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Infant temperament and the quality of the childrearing environment.

The purpose of this study was to determine the relationship between infant temperament and the quality of the childrearing environment by examining (a) maternal ratings of infant's behavior utilizing questionnaire category scores, (b) maternal impressions of infant's behavior, (c) the relationship of maternal ratings of infant's behavior to the quality of the childrearing environment, and (d) the relationship of maternal impressions of infant's behavior to the quality of the childrearing environment. Mothers of 20 normal, full-term infants with a mean age of 5.2 months were involved in the study. During a home visit, the Revised Infant Temperament Questionnaire (RITQ) and the Home Observational Measurement Evaluation Inventory (HOME) were completed. Pearson Product Moment Correlation, chi-square, and Z tests were used to analyze the data. The findings of the study suggested no significant difference in the quality of the childrearing environment with difficult or easy temperament infants as measured by the questionnaire category scores. There was a significant positive relationship between infants perceived as "easier-than-average" on the maternal impression responses and maternal organization and stimulation as measured by the HOME.

Environment↗

Infant joint attention skill and preschool behavioral outcomes in at-risk children.

This study examined whether infant joint attention (JA) skills predicted social behaviors in a sample of at-risk preschool children (n = 30) with a history of prenatal exposure to cocaine. JA behaviors were assessed with the Early Social and Communication Scales at 12, 15, and 18 months of age. Three classes of JA were measured: Initiating JA (IJA), Responding to JA (RJA), and Requests. Behavioral outcomes were measured at 36 months and included ratings of disruptive and withdrawn behaviors and social competence. JA behaviors were related to behavioral outcomes after controlling for language and cognitive ability. The functionally distinct uses of JA were differentially related to behavioral outcome. IJA negatively predicted disruptive behaviors, whereas Requests positively predicted disruptive behaviors. Infant RJA negatively predicted withdrawn behaviors and positively predicted social competence. These results are interpreted in the context of competing theories that attempt to explain variability in the expression of JA skills in the second year of life.

Attention↗

The assessment of behavioral change in infants undergoing narcotic withdrawal: comparative data from clinical and objective methods.

Studies comparing objective measures of sucking with data from finegrained clinical assessments of the neonate have shown significant correlations between painstaking and time-comsuming clinical methods which may only be reliably applied by highly trained clinician-investigators, and the data generated by a simple technique which can be rapidly and precisely administered in the nursery by nurses or technicians. Within a few minutes the sucking instrument can generate data that explain 50% or more of the variance in certain relevant factors of the Brazelton neonatal neurobehavioral assessment scale, which in our hands requires the participation of two trained clinician-investigators for a period of almost one hour for each test and recording session. There are certain limitations to the information directly available from the sucking measures. Clinical observations must be made in order to correctly interpret some of the findings such as the biphasic relationship between irritability and sucking. For example, an infant may not suck at all because it is obtunded, or it may not suck because it is overexcited. In the case of irritability, sucking performance provides a measure of the magnitude, but not of the polarity of the CNS arousal sucking correlates directly and gives a good estimate of both polarity as well as amount of these behaviors. Objective measures of sucking behavior are a convenient and reliable means for measuring drug effects in the nursery and may be useful in regulating therapy of the newborn.

Arousal↗

Feeding and behavioral activation in infant rats.

Three-day-old rats that were separated from their mothers and deprived of food were found to be capable of feeding either from small puddles of milk or when milk was infused into the front of their mouths. Such feeding was accompanied by a dramatic increase in behavioral activity and only occurred in a warm environment. These data demonstrate that neural systems for ingestive behavior are present at birth and suggest the existence of feeding-related arousal or motivational systems.

Animals↗

Contact-lens correction of aphakic infants and children: early behavioral and VEP results.

We studied 11 infants and young children fitted with contact lenses for correction of unilateral or bilateral aphakia. The visual-acuity estimates obtained from behavioral cues (alternate-cover test and central-fixation monitoring) were compared with results obtained from pattern-reversal visual-evoked potentials (VEP). We conclude that VEP may be more sensitive than behavioral observation for monitoring the visual progress in certain aphakic children.

Aphakia↗

The relationship between auditory brainstem response and behavioral thresholds in normal hearing infants and adults.

The nature of age-related improvements in auditory sensitivity was explored by comparing behavioral and auditory brainstem response (ABR) thresholds in 3- and 6-month-old infants and in adults. Thresholds were estimated for tone pips at 1, 4, and 8 kHz, presented at a rate of 13.3/s. The time course of development of the two response measures was compared, and the correlation between thresholds for individual subjects was examined. Infant ABR threshold was adultlike at all frequencies, even among 3-month-olds. Infant behavioral thresholds were elevated relative to adult thresholds. Between 3 and 6 months, significant improvement occurred in the 8-kHz behavioral threshold, but no improvement occurred at other frequencies. This difference between ABR and behavioral measures in developmental time course suggests that peripheral sensitivity is not a major determinant of behavioral threshold elevation during infancy. The correlation between behavioral and ABR thresholds was significant at 4 kHz for 3-month-olds and at 8 kHz for adults. This suggests that variability in sensory function at these frequencies contributes to both behavioral and ABR thresholds, although other factors are likely to be involved as well.

