighbourhood-level determinants to improve the uptake of postpartum care and therewith overall community health.

Parental sensitivity and family conversation: A naturalistic longitudinal study with both mothers and fathers across three time-points in early infancy.

Parental verbal sensitivity is known to promote child language skills, but few studies have considered: (a) links between global (i.e., verbal, behavioral, and affective) measures of parental sensitivity and infant-initiated conversations, an important precursor to language development; (b) whether maternal and paternal sensitivity show similar links with infant-initiated conversation; or (c) the transactional role of infant conversation for later parental sensitivity. Addressing these gaps, this study of 186 British first-time parents (93 families) examines the developmental dynamics between parental sensitivity and infant communication across the first year of life. We explore; (i) the role of maternal and paternal sensitivity (assessed during structured home observations at 4 months post-partum) for parent-infant conversational interactions at 7 months (indexed by day-long naturalistic recordings), and (ii) whether these mother-infant and father-infant conversations at 7 months shape maternal and paternal sensitivity at 14 months (also assessed via structured home observations). For both male and female infants, maternal (but not paternal) sensitivity at 4 months predicted infant vocalisations and conversational initiation at 7-months. By contrast, neither index of infant talk predicted maternal or paternal sensitivity at 14 months. Together these findings refine understanding of theoretical models of social development and suggest new possibilities for future research.

How does social contingency facilitate vocabulary development?

Previous research shows that infants of parents who are more likely to engage in socially contingent interactions with them tend to have larger vocabularies. An open question is how social contingency facilitates vocabulary growth. One possibility is that parents who speak in response to their infants more often produce larger amount of language input, which accelerates vocabulary growth. Another possibility is that the simplicity of contingent language input is especially suitable to support early word learning. A third possibility is that more evidence of the communicative nature of language, achieved through frequent contingent responses, helps infants build a link between their own words or vocalizations and others' behaviors. This link may lead to a better understanding of the communicative nature of language and further language advances, including vocabulary growth. To distinguish between these hypotheses, we analyzed the relations between parent-infant interactions when infants were 9 months and their vocabulary size at 12 months, using a naturalistic corpus. Our findings show that the frequency of parents' verbal contingent responses predicts receptive vocabulary size at 12 months and this predictive relation is unlikely to be due to the amount of language input or the simplicity of language within socially contingent interactions. RESEARCH HIGHLIGHTS: Infants of parents who respond to their vocalizations more often during the first year of life tend to have larger vocabularies in the second year. It is an open question what drives the predictive relation between parents' responsiveness and infants' vocabulary; we tested three hypotheses that offer competing explanations. More responsive parents might provide (1) more language input, (2) simpler language input, (3) more evidence of the communicative nature of language (via frequent responses). We find support for the third hypothesis; the frequency of parents' responses predicts infants' vocabularies above and beyond the amount and simplicity of language input.

Heart-to-heart: infant heart rate at 3 months is linked to infant-directed speech, mother-infant interaction, and later language outcomes.

Previous studies underscore the importance of speech input, particularly infant-directed speech (IDS) during one-on-one (1:1) parent-infant interaction, for child language development. We hypothesize that infants' attention to speech input, specifically IDS, supports language acquisition. In infants, attention and orienting responses are associated with heart rate deceleration. We examined whether individual differences in infants' heart rate measured during 1:1 mother-infant interaction is related to speech input and later language development scores in a longitudinal study. Using a sample of 31 3-month-olds, we assessed infant heart rate during mother-infant face-to-face interaction in a laboratory setting. Multiple measures of speech input were gathered at 3 months of age during naturally occurring interactions at home using the Language ENvironment Analysis (LENA) system. Language outcome measures were assessed in the same children at 30 months of age using the MacArthur-Bates Communicative Development Inventory (CDI). Two novel findings emerged. First, we found that higher maternal IDS in a 1:1 context at home, as well as more mother-infant conversational turns at home, are associated with a lower heart rate measured during mother-infant social interaction in the laboratory. Second, we found significant associations between infant heart rate during mother-infant interaction in the laboratory at 3 months and prospective language development (CDI scores) at 30 months of age. Considering the current results in conjunction with other converging theoretical and neuroscientific data, we argue that high IDS input in the context of 1:1 social interaction increases infants' attention to speech and that infants' attention to speech in early development fosters their prospective language growth.

