Sensitive Caregiving Research Articles

Maternal childhood trauma, caregiving behavior, and child cognitive development in the context of drug addiction.

Exposure to childhood trauma confers intergenerational risk on child development. However, the mechanism linking a mother's childhood trauma with her child's cognitive development remains poorly understood. This study recruited 71 mother-child dyads affected by substance use disorder from local, community-based, outpatient substance use treatment programs. Maternal exposure to childhood trauma, caregiving behavior, and child cognitive development were assessed in each mother-child dyad. These were measured through a comprehensive biopsychosocial interview, an observed dyadic interaction coded using the Coding Interactive Behavior system, and the Bayley Scales of Infant and Toddler Development, Screening Test, respectively. We hypothesized that compromised caregiving behavior would mediate a negative relationship between maternal childhood trauma and child cognitive development. Analyses did not support this hypothesis. Specifically, maternal childhood trauma was not significantly associated with child cognitive development nor the four dimensions of maternal caregiving behavior. However, caregiving behavior (specifically maternal sensitivity and limit setting) was associated with child cognitive development, when controlling for maternal childhood trauma and child age. The lack of associations observed suggests that protective factors may buffer the intergenerational impact of childhood trauma. Furthermore, the relationship between quality of caregiving and child cognitive development highlights the importance of interventions which foster sensitive caregiving behaviors that may bolster child cognitive development in the context of maternal substance use disorder and maternal childhood trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Touch: A Review of the Infant-Caregiver Relationship in the Neonatal Field

Touch is a domain of enormous importance with implications in development, from birth, and across the lifespan. This work aims to review touch implications within infant-caregiver interaction. A non-systematic review of the literature was performed to assess the relevance of touch in the neonatal period, on attachment, and in child development. The review was conducted on PubMed database, in May 2023 using the following keywords: “infant”, “child”, “baby”, “newborn”, “neonatal”, “touch”, “contact”, “tactile”, and “attachment”. In the neonatal period, close skin contact facilitates caregiver sensitivity and responsiveness, promotes parent-infant reciprocity, reduces psychological distress both in caregiver and infants, and regulates the infant’s physiological systems (circadian rhythm, autonomic regulation). Touch also plays a crucial role in attachment by contributing to synchrony and self-regulation abilities, since secure attachment promotes learning of emotional regulation, social skills, and behavioural organization. Early sensory experiences are critical to developmental dimensions such as cognitive, motor, and socio-emotional, and influence physical growth rate. Concluding, in neonatal care services, touch should be systematically addressed in routine appointments. Within the field of infant-caregiver interactions, there is an urgent need to create a reliable tool for tactile assessment, allowing clear interpretations and the development of target interventions.

Maternal antenatal depression, oxytocin, and infant temperament: The roles of ethnicity and adult attachment avoidance

This study examined the associations between maternal depression and oxytocin in pregnancy, caregiving sensitivity and adult attachment style, and infant temperament. One hundred and six women recruited from a public hospital antenatal clinic in Australia, and their infants completed assessments at three time points (Time 1: pregnancy; Time 2: 3-month postpartum; Time 3: 12-month postpartum). Mothers completed self-report questionnaires assessing maternal depression symptom severity at Time 1-3, adult attachment style at Time 2, and infant temperament at Time 3. At Time 1, they also provided a blood sample to assess peripheral oxytocin levels, and at Time 2, participated in a parent-child interaction session, which was later coded for caregiving behavior (sensitivity). Neither maternal depression nor lower levels of oxytocin during pregnancy predicted difficult infant temperament; rather, it was predicted by non-Caucasian ethnicity. When all other variables were free to vary, adult attachment avoidance mediated an association between maternal depression during pregnancy and difficult infant temperament. Results highlight the potential value of interventions focusing on adult attachment insecurity for pregnant women and raise questions about associations between culture/ethnicity and infant temperament.