Acoustic Stimulation↗

The importance of eyes: how infants interpret adult looking behavior.

Two studies assessed the gaze following of 12-, 14-, and 18-month-old infants. The experimental manipulation was whether an adult could see the targets. In Experiment 1, the adult turned to targets with either open or closed eyes. Infants at all ages looked at the adult's target more in the open- versus closed-eyes condition. In Experiment 2, an inanimate occluder, a blindfold, was compared with a headband control. Infants 14- and 18-months-old looked more at the adult's target in the headband condition. Infants were not simply responding to adult head turning, which was controlled, but were sensitive to the status of the adult's eyes. In the 2nd year, infants interpreted adult looking as object-directed--an act connecting the gazer and the object.

Adult↗

Event-related potentials in year-old infants: relations with emotionality and cortisol.

Event-related potentials (ERPs) were recorded from year-old infants presented with sets of familiar faces presented frequently and infrequently, and a set of novel faces presented infrequently. The normative response of infants in this sample was a late positive slow wave to the Infrequent Familiar faces, and a return to baseline to the Frequent Familiar and Infrequent Novel faces (although there was a tendency for some infants to show a positive slow wave to the latter events). A factor score based on data from frontal and central leads that reflected this normative pattern was significantly associated with infant emotional behavior and cortisol. Infants scoring higher on the normative ERP factor were more distressed during separation, were reported by their parents to smile and laugh more, and had lower cortisol concentrations during ERP testing. These data were interpreted as reflecting the coordination of adaptive responding among different physiological and behavioral systems.

Electroencephalography↗

Nonnutritive sucking modulates behavioral state for preterm infants before feeding.

Forty-two pre-term infants were studied to determine the effect of nonnutritive sucking pre-feeding on behavioral state. Infants were randomly assigned to pacifier or rest groups. Pacifiers or rest were given for 5 minutes following routine caregiving and before each of the first 16 bottle feedings. A 12-category scale was used to measure state immediately before the 5-minutes and after. Frequencies of states that precede optimal feedings changed for infants given pacifiers versus rest: alert inactivity (+6 vs. -2), quiet awake (+19 vs. -6), and active awake (-24 vs. +12); infants given pacifiers had more sleep and fewer restless states. Group differences were non-significant before nonnutritive sucking (p = 0.16) but significant after (p = 0.00001). When self-regulatory feeding policies based on early hunger cues are not allowed, nonnutritive sucking for 5 minutes pre-feeding is simple, brief, and appropriate for busy intensive care units. These findings confirm those from earlier less conclusive research and indicate that nonnutritive sucking modulates behavioral state.

Feeding Behavior↗

The use and effectiveness of maternal scaffolding in mother-infant games.

Maternal behaviors within mother-infant games were examined to determine the amount, type, and functional value of maternal helping behaviors. 17 mother-infant pairs were videotaped on monthly visits from 8 to 16 months as they played 5 separate games. 2 of these games, roll the ball and peekaboo, were analyzed in terms of "rounds" of each game. Results show that dyads play more rounds of both games in the first months that infants perform game-relevant behaviors (e.g., returning a ball, performing uncovering or covering-uncovering). Maternal attention-getting and physical "stage-setting" behaviors occur in the early rounds of both games. In roll the ball, maternal hands-out and reinforcement behaviors increase in the months after the child begins to return the ball, while the percentage of rounds in which dyads play nonreturn variants decreases. Infants are more likely to return a ball when mother holds out her hands than when she does not. Infants are also able to perform returning or uncovering in game contexts before they perform similar behaviors in cognitive tests. The general similarity of findings in the peekaboo and roll-the-ball games, in spite of differences in the amounts of scaffolding, attention-getting, stage-setting, and reinforcement behaviors between the 2 games, indicates that the types and functions of maternal helping behaviors may be generalizable to other contexts of mother-infant interactions.

Child Development↗

Extraordinary changes in behavior in an infant after a brief separation.

