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1

Richter, M., A. Angell, P. Kellner, J. Smith, and R. Pineda. "Infant and Parent Outcomes Related to NICU-Based Co-occupational Engagement." OTJR: Occupational Therapy Journal of Research 44, no. 1 (March 21, 2023): 3–12. http://dx.doi.org/10.1177/15394492231160690.

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Neonatal intensive care unit (NICU) co-occupations may impact parent–infant outcomes. The main objective of this study was to explore relationships between parent and infant outcomes based on whether sensory-based interventions (co-occupations) occurred most often between parent–infant dyads or provider/volunteer–infant dyads. Thirty-five families received the Supporting and Enhancing NICU Sensory Experiences (SENSE) program, which includes education defining specific amounts of sensory exposures for infants to receive each day of NICU hospitalization (with a preference for parent delivery). Infant sensory experiences in the NICU were logged, and dyads were grouped based on who conducted most of the sensory interventions with the infant in the NICU into a Parent–Infant Co-occupation group or Other Administered group. The Parent–Infant Co-occupation group had infants with less lethargy on the NICU Network Neurobehavioral Scale ( p = .04), and parents with lower scores on the Parental Stress Scale ( p = .003) and State-Trait Anxiety Inventory-state ( p = .047). Parent–infant engagement in co-occupations was related to parental mental health and infant neurobehavior.
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Vittner, Dorothy, Jacqueline McGrath, JoAnn Robinson, Gretchen Lawhon, Regina Cusson, Leonard Eisenfeld, Stephen Walsh, Erin Young, and Xiaomei Cong. "Increase in Oxytocin From Skin-to-Skin Contact Enhances Development of Parent–Infant Relationship." Biological Research For Nursing 20, no. 1 (October 11, 2017): 54–62. http://dx.doi.org/10.1177/1099800417735633.

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Objective: To examine changes that occur in infant and parent salivary oxytocin (OT) and salivary cortisol (SC) levels during skin-to-skin contact (SSC) and whether SSC alleviates parental stress and anxiety while also supporting mother–father–infant relationships. Methods: This randomized crossover study was conducted in the neonatal intensive care unit (NICU) with a sample of 28 stable preterm infants and their parents. Saliva samples were collected from infants, mothers, and fathers on Days 1 and 2 (1/parent) for OT and cortisol measurement pre-SSC, during a 60-min SSC session, and a 45-min post-SSC. Parental anxiety was measured at the same time points. Parent–infant interaction was examined prior to discharge on Day 3 via video for synchrony and responsiveness using Dyadic Mutuality Coding. Results: Salivary OT levels increased significantly during SSC for mothers ( p < .001), fathers ( p < .002), and infants ( p < .002). Infant SC levels decreased significantly ( p < .001) during SSC as compared to before and after SSC. Parent anxiety scores were significantly related to parent OT and SC levels. Parents with higher OT levels exhibited more synchrony and responsiveness ( p < .001) in their infant interactions. Conclusion: This study addresses a gap in understanding the mechanisms linking parent–infant contact to biobehavioral responses. SSC activated OT release and decreased infant SC levels. Facilitation of SSC may be an effective intervention to reduce parent and infant stress in the NICU. Findings advance the exploration of OT as a potential moderator for improving responsiveness and synchrony in parent–infant interactions.
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Walker, Lynne J. "Bonding With Books: The Parent–Infant Connection in the Neonatal Intensive Care Unit." Neonatal Network 32, no. 2 (2013): 104–9. http://dx.doi.org/10.1891/0730-0832.32.2.104.

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Parents of infants in the neonatal intensive care unit (NICU) experience one of the most stressful events of their lives. At times, they are unable to participate fully, if at all, in the care of their infant. Parents in the NICU have a need to participate in the care of their infant to attain the parental role. Parental reading to infants in the NICU is an intervention that can connect the parent and infant and offers a way for parents to participate in caregiving. This intervention may have many benefits and may positively affect the parent–infant relationship.
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Väliaho, Anniina, Liisa Lehtonen, Anna Axelin, and Riikka Korja. "Parental Narratives of Bonding and Relational Experiences with Preterm Infants Born at 23 to 24 Weeks—A Qualitative Descriptive Study." Children 10, no. 5 (April 28, 2023): 793. http://dx.doi.org/10.3390/children10050793.

