From birth, infants grow and develop in their capacity to show feelings, to communicate both verbally and through their gestures and facial expressions, to think, and to relate socially. We now know that early relationships affect how well infants develop, and that problems in an infant's early relationships are linked to later problems in social relationships, emotional health, thinking, and problem solving. Increasingly, parents seem to be recognizing the importance of their relationships with their infants, and when this is not going well, many seek help.
Fifty-eight mothers and infants participating in two infant-mother psychotherapeutic interventions in a comparative infant-mother clinical intervention study were followed six months after treatment ended. One treatment was an infant-led psychotherapy, Watch, Wait, and Wonder (WWW). The other was a more traditional mother-infant psychodynamic psychotherapy (PPT). Infants ranged in age from 10 to 30 months at the outset of treatment, which took place in weekly sessions over approximately five months. Results indicated that positive effects observed from the beginning to the end of treatment in both treatment groups in infant symptoms, parenting stress, and mother-infant interaction were maintained or improved further at six-month follow-up. Additionally, decreased maternal depression, gains in infant cognitive development and emotion regulation, and improved infant-mother attachment security or organization had been observed posttreatment only in the WWW group. Interestingly, between the posttreatment to follow-up period the PPT group also showed such gains. Thus, for these variables it would be more accurate to say that the outcomes were similar for the two treatment groups but change emerged at a different pace. Nevertheless, an advantage persisted in the WWW group in This research was supported by a grant from Health Canada National Health and Postdoctoral Award from the Ontario Mental Health Foundation to Mirek Lojkasek. The first three authors played equal roles in the planning and execution of this research. We are grateful to Melanie Barwick for her collaboration on a part of this study as well as to Myrna Brown, Samantha Callender, Heather Davidson, Heather MacDonald, and Mirella Pugliese for their careful attention to detail in coordination, data collection, and coding and to Lennox White for audiovisual assistance. We are indebted to Susan Goldberg and Jane Washington for coding the Strange Situation videotapes. We also are deeply indebted to the families whose cooperation provided the data on which this study was based. Direct correspondence to: Nancy J. Cohen, Hincks-Dellcrest Institute, 114 Maitland Street, Toronto, Ontario, Canada M4Y 1E1; e-mail: nancy.cohen @utoronto.ca. • N. J. Cohen et al.relation to mothers' comfort dealing with infant behaviors and their ratings of parenting stress which improved more in this group from the end of treatment to follow-up. The direct inclusion of the infant as an initiator in WWW was set forth as an explanation of differentially timed treatment effects.RESUMEN: A 58 madres y sus infantes que participaron en dos intervenciones sicoterapéuticas dentro de un estudio de intervención clínico comparativo, se les dio seguimiento durante los seis meses posteriores al tratamiento. Uno de los tratamientos fue la sicoterapia guiada por el infante, de Observar, Esperar y Preguntarse (WWW). La otra fue una sicodinámica sicoterapia materno-infantil más tradicional (PPT). Los infantes tenían entre 10 y 30 meses al principio del tratamiento, el cual se llevó a cabo en...
Deprivation in experience in the first year of life has more long-lasting effects on physical growth than on mental development. The variable most consistently related to development was height-to-age ratio. As a measure of nutritional status, the findings reinforce the critical importance of early nutrition.
Professionals and parents alike have long believed that good mothering is good for children. The endless stream of books on raising children and the financial success of such books constitute eloquent testimony both to the strength of this belief and to parents' uncertainty about what good mothering is. Indeed, over the years, experts' views of good mothering have undergone many changes (Lomax, Kagan, and Rosenkranu, 1978;Stendler, 1950;Wolfenstein, 1955). Empirical evidence on the relation between parental behavior and subsequent development has contributed little to this popular literature, but research in this domain continues to flourish.