Knowing, recognizing, and preventing shaken baby syndrome: The role of primary care pediatrician

The Shaken Baby Syndrome (SBS) is the result of a severe form of physical abuse inflicted on children under the age of 2, mostly by parents or other caregivers, to quiet their inconsolable crying. The violent shaking of the child results in devastating consequences up to death or can lead to serious neurological sequelae and/or compromise of their neurodevelopment. The clinical diagnosis of SBS is not always easy and immediate, especially in cases where the picture presents with subtle signs and symptoms not directly attributable to abuse: it is therefore fundamental that the family pediatrician is aware of this nosological entity, suspects it in the presence of certain risk factors, always considers it in the differential diagnosis like any other pathology, and above all prevents it through sensitization and education of parents and other caregivers to adequately manage their child's crying. This article aims to emphasize the role of primary care pediatricians in knowing, recognizing, and preventing the shaken baby syndrome.

Maternal and paternal sensitivity: Key determinants of child attachment security examined through meta-analysis.

Sensitive caregiving behavior, which involves the ability to notice, interpret, and quickly respond to a child's signals of need and/or interest, is a central determinant of secure child-caregiver attachment. Yet, significant heterogeneity in effect sizes exists across the literature, and sources of heterogeneity have yet to be explained. For all child-caregiver dyads, there was a significant and positive pooled association between caregiver sensitivity and parent-child attachment (r = .25, 95% CI [.22, .28], k = 174, 230 effect sizes, N = 22,914). We also found a positive association between maternal sensitivity and child attachment security (r = .26, 95% CI [.22, .29], k = 159, 202 effect sizes, N = 21,483), which was equivalent in magnitude to paternal sensitivity and child attachment security (r = .21, 95% CI [.14, 27], k = 22, 23 effect sizes, N = 1,626). Maternal sensitivity was also negatively associated with all three classifications of insecure attachment (avoidant: k = 43, r = -.24 [-.34, -.13]; resistant: k = 43, r = -.12 [-.19, -.06]; disorganized: k = 24, r = -.19 [-.27, -.11]). For maternal sensitivity, associations were larger in studies that used the Attachment Q-Sort (vs. the Strange Situation), used the Maternal Behavior Q-Sort (vs. Ainsworth or Emotional Availability Scales), had strong (vs. poor) interrater measurement reliability, had a longer observation of sensitivity, and had less time elapse between assessments. For paternal sensitivity, associations were larger in older (vs. younger) fathers and children. These findings confirm the importance of both maternal and paternal sensitivity for the development of child attachment security and add understanding of the methodological and substantive factors that allow this effect to be observed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of a Baby Carrier Intervention on Fathers’ Sensitivity, Involvement, and Hormonal Levels: Follow-Up of a Randomized Controlled Study

SYNOPSIS Objective. Fathers are of great importance for healthy child development. This randomized controlled study investigated the longer-term effects of an intervention using a soft baby carrier on fathers’ observed sensitive caregiving, involvement, and oxytocin and cortisol levels. Design. First-time fathers were randomly assigned to use a baby carrier (n = 41) or baby seat (n = 39) and were asked to use the carrier or seat for at least 6 h per week for 3 weeks. Pretest (M child age = 2.67 months), posttest (M child age = 3.99 months), and follow-up (M child age = 8.25 months) father data were collected. Results. No intervention effects of baby carrier use on fathers’ sensitivity, involvement, and oxytocin or cortisol levels at follow-up emerged. Unexpectedly, fathers in the baby seat condition reported an increase in the amount of time spent with the infant. Fathers’ sensitivity and oxytocin levels decreased over time, while cortisol levels increased over time, irrespective of condition. Conclusions. This study showed less optimal hormonal levels in fathers over time, suggesting that support during the first months of fatherhood is needed. Furthermore, use of a baby seat may have contributed to fathers enjoying their time with their infant and consequently their involvement in child caregiving.

Children’s involvement in home-based childcare: are boys more susceptible to caregiver sensitivity than girls?

Children’s involvement in home-based childcare: are boys more susceptible to caregiver sensitivity than girls?

