Sensitive Caregiving Research Articles

Mother-Child Interaction and Early Language Skills in Children Born to Mothers with Substance Abuse and Psychiatric Problems.

This prospective, longitudinal study with data collected at four time points investigated how maternal psychiatric symptoms, substance abuse and maternal intrusiveness in interaction were related to early child language skills. Three groups of mothers were recruited during pregnancy: One from residential treatment institutions for substance abuse (n=18), one from psychiatric outpatient treatment (n=22) and one from well-baby clinics (n=30). Maternal substance abuse and anti-social and borderline personality traits were assessed during pregnancy, postpartum depression at 3months, maternal intrusiveness in interaction at 12months, and child language skills at 2years. Results showed that the mothers in the substance abuse group had the lowest level of education, they were younger and they were more likely to be single mothers than the mothers in the two other groups. There was a significant difference in expressive language between children born to mothers with substance abuse problems and those born to comparison mothers, however not when controlling for maternal age, education and single parenthood. No group differences in receptive language skills were detected. Results further showed that maternal intrusiveness observed in mother-child interaction at 12months was significantly related to child expressive language at 2years, also when controlling for socio-demographic risk factors. This suggests that in addition to addressing substance abuse and psychiatric problems, there is a need for applying treatment models promoting sensitive caregiving, in order to enhance child expressive language skills.

Child Negative Emotionality and Caregiver Sensitivity Across Context: Links with Children's Kindergarten Behaviour Problems

Behavioural adjustment is critical for children's school readiness. This study used data from a nationally representative sample of children from the Early Childhood Longitudinal Study – Birth Cohort. We examined the effects of interactions between children's negative emotionality, maternal sensitivity and preschool teacher sensitivity on children's kindergarten internalizing and externalizing behaviours. Parent report of children's negative emotionality and observations of maternal sensitivity were obtained at age 2 years, teacher sensitivity was observed in preschool and teacher report of children's behaviour problems was obtained in kindergarten. Negative emotionality moderated links between maternal sensitivity, teacher sensitivity and children's internalizing behaviours. For children high in negativity, maternal sensitivity was positively associated with internalizing behaviour in the context of low teacher sensitivity, whereas for children low in negativity, maternal sensitivity was negatively associated with internalizing behaviour. For children high or low in negativity, internalizing behaviour was comparable when teacher sensitivity was high regardless of maternal sensitivity. Maternal sensitivity and teacher sensitivity interacted to predict externalizing behaviour regardless of child negativity. Children who experienced high teacher sensitivity displayed comparable externalizing behaviour regardless of maternal sensitivity. When children experienced low teacher sensitivity, maternal sensitivity was negatively associated with externalizing behaviour. Interactions between child characteristics and caregiving across developmental contexts are discussed. Copyright © 2014 John Wiley & Sons, Ltd.

Quality of institutional care and early childhood development

Institutional rearing adversely affects children’s development, but the extent to which specific characteristics of the institutional context and the quality of care provided contribute to problematic development remains unclear. In this study, 72 preschoolers institutionalised for at least 6 months were evaluated by their caregiver using the Child Behavior Checklist and the Disturbances of Attachment Interview. Distal and proximate indices of institutional caregiving quality were assessed using both staff reports and direct observation. Results revealed that greater caregiver sensitivity predicted reduced indiscriminate behaviour and secure-base distortions. A closer relationship with the caregiver predicted reduced inhibited attachment behaviour. Emotional and behavioural problems proved unrelated to caregiving quality. Results are discussed in terms of (non)-shared caregiving factors that influence institutionalised children’s development.

What promotes secure attachment in early adoption? The protective roles of infants’ temperament and adoptive parents’ attachment

Life before adoption is characterized by the lack of sensitive and stable caregiving, putting infants at risk for non-secure attachment patterns. What leads to adoptees’ attachment security in their adoptive families has not been conclusively determined. We investigated the roles of children’s temperament and adoptive parents’ attachment on adoptees’ attachment security. The variables were studied in a sample of 30 early-placed adoptees (age at adoption placement M = 5.37 months, SD = 4.43) and their adoptive mothers and fathers. Attachment patterns were investigated by means of the Strange Situation Procedure and the Adult Attachment Interview, and temperament via the Infant Behavior Questionnaire. Results showed that mothers’ secure attachment, but not fathers’ attachment or adoptees’ temperament, increased the chance of secure attachment in adoptees. Temperament moderated the mother–child attachment match.