Mellow Babies: A Randomised Feasibility Trial of an Intervention to Improve the Quality of Parent-Infant Interactions and Parental Mental Wellbeing.

Mellow Babies aims to improve mothers' mental wellbeing and the quality of their interactions with their baby. The feasibility of a definitive trial of Mellow Babies was assessed using a waiting-list randomised pilot trial (Clinicaltrials.gov: NCT02277301). Mothers with substantial health/social care needs and a child aged <13 months were randomly allocated either to a 14-week Mellow Babies programme or to receive usual care whilst on a waiting list for the intervention. Rates of recruitment and retention as well as participants' views of their experience in this study were recorded. Outcomes were parenting behaviour, assessed by the blind-rated Mellow Parenting Observation System (primary) and self-report maternal wellbeing pre- and post-intervention/waiting period. We recruited 38 eligible participants: 36 (95%; 18 intervention, 18 control) completed baseline measures, and 28 (74%; 15 intervention, 13 control) provided post-intervention data. Two practitioners took part in feedback interviews. Intervention participants had significantly more positive interactions with their babies at post-intervention compared to those in the control group (p = 0.019), adjusted for pre-intervention scores. There was no significant improvement in mothers' mental wellbeing on any measure. A definitive trial of Mellow Babies is feasible and should include longer follow up of mothers and the opportunity for fathers to take part.

Offline and online parental mentalizing in mothers with symptoms of postpartum depression: Examining the association between self-reported parental reflective functioning and interactional mind-mindedness.

Mentalizing is, to a certain extent, considered context specific. However, research on the association between parents' abilities to reflect upon their infant's mental states outside social interaction (offline) versus during ongoing parent-infant interaction (online) is currently limited. This study investigated the association between self-reported offline and online mentalizing in a sample of primarily ethnically Danish mothers (N=142), with symptoms of postpartum depression, and their 1-11-month-old infants. Offline mentalizing was assessed with the Parental Reflective Functioning Questionnaire-Infant Version (PRFQ-I) and online mentalizing was assessed with interactional mind-mindedness. Ordinal logistic regressions showed that a higher score on the PRFQ-I prementalizing subscale was negatively related to number of overall mind-related comments and appropriate mind-related comments produced by mothers during interaction with their infant. Our results indicate partial overlaps between self-reported parental reflective functioning and mind-mindedness, that is, that particularly offline maladaptive mentalizing is associated with lower levels of mentalizing during interaction in mothers with symptoms of depression. Post-hoc examination of the interaction effect of postpartum depression showed that this association was only evident in mothers with medium to high levels of depression. Findings and implications are discussed.

How still? Parent–infant interaction during the still‐face and later infant attachment

AbstractIn the still‐face episode of the Face‐to‐Face/Still‐Face (FFSF), parents are asked to become unresponsive. However, infant–parent interaction may be irrepressible, and there is some evidence that interaction during the still‐face is associated with attachment outcome. To explore these questions, we independently coded the continuous affective valence (negative to positive) of seventy‐three 6‐month‐old infants (45 males; 36 Hispanic/Latinx; 38 White, 3 Black/African‐American, 2 Asian, 30 multiracial) and their parents (Mage = 36 years; 5 males; 30 Hispanic/Latinx; 65 White, 3 Black/African‐American, 2 Asian, 2 unknown) during the FFSF and assessed attachment at 15 months with the Strange Situation Procedure (n = 66). There was a mean positive correlation between moment‐to‐moment parent and infant affective valence, indicating synchronous affective interaction during the still‐face (d = 0.63). Higher levels of affect interaction during the still‐face episode were detected in infants later classified as disorganised compared to securely attached (d = 0.97). Findings underscore the importance of testing for still‐face interaction and suggest that this interaction may be an unappreciated predictor of infant attachment outcomes.