Secure base script knowledge and video-feedback intervention to promote positive parenting-sensitive discipline

This preregistered randomized controlled study investigated the effects of Video-Feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) on parents' secure base script knowledge (SBSK). Furthermore, we examined whether effects of VIPP-SD on sensitive caregiving and sensitive discipline behavior and parents' attitudes toward these behaviors were moderated by SBSK at baseline. Families (n = 445) with pre- and school-aged children (n = 890) were randomized to receive VIPP-SD or telephone calls. Results showed no effects of VIPP-SD on SBSK. Furthermore, there was no moderation of effects on sensitive caregiving or sensitive discipline behavior by SBSK. VIPP-SD promoted positive attitudes toward sensitive caregiving and sensitive discipline behavior. The latter effect was moderated by SBSK: parents with lower SBSK showed the strongest improvements in positive attitudes toward sensitive discipline behavior. This effect was driven by a subgroup of younger children. These findings highlight the potential importance of tailoring interventions to meet the specific needs of parents with varying levels of SBSK.

Understanding emotion dysregulation from infancy to toddlerhood with a multilevel perspective: The buffering effect of maternal sensitivity.

Challenges with childhood emotion regulation may have origins in infancy and forecast later social and cognitive developmental delays, academic difficulties, and psychopathology. This study tested whether markers of emotion dysregulation in infancy predict emotion dysregulation in toddlerhood, and whether those associations depended on maternal sensitivity. When children (N = 111) were 7 months, baseline respiratory sinus arrhythmia (RSA), RSA withdrawal, and distress were collected during the Still Face Paradigm (SFP). Mothers' reports of infant regulation and orientation and maternal sensitivity were also collected at that time. Mothers' reports of toddlers' dysregulation were collected at 18 months. A set of hierarchical regressions indicated that low baseline RSA and less change in RSA from baseline to stressor predicted greater dysregulation at 18 months, but only for infants who experienced low maternal sensitivity. Baseline RSA and RSA withdrawal were not significantly associated with later dysregulation for infants with highly sensitive mothers. Infants who exhibited low distress during the SFP and who had lower regulatory and orienting abilities at 7 months had higher dysregulation at 18 months regardless of maternal sensitivity. Altogether, these results suggest that risk for dysregulation in toddlerhood has biobehavioral origins in infancy but may be buffered by sensitive caregiving.

Look at Grandma! Joint visual attention over video chat during the COVID-19 pandemic

Social interactions are crucial for many aspects of development. One developmentally important milestone is joint visual attention (JVA), or shared attention between child and adult on an object, person, or event. Adults support infants’ development of JVA by structuring the input they receive, with the goal of infants learning to use JVA to communicate. When family members are separated from the infants in their lives, video chat sessions between children and distant relatives allow for shared back-and-forth turn taking interaction across the screen, but JVA is complicated by screen mediation. During video chat, when a participant is looking or pointing at the screen to something in the other person’s environment, there is no line of sight that can be followed to their object of focus. Sensitive caregivers in the remote and local environment with the infant may be able to structure interactions to support infants in using JVA to communicate across screens. We observed naturalistic video chat interactions longitudinally from 50 triads (infant, co-viewing parent, remote grandmother). Longitudinal growth models showed that JVA rate changes with child age (4 to 20 months). Furthermore, grandmother sensitivity predicted JVA rate and infant attention. More complex sessions (sessions involving more people, those with a greater proportion of across-screen JVA, and those where infants initiated more of the JVA) resulted in lower amounts of JVA-per-minute, and evidence of family-level individual differences emerged in all models. We discuss the potential of video chat to enhance communication for separated families in the digital world.

Stroking in early mother-infant exchanges: The role of maternal tactile biography and interoceptive sensibility.