Evaluation of a parenting skills program in Russia.

This article analyzes participant interviews and the photovoice project of 15 young disadvantaged mothers in Pskov, Russia. The women's statements and photovoice were part of a formative evaluation of the Pskov Positive Parenting Program, designed by the University of Massachusetts Institute for Global Health (IGH) and funded by USAID. The evaluation revealed that the Program met its goal of helping the women learn sensitive caregiving behaviors. The mothers emphasized that the Program met their need for social connection. The young mothers' participation in the positive social network of the group may have been a key ingredient to the Program's success and may have implications for the design of parenting programs cross-culturally.

Mothers' electrophysiological, subjective, and observed emotional responding to infant crying: The role of secure base script knowledge.

This study examined the extent to which secure base script knowledge-reflected in the ability to generate narratives in which attachment-relevant events are encountered, a clear need for assistance is communicated, competent help is provided and accepted, and the problem is resolved-is associated with mothers' electrophysiological, subjective, and observed emotional responses to an infant distress vocalization. While listening to an infant crying, mothers (N = 108, M age = 34 years) lower on secure base script knowledge exhibited smaller shifts in relative left (vs. right) frontal EEG activation from rest, reported smaller reductions in feelings of positive emotion from rest, and expressed greater levels of tension. Findings indicate that lower levels of secure base script knowledge are associated with an organization of emotional responding indicative of a less flexible and more emotionally restricted response to infant distress. Discussion focuses on the contribution of mothers' attachment representations to their ability to effectively manage emotional responding to infant distress in a manner expected to support sensitive caregiving.

Deer mothers are sensitive to infant distress vocalizations of diverse mammalian species.

Acoustic structure, behavioral context, and caregiver responses to infant distress vocalizations (cries) are similar across mammals, including humans. Are these similarities enough for animals to respond to distress vocalizations of taxonomically and ecologically distant species? We show that mule deer (Odocoileus hemionus) and white-tailed deer (Odocoileus virginianus) mothers approach a speaker playing distress vocalizations of infant marmots (Marmota flaviventris), seals (Neophoca cinerea and Arctocephalus tropicalis), domestic cats (Felis catus), bats (Lasionycteris noctivagans), humans (Homo sapiens), and other mammals if the fundamental frequency (F0) falls or is manipulated to fall within the frequency range in which deer respond to young of their own species. They did not approach to predator sounds or to control sounds having the same F0 but a different structure. Our results suggest that acoustic traits of infant distress vocalizations that are essential for a response by caregivers, and a caregiver's sensitivity to these acoustic traits, may be shared across diverse mammals.

Applying Pleck's model of paternal involvement to the study of preschool attachment quality: a proof of concept study

Recent re-conceptualisation of paternal involvement (Pleck, J. H. (2010). Paternal involvement: Revised conceptualization and theoretical linkages with child outcomes. In M. Lamb (Ed.), The role of the father in child development (5th ed., pp. 67–107). London: Wiley), while proving fruitful, has yet to be applied to investigations into what extent a father's level of involvement may affect child–peer interactions in the preschool age range, over and above the effects of mother–child attachment quality and socio-economic status (SES). Patterns of associations between attachment quality, sensitivity and general caregiving behaviours have also yet to be compared in equally involved mothers and fathers. Thirty preschool children (17 males:13 females) with similar SES profiles and their immediate caregivers participated in hour-long observations, conducted in the home. Even when attachment quality was controlled for, children with low paternal involvement were found to have higher levels of child–peer aggression. Further, patterns of effects between caregiver sensitivity, child–caregiver attachment quality and general caregiver interactions were similar for equally involved mothers and fathers. These preliminary data support the concept of applying Pleck's (2010) re-conceptualisation of paternal involvement to preschool attachment, and have implications towards the wider study of child–father attachment. Limitations of the current study and directions for future research are discussed.

