Biomedical subjects
Publications and source records attributed to T Field.
Studies on supplemental stimulation of preterm infants treated in intensive care nurseries suggest some benefits for the stimulated infants. The types, degree and duration of benefit, however, vary across studies. The following is a review of these studies, with a discussion of methodological considerations which may explain variability of findings and which may be modified in future investigations.
Face-to-face interactions were compared for mother-infant dyads from working- and middle-class groups living in the United States and England. The dyads engaged in equivalent amounts of proximal interaction but varying amounts of distal interaction. Distal interaction behaviors occurred less frequently in working-class dyads. While there were no differences between the British and American dyads on total time spent in distal interaction, the British dyads engaged in more toy-related games and American dyads exhibited more socially oriented interactions and games. The findings highlight the importance of cultural context in investigating early interactions.
The onset of rhythmic activities was compared for 2 groups of high-risk infants (a preterm Respiratory Distress Syndrome and a postterm postmature group) and a normal term group over their 1st year of life. The postterm postmature group experienced earlier onsets of rhythmic activities. The preterm RDS group showed delays in the onset of rhythmic activities, but when a correction was made for the prematurity, did not differ from the other groups. These differences suggest that the onset dates for rhythmic activities are not affected by the perinatal complications of RDS or postmaturity, but are related to gestational age differences. A comparison of the 3 groups on Bayley 1st-year motor skills revealed group differences even after an adjustment for gestational age differences, suggesting that the development of motor skills, unlike the development of rhythmic activities, may have been affected by these perinatal complications.
Game playing during early infant-parent interactions provides a context for learning conversational turntaking and contingent responsivity. The types and frequency of "universally" recognized infant games were observed during face-to-face interactions of normal and high risk infant-parent dyads when the infants were four months old. Approximately six different games were played for approximately one-third of the interaction time. Except during interactions with normal male infants mothers and fathers played games equally as often. The high-risk infant-parent dyads engaged in game playing less frequently than the normal infant-parent dyads. These differences are discussed in the context of the high-risk infants being "difficult" babies and relatively less responsive.
Multiple developmental assessments were made at 4-month intervals over the first year of life for 2 groups of infants born at risk and 1 normal group. The groups included 46 preterm respiratory distress syndrome infants, 46 postterm postmaturity syndrome, and 59 term normal infants. The mothers were white, multiparous, middle-class, high school graduates averaging 25 years of age. Analyses of group differences revealed that the preterm respiratory distress syndrome (RDS) infants continued to exhibit delays in motor and mental development and the postmature infants in mental development. Discriminant function analyses suggesting that the most efficient predictors and accurate discriminators of continuing risk were as follows: the Parmelee obstetric and postnatal complications scores and the Brazelton interactive and motoric process scores at birth; the Denver rating, mother-infant interaction and Carey temperament ratings at 4 months; and the Bayley mental and motor scores at 8 months. On the basis of their weighted assessment scores, infants were assigned a cumulative risk index at each assessment period.
Female rats were addicted to methadone via small dosages in their drinking water. The addicted animals were impregnated, and continued to receive the drug during pregnancy and lactation. Offspring were examined at birth and at age 21 days. Compared to controls whose mothers did not receive the drug, pups of addicted mothers at birth had significantly lower weight, brain weight and brain protein; litter size, brain DNA and brain acetylcholinesterase activity were not significantly different between the two groups. At age 21, pups of addicted mothers had significantly lower brain protein and brain acetylcholinesterase than did controls; body weight and brain DNA were not significantly different.
Our recent research suggests that: (1) maternal depression negatively affects infants as early as the neonatal period, implicating prenatal effects of maternal depression; (2) as early as birth the infants show a profile of "dysregulation" in their behavior, physiology, and biochemistry which probably derives from prenatal exposure to a biochemical imbalance in their mothers; (3) these effects are compounded by the disorganizing influence of the mother's interaction behavior; (4) depressed mothers have two predominant interaction styles, withdrawn or intrusive, which seem to have differential, negative effects on their infants related to inadequate stimulation and arousal modulation; (5) nondepressed caregivers such as fathers may buffer these effects because they provide more optimal stimulation and arousal modulation; and (6) interventions that are mood altering for the mothers (e.g., music and massage therapy) and arousal reducing for the infants (e.g., the same therapies) make the mothers and infants more responsive to interaction coaching and improve their interactions.
Young children with atopic dermatitis were treated with standard topical care and massaged by their parents for 20 minutes daily for a 1 month period. A control group received standard topical care only. The children's affect and activity level significantly improved, and their parent's anxiety decreased immediately after the massage therapy sessions. Over the 1 month period, parents of massaged children reported lower anxiety levels in their children, and the children improved significantly on all clinical measures including redness, scaling, lichenification, excoriation, and pruritus. The control group only improved significantly on the scaling measure. These data suggest that massage therapy may be a cost-effective adjunct treatment for atopic dermatitis, since there is a one-time expense of $30 for the child to receive the massage and the parent to learn the technique.
Twenty patients with burn injuries were randomly assigned to a massage therapy or a standard treatment control group during the remodeling phase of wound healing. The massage therapy group received a 30-minute massage with cocoa butter to a closed, moderate-sized scar tissue area twice a week for 5 weeks. The massage therapy group reported reduced itching, pain, and anxiety and improved mood immediately after the first and last therapy sessions, and their ratings on these measures improved from the first day to the last day of the study.
Twenty-eight adult patients with burns were randomly assigned before debridement to either a massage therapy group or a standard treatment control group. State anxiety and cortisol levels decreased, and behavior ratings of state, activity, vocalizations, and anxiety improved after the massage therapy sessions on the first and last days of treatment. Longer-term effects were also significantly better for the massage therapy group including decreases in depression and anger, and decreased pain on the McGill Pain Questionnaire, Present Pain Intensity scale, and Visual Analogue Scale. Although the underlying mechanisms are not known, these data suggest that debridement sessions were less painful after the massage therapy sessions due to a reduction in anxiety, and that the clinical course was probably enhanced as the result of a reduction in pain, anger, and depression.
Before dressing changes, 24 young children (mean age = 2.5 years) hospitalized for severe burns received standard dressing care or massage therapy in addition to standard dressing care. The massage therapy was conducted to body parts that were not burned. During the dressing change, the children who received massage therapy showed minimal distress behaviors and no increase in movement other than torso movement. In contrast, the children who did not receive massage therapy responded to the dressing change procedure with increased facial grimacing, torso movement, crying, leg movement and reaching out. Nurses also reported greater ease in completing the dressing change procedure for the children in the massage therapy group. These findings suggest that massage therapy attenuates young childrens' distress responses to aversive medical procedures and facilitates dressing changes.