Longitudinal follow-up data for 69 very low birthweight preterm infants were used to assess the influence of four factors (neonatal medical complications, infant temperament, mother-child relationships, and family environment) on mother and teacher reports of behavior problems at 4 years. The proposed model of such influences being tested assumed that (1) the effects of neonatal medical factors would be indirect, and (2) each of the other three factors would show high stability from 1 to 4 years and would have a direct influence on behavior problem outcomes. Neither neonatal medical data nor infant-mother attachment were good predictors of behavior problems at age 4. With these exceptions, teacher report of behavior problems was predicted in a fashion consistent with the preliminary model. However, mother reports of behavior problems was predicted only by prior mother reports of child temperament. Discussion focuses on reasons for discrepancies in these pathways of influence.
Four intervention models that aim to reduce problematic caregiver-infant relationships are reviewed within the context of attachment theory. These models include support, guidance, psychotherapy and infant-led psychotherapy. Most empirical research has evaluated support and guidance and a few studies have evaluated psychotherapy. The bulk of these studies report improvements in the caregiver-infant relationship and the infant's developmental outcome, suggesting a variety of interventions may be effective. However, although it is agreed that infants actively contribute to their relationships and development, and that in infant intervention changes in the caregiver-infant relationship are essential, only a few interventions directly include the infant and work with the caregiver-infant dyad. Most interventions work with the more verbal partner, the caregiver. Future research is needed to address the specific gains Preparation of this manuscript was partially supported by a grant from the Ontario Ministry of Community and Social Services, Children's Services Branch.
Infants' emerging communication skills are understood to be associated with the maternal relationship, particularly for children experiencing high levels of social risk. This study attempts to determine the extent to which this association is influenced by (a) the mental health risk of the dyad and (b) different operational definitions and measurement of both the dyadic relationship and the construct of "communication." Ninety-six infants (10-30 months) and their mothers were recruited: A total of 46 were at-risk dyads referred to a mental health clinic for relationship-based emotional and/or behavioral Melanie A. Barwick is Psychologist in the Community Health Systems Resource, Hospital for Sick Children, Associate Scientist, Hospital for Sick Children Research Institute, and Assistant Professor, Department of Psychiatry and Department of Public Health Sciences, University of Toronto. Nancy J. Cohen is Director of Research at the Hincks Institute and is with the Department of Psychiatry, University of Toronto, and Department of Psychology, York University. Mirek Lojkasek is with the Department of Psychiatry, University of Toronto and is both a private practitioner and a Staff Psychologist at the Hincks Institute. Naomi B. Horodezky is a speech-language pathologist in private practice and speech-language consultant for the Hincks Institute. This research was supported by a grant to Melanie A. Barwick from the Health Canada National Health Research Development , and a grant to Nancy J. Cohen and Elisabeth Muir from the Health Canada National Health Research Development Program (6606-4431). Melanie A. Barwick was supported by consecutive postdoctoral awards from the Social Science and Humanities Research Council of Canada, and from the Health Canada National Health Research Development Program. Additional career support was provided to Dr. Barwick by the Carr-Harris Foundation, The George Hull Center for Children and Families, and the Hospital for Sick Children during the preparation of this article. The authors thank the clients of the Hincks Institute for their contribution, and acknowledge research collaborators Elisabeth Muir, Roy Muir, and Carol Jane Parker. The authors also thank Nancie Im, Myrna Brown, Claire Millar, and Samantha Callendar for providing project coordination and research assistance, Lennox White for audiovisual assistance, Susan Goldberg and Jane Washington for coding the Strange Situation videotapes, Kary Kublin for coding the CSBS protocols, and Zohreh Yagoubzadeh for assistance with the statistical analysis. Direct correspondence to: Melanie A. Barwick, Psychologist and Associate Scientist, Community Health Systems Resource Group, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; e-mail: melanie.barwick@sickkids.ca. Infant Communication • 241difficulties, and 50 were nonrisk dyads not seeking mental health services and served as a normative reference or comparison group. Several factors were assessed: (a) developmental competence, (b) matern...
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