Caregivers' attachment patterns and their interactions with cancer patients' patterns.

To provide a brief review of the empirical literature regarding the attachment style of the cancer patients' caregivers as well as the link between attachment, caregiving, and care-receiving behaviors are defined. An extensive systematic electronic review (Medline, PsycINFO, and Attachment Theory Website (ATW)) and subsequent examination of reference lists were carried out to retrieve published articles up to 2011, using attachment and cancer in combination with caregiver, spouse, dyad, and family as the key words. The titles, abstracts, or full articles, if necessary, were reviewed to determine whether the articles met the eligibility criteria. Eighty-seven studies have been identified, including research articles, books, and chapters in books. The attachment style of a caregiver can influence how they respond to a patient's needs. Studies have found that attachment anxiety or avoidance is more likely to interfere with effective and sensitive caregiving.

Baby Watching: Facilitating parent–infant interaction groups

The Oxford Parent Infant Project's Baby Watching groups aim to increase parental sensitive care-giving and encourage mind-mindedness towards babies. In this article, clinical vignettes demonstrate the concept of bodily mentalisation and illustrate the combined use of Watch, Wait and Wonder and Video Interaction Guidance in parent–infant groups. Seeing positive visual images of themselves and experiencing multiple benign relationships in the Baby Watching group can empower parents to become more attuned to their babies.

Moving Beyond the Mother–Child Dyad: Exploring the Link Between Maternal Sensitivity and Siblings’ Attachment Styles

ABSTRACTAttachment theory asserts that secure attachment representations are developed through sensitive and consistent caregiving. If sensitive caregiving is a constant characteristic of the parent, then siblings should have concordant attachment classifications. The authors explored maternal attachment quality assessed by the Attachment Q-Set, maternal sensitivity, and specific mother–child interactions between siblings. Hour-long observations took place in the homes of 9 preschool sibling pairs and their immediate caregivers. The interactions were analyzed using a modified version of Bales’ Small Group Analysis. The results reveal attachment discordance in a third of sibling pairs. While maternal sensitivity was higher with older siblings and mothers displayed more positive emotions when interacting with their younger siblings, attachment quality was not associated with birth order. Therefore, a shift toward a more contextual, family-based perspective of attachment is recommended to further understand how attachment strategies are created and maintained within the child's everyday context.

Stress and caregiver sensitivity among childcare staff in Santiago, Chile

ABSTRACTBackground: This exploratory study examines the relationship between stress and caregiver sensitivity among non-parental childcare centre staff who attend Chilean daycare centres serving low-income children between 12- and 24-months-old.Method: Participants were 23 childcare providers (nine teachers and 14 childcare technicians) who were evaluated with an average of three children each at one time. Stress associated to caregiving practices was assessed using the Parenting Stress Index–Short Form (PSI–SF), and caregiver sensitivity was measuring using the Child–Adult Relationship Experimental Index Toddlers (CARE-index).Results: No association was found between global level of stress and caregiver sensitivity. However, there was a significant association between the caregiver–child dysfunctional interaction subscale and caregiver sensitivity, specifically with the cognitive aspects of sensitive response and when a caregiver was nonresponsive. Furthermore, the ‘Difficult Child’ PSI subscale was associated with the cognitive aspects of the caregiver´s sensitive response.Conclusions: These findings support the relevance of children's early interactions with their non-parental caregivers and demonstrate how daily stress can affect the cognitive aspects of the caregivers’ sensitive response to the infants’ needs.

Family Idealization Explains the Effect Between Family Religiousness and Youth Psychological Functioning

Research suggests that family religiousness may contribute to youth psychological functioning directly and also by protecting against socialization among peers who engage in externalizing behaviors such as substance use. However, attachment variables and their causes may confound the effects between family religiousness, peer substance use, and youth psychological functioning. This study brings family idealization, a novel construct theorized to translate sensitive caregiving into the formation of secure attachments, to bear on this possibility for the first time. We performed a secondary analysis of data from a sample of 522 secondary students and used structural equations modeling to simultaneously estimate the effects between family religiousness and idealization, peer substance use, and psychological functioning. We found that family religiousness and youth psychological functioning were statistically independent conditional on family idealization. Family idealization was independent of peer substance use, while family religiousness predicted lower levels of socially acceptable substance use among peers. Interestingly, peer substance use did not predict psychological functioning. These results suggest family religiousness may impact peer selection, while its association with youth psychological functioning may be attributable to family idealization.