Caress-like is a crucial component of caregiving and a key factor in mother-infant interactions. Mother's experience of touch during her own childhood (i.e., tactile biography) has been found to be related to maternal actual use of caress-like touch (i.e., stroking) during mother-infant exchanges. Evidence also suggests that maternal interoceptive sensibility (i.e., self-perceived sensitivity to inner-body sensations) might be related to sensitive caregiving abilities. However, further empirical investigation is needed to understand to what extent tactile biography and interoceptive sensibility have an impact on mothers' stroking when interacting with their infants. Using an online survey, this cross-sectional study explored the potential association between maternal tactile biography, interoceptive sensibility and use of touch for interaction with their own infants in a group of 377 Italian mothers (mean age = 33.29; SD = 4.79). We tested and compared a series of multivariate linear mediation models using maternal tactile biography as predictor, maternal use of affective touch as outcome variable and Multidimensional Assessment of Interoceptive Awareness (MAIA) subscale scores as mediators. We found that, if a mother had positive touch experiences in her own childhood, she may be more likely to use touch in a positive and nurturing way with her own infant (i.e., stroking). Furthermore, mothers' interoceptive sensibility in the form of attention regulation, self-regulation and body listening mediates the association between their past experiences of positive touch and their use of caress-like touch in mother-infant exchanges. This study highlights that maternal tactile biography is directly associated with mothers' use of caress-like touch and indirectly linked to it through the mediating role of interoceptive sensibility.

Caregiving style and quality of life in caregivers of patients with cardiovascular disease

Objectives Cardiovascular disease (CVD), a leading cause of morbidity and mortality, frequently requires informal caregiving. Spousal caregivers may gain satisfaction while providing care, but there are associated risks, including reduced quality of life (QoL). Caregiving Style (CS; i.e. the ways one responds and is attentive towards their partner’s needs) may help explain why some caregivers experience worse QoL. This study investigated the relationship between CS and QoL among caregivers of patients with a diagnosed cardiac condition. Methods Spousal caregivers recruited from a cardiac rehabilitation program at an academic teaching hospital completed a sociodemographic questionnaire, CS Questionnaire, and QoL Questionnaire for Cardiac Spouses. Multiple regression analyses were conducted, controlling for age, gender, and education. Results The sample consisted of 170 spousal caregivers (M age = 61.8; 74.3% female). The mean of the physical and social functioning scale was 59.4 (SD 10.3) and emotional scale was 71.5 (SD 14.4). Average scores for proximal, sensitive, controlling, and compulsive styles were 4.95, 4.33, 2.82, and 3.22, respectively. Spouses reporting compulsive caregiving (e.g. overprotection, providing intensive care) indicated poor physical/social (β=-0.42, SE=1.02, −7.19, −3.18, p<.001), and emotional functioning (β=-0.41, SE = 1.41, −10.15, −4.60, p<.001). Those reporting sensitive caregiving (i.e. understanding patient needs and feelings) indicated better emotional functioning (β=.19, SE = 1.46, .10, 5.85, p=.04). No other CS was significantly associated with QoL. Conclusions Spousal caregivers engaging in compulsive styles of care may be susceptible to poor QoL, whereas engaging in sensitive styles may promote better QoL. CS may be an important consideration in programming and services designed to support caregivers.

Maternal contingent responses to distress facilitate infant soothing but not in mothers with depression or infants high in negative affect.

Depression in mothers is consistently associated with reduced caregiving sensitivity and greater infant negative affect expression. The current article examined the real-time behavioral mechanisms underlying these associations using Granger causality time series analyses in a sample of mothers (N = 194; 86.60% White) at elevated risk for depression and their 3-month-old infants (46.40% female) living in a major metropolitan area in the United States. Overall, mothers contingently responded to infant distress, and mothers' responses to infant distress increased the likelihood of infant soothing in real time. However, there was no evidence for maternal contingent responding or facilitation of infant soothing in subsamples of mothers who were currently experiencing elevated depression symptoms or in mothers of highly negative infants. These findings suggest real-time behavioral mechanisms by which risks for maladaptive self-regulation may develop. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mental states in caregivers toward people with Alzheimer's disease at different stages.

