Parent-Infant Interaction during the First Year of Life in Infants at High Risk for Cerebral Palsy: A Systematic Review of the Literature

Abstract

Introduction. Perinatal adverse events put neonates at high risk for short and long-term disabilities, including cerebral palsy (CP). The most recent guidelines about early intervention in infants with brain damage have emphasized the importance of family involvement from the very first phases of development. Early parent-infant interactions are pivotal in promoting infant cognitive and social developmental trajectories. However, little is known about the extent to which severe adverse perinatal events can affect the quality of early parent-infant interactions. Patients and Methods. We systematically searched five databases (PubMed, PsycINFO, EMBASE, CINAHL, and Cochrane Library) for the publications assessing parent-infant interactions in infants at high neurological risk within 1 year of age. Articles were selected if they involved direct comparison between high-risk populations and healthy controls or low-risk populations, and if quantitative or semiquantitative tools were used to assess the parent-infant interaction. Measures of parent-infant interaction included infant interactive behaviors, parental interactive behaviors, and dyadic interactive patterns. Results. The search yielded 18 publications that met the inclusion criteria. The articles represent a high level of heterogeneity in terms of infant neurological risk, infant age, and tools assessing interactive behaviors. Both infant and maternal behaviors within the investigated interactive exchanges were reported to be compromised, leading to subsequent overall impairment of the dyadic patterns. Conclusion. While the studies reviewed here provide general and important information, the review did not yield a clear picture of early dyadic interactions in high-risk infant populations. Further observational studies are warranted in order to provide a more accurate knowledge of the early dyadic exchanges between infants at high neurological risk and their parents, as they might provide a critical opportunity for early family centered habilitative interventions.

Early intervention evidence for infants with or at risk for cerebral palsy: an overview of systematic reviews

“…One reviewed the extent to which families were involved in early intervention but did not evaluate the effectiveness of the interventions themselves, 24 one reviewed coaching practices but did not consider child outcomes, 25 and one focused solely on parentchild interactions, not development. 26 One was on older children, 27 two included mixed or other diagnoses, 28,29 and three did not involve younger children and/or were not about CP exclusively. [30][31][32] Table 1 summarizes the data from each of the systematic reviews, including details from each of the included studies and indicating overlap where present.…”

Rehabilitation services lockdown during the COVID-19 emergency: the mental health response of caregivers of children with neurodevelopmental disabilities

“…Investigating the emotional, psychological and stressful consequences of the COVID-19 emergency for the primary caregivers of children with neurodevelopmental disabilities is key to promote timely and appropriate support for parents as well as for the children themselves. Indeed, several studies suggest that parental well-being is linked with the quality of parenting even in the presence of neurodevelopmental conditions [9,10]. Caregivers are well-recognized as the primary source of prevention and care for children [11] and they can provide relevant stimulation to promote long-term cognitive, language and socio-emotional development up to preschool-and school-age [6,12,13].…”

Evidence and Open Questions for the Use of Video-Feedback Interventions With Parents of Children With Neurodevelopmental Disabilities

“…In humans, parenting represents a key factor to promote the physical, socio-emotional, behavioral, and cognitive development of infants and children (Perrin et al, 2016;Provenzi et al, 2018). The role of parenting is much more relevant when infants and children present special healthcare needs due to neurodevelopmental risk or disabilities (Festante et al, 2019). Recent research shows that maximizing parental engagement and targeting parents' caregiving skills alongside infants' needs and disabilities are crucial for the success of early rehabilitation programs (Britto et al, 2017;Schuster and Fuentes-Afflick, 2017).…”

“…Moreover, these interactive and relational difficulties can ultimately increase the risk of developing behavioral problems in children (Spittle and Treyvaud, 2016). Importantly, several studies have documented that the quality of parenting is associated with children's developmental outcomes, even in the presence of ND (Spiker et al, 2002;Assel et al, 2003;Festante et al, 2019). It has been shown that, beside social interaction and emotional support, parents also provide cognitive stimulation during their exchanges with their children, with long-term benefits for cognitive, language, and socio-emotional outcomes up to preschool-and school-age (Anderson et al, 2013;Innocenti et al, 2013;Totsika et al, 2019).…”