Does oxytocin modulate variation in maternal caregiving in healthy new mothers?

BackgroundMaternal sensitivity to infant cues and developmental needs may be pivotal for social and cognitive development. Animal and recent human studies emphasise a major role for Oxytocin (OT) in mediating sensitive caregiving but no study has examined the relationship between OT and extreme variation in human maternal sensitivity. Methods: From 105 expectant mothers, 80 underwent blind-rating of maternal sensitivity at 4–6 months postpartum through free-play interaction with their infants. At 7–9 months postpartum, 30 mothers at extremes of maternal sensitivity: 15 ‘sensitive mothers’ (high sensitivity mothers – HSMs, mean=4.47; SD=0.74) and 15 ‘less sensitive mothers’ (low sensitivity mothers – LSMs, mean=2.13; SD=0.52) underwent plasma OT measurements before and after 10min infant play. Results: Baseline and post-interaction plasma OT was higher in LSMs than HSMs [F(1, 26)=8.42; p=0.01]. HSMs showed a trend towards significant reduction in plasma OT [t(14)=2.01; p=0.06] following play-interaction; no change was shown by LSMs [t(13)=−0.14; p=0.89]. Conclusion Higher baseline OT levels in healthy LSMs may imply greater stress responses to the demands of caring for an infant, or past deficiencies in own parenting relationship and act as a biomarker for poor parental sensitivity. OT may be acting to reduce stress and anxiety in LSMs consistent with studies of plasma OT and stress in women. By contrast, in HSMs, play interaction with their infants maybe relaxing as indicated by significant reduction in plasma OT from baseline. Ascertainment of mothers in well-defined sensitivity groups might facilitate examination of distinct coping strategies in parents and better understanding of variation in parental caregiving behaviour and its potential for modulation by OT.This article is part of a Special Issue entitled Oxytocin and Social Behav.

Schizophrenia, the Patient, the Caregiver and the Psychiatrist: Interrelationship in Bollywood films

This study analyses the portrayal of schizophrenia in Indian Bollywood films with special reference to the individuals suffering from schizophrenia, their caregivers and the psychiatrists treating them. Seven films dealing with schizophrenia as a key element of the storyline were chosen for the study. A number of themes emerged during data collection: schizophrenia, stereotypes and social attitudes; schizophrenia and its treatment; role of psychiatrist; and, aspects of caregiving. Results showed that some films portrayed negative aspects of schizophrenia such as violence, dangerousness and unpredictable behaviour while others portrayed the positive aspects such as sensitivity of psychiatrist and caregivers towards the patient. It can be concluded that positive portrayal of mental illnesses in films can play an important role in changing public perception about mental illnesses.

Sensitive attunement to infants’ internal states: operationalizing the construct of mind-mindedness

This paper focuses on caregiver sensitivity, its relation to mind-mindedness (caregivers’ attunement to their infants’ internal states), and how well both constructs predict infant attachment security. The seminal Baltimore research on sensitivity and its relation to attachment security is summarized, highlighting the conclusion that mothers in the insecure-resistant and insecure-avoidant categories could not be distinguished on the basis of sensitivity. The contrast between the complex, sophisticated construct detailed in the original studies and the broad-based nature of the sensitivity coding scale is discussed. This paper argues that we should return to Ainsworth, Bell, and Stayton’s (1971, 1974) original emphasis on the caregiver’s ability to perceive things from the child’s point of view in defining a measure of the quality of early infant–caregiver interaction. This approach led to the development of the construct of mind-mindedness. There are two mind-mindedness indices: caregivers’ tendency during infant–caregiver interaction to (a) comment appropriately on their infants’ putative thoughts and feelings (appropriate mind-related comments), and (b) misread their infants’ internal states (non-attuned mind-related comments). Both indices predict independent variance in infant–caregiver attachment security, and together can distinguish between the secure, avoidant, and resistant categories. The specific, multidimensional nature of mind-mindedness complements the global construct of sensitivity.