Caring for people with Alzheimer's disease (AD) is burdensome, especially when family members act as caregivers. This multicenter survey first aimed to investigate caregivers' mental states as well as its influencing factors in caring for people with different severities of AD in China. People with AD and their caregivers from 30 provincial regions in mainland China were enrolled from October 2020 to December 2020 to be surveyed for caregivers' mental states and living conditions, as well as caregivers' attitudes toward treatment and caring. Logistic regression was used to explore the factors that influence the positive and negative states of caregivers who care for people with different stages of AD. A total of 1,966 valid questionnaires were analyzed (mild AD: 795, moderate AD: 521, severe AD: 650). A total of 73.6% of caregivers maintained normal states (mild group: 71.9%, moderate group: 73.9%, severe group: 75.2%; X2 = 2.023, p = 0.364), and the proportions of caregivers with positive and negative states were 26.3% (mild group: 38.4%, moderate group: 24.6%, severe group: 13.1%; X2 = 119.000, p < 0.001) and 36.5% (mild group: 25.2%, moderate group: 36.9%, severe group: 50.2%; X2 = 96.417, p < 0.001), respectively. The major factors that both influenced caregivers' positive and negative states were the severity of AD, perceived efficacy of treatment, safety issues after AD dementia diagnosis and perceived social support (p < 0.005), while neuropsychiatric symptoms causing stress in caregivers (p < 0.001) only affected the negative states of caregivers. The results of further analysis according to disease severity showed that safety issues after AD dementia diagnosis (p < 0.005) only made significant differences in the mild-to-moderate group. To reduce negative states and promote positive states among caregivers, flexible and sensitive caregiving support could be built on caregivers' demands in caring for people with different stages of AD. The support of emotion, social functioning and nursing skills is one of the significant ways for health workers to enhance caregivers' competency.

Being sensitive in their own way: parental ethnotheories of caregiver sensitivity and child emotion regulation across five countries.

Caregiver sensitivity builds a basis for children's sense of security and effective emotion regulation during their development. Applying a cross-cultural lens, caregiver sensitivity can be divided into two subtypes, reactive and proactive, and its prevalence and meaning may differ across cultures. Guided by the theoretical frameworks of developmental niche and parental ethnotheories, the current study examines culture-specific meanings of caregiver sensitivity across five countries: India, Nepal, Korea, the United States of America (USA), and Germany. We examine the prevalence of maternal reactive and proactive sensitivity, children's emotional lability and regulation, and how mothers' sensitivity types are related to children's emotional characteristics. Participants included 472 mothers from the five countries with children aged between 6 and 7 years. Mothers reported their sensitivity preference in multiple vignettes and completed an emotion regulation checklist to report their children's emotional lability and regulation. A set of analyses of covariance (ANCOVAs) found cultural differences in mothers' preference for proactive and reactive sensitivity. Mothers in India and Nepal reported the highest preference for proactive sensitivity followed by Korea and the USA, while German mothers reported the lowest preference for proactive sensitivity. Consequent regression analyses revealed varying associations between proactive sensitivity and child emotional characteristics in all five countries either directly or as moderated by child sex. These results evidence that parental ethnotheories are part of the developmental niche embedded in a larger cultural context. Findings on the differential links between the types of sensitivity and child emotion regulation provide cultural models of parental emotion socialization and children's emotional functioning.

Movement through motherhood: Exploring mood, wellbeing, and prenatal emotional availability (EA) through EA-based dance intervention.

Emotional availability (EA) is a construct that describes the observed emotional connection in parent-child relationships. During pregnancy, EA is assessed only using caregiver sensitivity and nonhostility. We used the nonverbal aspects of these qualities to create a new dance/movement intervention ("EA-Based Dance Intervention"). Given the scarcity of pregnancy interventions, we provided training to participants on how to be emotionally engaged with their unborn babies through dance/movement. The EA-Based Dance Intervention alone comprised the first intervention arm (n=12). A second intervention arm involved the combination of EA-Based Dance Intervention with brief psychoeducation (n=10). The third arm was a control group, which received only the assessments (n=7). Measures of self-reported symptoms of depression and anxiety, emotional expressivity, flourishing, and the (newly developed) self-reported prenatal EA were used at pre- and posttest. The measure of observed prenatal EA was used to compare intervention versus control at posttest only. In this pilot study, we found that participants receiving the EA-Based Dance Intervention alone or combined with psychoeducation, self-reported improved anxiety symptoms and self-reported higher prenatal EA. When compared with the control group, those experiencing EA-Based Dance Intervention reported fewer depressive symptoms from pre- to posttest.