A previously healthy 8-month-old infant experienced a dramatic change in affect, motor patterns, and appetite after a brief (4-day) separation from her parents. She went from being a happy, interactive, and engaging child to being withdrawn, with limited vocalization, spontaneous motor activity, or interest in her environment. For the first 3 days after her parents returned home, she refused solid food and most of the formula or water she was offered. Over the following week, her appetite increased minimally. Her parents were concerned about her apathy, excessive quietness, and lack of interest in food, toys, or their own attempts to engage her in play. At the pediatrician's office, she was significantly less interactive and playful compared with previous visits. Her temperature, heart rate, and respiratory rate were normal. Although there were no objective signs of dehydration, her weight was 8 ounces less than the previous recorded weight 1 month ago. Results of the physical examination were normal, with the exception of neurological and behavioral findings. She had mild, generalized decreased tone and strength, with normal deep tendon reflexes, a sad facial appearance with sustained furrowing of the lines in her forehead, difficulty in eliciting a social smile, and limited spontaneous sounds. There was an absence of focal neurological findings, a flat open anterior fontanel, and a head circumference measurement consistent with previous recorded results. There were no cutaneous bruises, and findings of her funduscopic examination did not reveal retinal hemorrhage. Before the 4-day holiday, child care was provided almost exclusively by her mother at home. On only two previous occasions, at 4 and 6 months of age, this first child of 20-year-old high school graduate parents was cared for by a neighbor when the parents went out to a movie theater. She cried for about 10 minutes when the parents left on these occasions. Her mother stated that she felt anxious about leaving the child for several days, but she and her husband decided that they needed a break and planned the 4-day vacation. Child care was provided by the neighbor, who did not notice any unusual behavior or refusal to feed while in her care during the parents' absence.

Anxiety, Separation↗

Time-lapse filming of newborn infants. A new technique in monitoring of behavioral states.

Knowledge of the newborn infant's behavior is of great importance for an understanding of postnatal adaptation and the influence of exogenous stimuli, such as drugs. To date, however, the methods used have been to sophisticated and complex for use on a busy ward. Moreover, procedures for monitoring physiological parameters in this age group should be non-invasive and gentle for the infant, and acceptable to parents and personnel. In this paper, a simplified technique is presented where observation of the infant can be registered with an ordinary super-8 movie camera adapted to time-lapse. Heart rate, EMG and vocalization are recorded simultaneously. The time-lapse filming technique is relatively easy to learn, it is simple and economic and can be used even during routine clinical care. Assessments were made from the films only, from the recordings only and from a combination of films and recordings. All these modes of assessment were found to be satisfactorily reproducible. Filming combined with respiratory recording gives sufficient information to classify neonatal infant behavior.

Adaptation, Physiological↗

Behavioral characteristics and early temperament of premature infants with intracranial hemorrhage.

Behavioral characteristics of 12 full-term and 44 premature infants with and without intracranial hemorrhage (ICH) were studied. Cranial ultrasonography prospectively documented Grade I-II ICH in 14, Grade III-IV in 19 and no ICH in 11 premature infants. Examination at corrected age of 40 +/- 2 weeks using the Neonatal Behavioral Assessment Scale showed that infants in the ICH groups had lower levels of arousal and more abnormal reflexes than full-terms. Infants with ICH III-IV displayed less optimal motor responses than full-term infants and diminished orientation responses, especially to visual stimuli. Thus, lower level of arousal, immature motoric processes, and poor visual orientation differentiated premature with ICH from full-term infants, although premature infants without these sequelae, did not differ significantly from full-term infants. The above may represent early manifestations of visual-perceptual and motor problems noted in the follow-up of ICH infants. Further, neonatal behavior was found to affect parent ratings of infant temperament (via the Bates Infant Characteristics Questionnaire) at 3 months corrected age, and the relationships between neonatal behavior and parental ratings differed depending upon the infant's gestational age and severity of hemorrhage. We conclude that neonatal behaviors are less optimal in premature infants, and least optimal in premature infants with severe intracranial hemorrhage when compared to fullterm infants.

Arousal↗

Postural effects on behavioral states of newborn infants--a sleep polygraphic study.

Physiological and behavioral correlates of neonates in the supine and prone positions were examined. Polygrams were recorded in 10 newborn infants in the prone and supine positions. Newborn infants slept more in the prone position than in the supine, and quiet sleep was significantly more in the prone position. Gross movement, jerky movement and twitch movement were less in the prone than the supine position. There was no difference in localized movement or tremor-like movement in the two positions. Respiration was more regular in the prone than the supine position. Sleep apnea (greater than or equal to 6 seconds) was less in the prone position. The pulse rate during quiet sleep was higher in the prone position.

Arousal↗

Spectral analysis of infant EEG and behavioral outcome at age five.

Power spectral and discriminant analysis techniques were used to compare EEG records obtained at term and at 3 months past term from 5 groups of varying risk and developmental outcome. The groups were: healthy full-terms; healthy pre-terms with normal outcomes; sick pre-terms with normal outcomes; sick pre-terms with delayed development; sick pre-terms with later neurological problems. The EEG samples recorded at term were identified as belonging to the correct subject group at 52-70% accuracy, 20% being chance for 5 groups. The accuracy varied with the 4 classes of EEG patterns used. The individual subjects were also classified into their correct groups with few exceptions. Similar success was obtained with EEG samples selected from recording at 3 months past term. The predominant power spectral discriminating features were changes in intra- and inter-hemispheric coherence, and increased power, particularly in the middle and higher frequency range. Thus, computer analyses of EEG samples, using features not readily identified visually, differentiated risk from non-risk infants and also differentiated infants with substantial neonatal medical complications who have good or poor developmental outcomes.

Brain↗