It Takes Two: Sensitive Caregiving Across Contexts and Children's Social, Emotional, and Academic Outcomes

Research Findings: Using longitudinal survey data from the Welfare, Children, and Families Study: A Three-City Study (n = 135), this study examines how congruence in maternal and child care provider sensitivities contributes to young children's social, emotional, and academic outcomes among low-income minority families. Congruence groups were created based on levels of high and low maternal and child care provider sensitivity. Children with high maternal sensitivity and low child care provider sensitivity had lower scores on measures of social competence and applied problems compared to children with high maternal and child care provider sensitivity. Children with low maternal sensitivity but high child care provider sensitivity displayed higher emotional competence than children with low maternal and child care sensitivity, implying an important protective benefit of child care. Practice or Policy: Current state and federal policy climates, including recently awarded Early Learning Challenge grants focused on social and personal development and the Academic, Social, and Emotional Learning Act, reflect an important emphasis on social and emotional learning. Given this, the findings from this study implicate the role of families and child care providers as important components in any policy or program focused on shaping children's early social and emotional outcomes.

MOTHERS' OWN RECOLLECTIONS OF BEING PARENTED AND RISK OF OFFSPRING DEPRESSION 18 YEARS LATER: A PROSPECTIVE COHORT STUDY

BackgroundAlthough the relationship between maternal bonding and risk of offspring depression has been demonstrated, it is unclear whether this risk exists for subsequent generations. This study examines the association between maternal reports of her own mother's parenting and later risk of depression in offspring at age 18.MethodThis study is based on data from the Avon Longitudinal Study of Parents and Children. Mothers enrolled in the study, completed the Parental Bonding Instrument to provide an assessment of how they were parented by their own mothers up to the age of 16. Offspring depression was assessed at age of 18 using the Clinical Interview Schedule-Revised. The sample comprised 10,405 respondents who had completed the Parental Bonding Instrument during the antenatal period. Results were adjusted for grandmother's history of depression, maternal depression, and a range of socioeconomic variables.ResultsA one standard deviation increase in mothers’ perceived lack of care in their own childhood was associated with a 16% increase in the odds of offspring depression at age 18 (odds ratios = 1.16, 95% confidence intervals = [1.04, 1.30]). This effect remained following adjustment for potential confounders (odds ratios = 1.14, 95% confidence intervals = [1.02, 1.27]). There was no evidence for an association between overprotection and offspring depression.ConclusionsThis study is consistent with the hypothesis that sensitive caregiving is important to future risk of depression across generations. Preventative interventions could be aimed at promoting positive parenting practices, which may help to reduce the risk of depression in subsequent generations.

Forms of Concern: Toward an Intersubjective Perspective

The growing interest in the issue of concern, which appeared relatively late in psychoanalytical literature, resulted in several distinctions. Winnicott distinguished between concern as an expression of guilt and concern as a manifestation of joy, Brenman Pick distinguished between real concern and spurious concern, and Bowlby distinguished between sensitive and compulsive caregiving. The basic concepts of Buber's dialogical philosophy and intersubjective approaches in psychoanalysis have created fertile ground for the study of concern, and enabled us to conceptualize these distinctions in a way that has heretofore been lacking in psychoanalytical thought.

Evolución del vínculo que establece el niño con el personal educativo en salas cuna chilenas

The present study pretends to evaluate the bond that the children develop with their care centre staff in Chilean crèches, analyzing the caregiver sensitivity and the cooperative child response. A group of 43 toddlers between 8 months and 2 years old in interaction with their principal care giver at the child centre, was observed in three different moments during a year. Results show that the care centre staff maintain their sensitivity, decrease their controlled response and increase significantly their non responsiveness in time; while children increase in a significantly way their cooperativeness and diminished significantly their ambivalent response.