Association between maternal sensitivity and child receptive language development: Quasi-causal evidence using a sibling comparison design.

Observational studies have shown that caregiver sensitivity predicts child language skills. These studies, however, have entirely relied on between-family designs (single parent-child dyad per family), which cannot rule out the contribution of shared family confounds (e.g., genetics, books in home). The current study investigates whether observed caregiver sensitivity predicts changes in child receptive language using a sibling comparison design. Participants were 890 Canadian children (51.7% male; 52.4% White) nested within 447 families from diverse socioeconomic backgrounds with children between the ages of 2 and 3.5 years (Wave 1) and 3.5 and 5 years (Wave 2). Independent observers provided ratings of maternal sensitivity with each sibling using several coding protocols (i.e., Coding of Attachment-Related Parenting and the Parent-Child Interaction System). Child receptive language was assessed using the Peabody Picture Vocabulary Test. Maternal sensitivity predicted within-person change in receptive language. That is, the sibling that receives comparatively more sensitivity from the caregiver showed more development in language over time when compared to their sibling. The obverse association, child language to later maternal sensitivity, was not observed, pointing to a unidirectional association of maternal sensitivity on child receptive language. Our sibling comparison design rules out the role of shared family confounders, which provides a strong test of causal processes within an observational design. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Study of the Relationship between Sensory Processing Sensitivity and Burnout Syndrome among Speech and Language Therapists

Background: Burnout syndrome can arise due to either situational factors such as working conditions, or dispositional factors such as certain temperaments, like a high sensory processing sensitivity. We aim to address the relative absence of studies on speech-language therapists and seek to determine the role of high sensitivity for these healthcare workers in relation to burnout syndrome. Method: The sample consisted of 602 female speech-language pathologists who anonymously completed a questionnaire measuring burnout (ProQOL 5th edition) and sensory processing sensitivity (HSPS-FR). Results: The results revealed that 77.41% of the participants reported moderate or high burnout scores. Furthermore, the analyses revealed that highly sensitive participants are more vulnerable to burnout than others. Conclusion: This study highlights the negative impact of high sensory processing sensitivity on burnout. However, according to the kind of sensitivity, we discuss the way in which highly sensitive caregivers can master this sensitivity in order to use it as a strength in their professions and to spare themselves from suffering deleterious effects, such as compassion fatigue and/or burnout.

How does sensitivity influence early executive function? A critical review on hot and cool processes

There is compelling evidence that the quality of caregiver-child interactions during toddlerhood and the preschool years supports the development of executive function (EF) (Bernier et al., 2010; 2015; 2016; Fay-Stammbach et al., 2014; Geeraerts et al., 2021). Based on such findings, we make the case herein that sensitivity may be one of the most important dimensions of parenting contributing to early EF. In the present article, we will review empirical evidence, integrating findings from a wide range of scientific disciplines – cognitive psychology, neuroscience, and developmental psychopathology – and present theoretical ideas about how two contexts of sensitive caregiving – i.e. sensitivity to distress and non-distress cues - may be contributing differently to hot and cool EF development. Implications for future investigations on the environmental contributors of early EF, and its mechanisms, are discussed.

Early childcare setting in Israel: structural quality, caregiver sensitivity, and children's behaviour

ABSTRACT The present study explored the association between the structural quality of child care, caregivers' sensitive responsiveness, children's involvement in play and activity in the setting, and children's expression of aggression. Eighty-four early childhood care settings were classified into either high (29) or low structural quality (55) based on group size and caregivers-children ratio. Caregivers and children (14-17 months) were filmed in various episodes. Findings showed that sensitive responsiveness of caregivers in highquality settings was significantly higher than in low-quality settings. Level of aggression in the group was lower in high-quality than in low-quality settings. We found a significant positive correlation between emotional responsiveness and involvement in high-quality but not low-quality settings. The findings demonstrate that structural quality is a necessary condition for ensuring process quality and facilitating beneficial relationships between adults and children.