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(1) Background. The birth of an infant at 23 to 24 weeks poses a significant challenge to healthy parent–infant bonding because of the high risk of infant loss and the prolonged separation. The aim of this study was to retrospectively explore the narratives of parents with children born at 23–24 weeks about their bonding formation and relational experiences. (2) Methods. This was a qualitative descriptive study conducted with Finnish parents of children born at 23 or 24 weeks of gestation. Twenty-nine mothers and eight fathers were retrospectively interviewed using a semi-structured interview about the bonding process with their infant during the period in the neonatal intensive care unit (NICU) and their later parent–child relationship. Parents’ narratives were deductively analysed according to a framework previously developed for studying parental bonding. (3) Results. Our results showed that several parents described the bonding process as natural or even easy despite the traumatic start to parenthood. Support from NICU staff and providing opportunities for participation in infant care and parent–infant physical closeness were reported to enhance the bonding process. Our study identified earlier parenting experience as a new element supporting bonding. (4) Conclusions. According to our results, essential elements enhancing parent–infant bonding in NICU settings seem to be supporting parents psychologically, promoting parent–infant closeness, and encouraging parental participation in the infants’ care, even with the most immature infants.
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McCarty, Dana B., Stacey C. Dusing, Alana Gilbert, Kristen D. LeBlond, Meredith Soucie, and T. Michael O’Shea. "Parent and Therapist Perceptions of the Feasibility, Acceptability, and Benefits of a Weekly Therapist-Led Massage Program for Extremely Preterm Infants in Neonatal Intensive Care." Children 10, no. 9 (August 25, 2023): 1453. http://dx.doi.org/10.3390/children10091453.

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Mothers of extremely preterm infants experience high rates of mental health disorders that impair maternal–infant interaction and lead to worse infant developmental outcomes. Therapist Education and Massage for Parent–Infant Outcomes (TEMPO) is a therapist-led program that standardizes the nature and frequency of parent education through weekly scheduled therapy sessions. Using a family-centered approach, the therapist facilitates positive maternal–infant interactions and massage interventions from birth throughout hospitalization with the goal of improving maternal mental health. This qualitative study presents the results of 19 parent interviews and of a focus group of four TEMPO interventionists to elicit feedback about the program. Overall, parents and therapists viewed the program positively. Parents and therapists valued the focus on parent education and engagement to increase parent competence and bonding opportunities. Both groups acknowledged that infant massage had both infant-centered and parent-centered benefits. One area where parent and therapist views did not align was regarding feasibility of TEMPO. Parents noted multiple logistical challenges to regular NICU visitation, but ultimately agreed that attending weekly therapy sessions was feasible. Therapists noted increased time and effort required of TEMPO and felt that institutional and system-level changes would be necessary to implement weekly parent education as standard of care.
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EIDEN, RINA DAS, ELLEN PETERSON EDWARDS, and KENNETH E. LEONARD. "Mother–infant and father–infant attachment among alcoholic families." Development and Psychopathology 14, no. 2 (May 15, 2002): 253–78. http://dx.doi.org/10.1017/s0954579402002043.

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This study examined the association between fathers' alcoholism and other risk factors such as parental depression, family conflict, infant temperament, and parent–infant attachment. The quality of parent–infant interactions was hypothesized to be a proximal mediator of the associations among alcoholism and other risk factors and attachment. The participants were 223 families (104 nonalcoholic families and 119 alcoholic families) with 12-month-old infants recruited through birth records. Infants in families with two parents with alcohol problem had significantly higher rates of insecure attachment with both parents. Structural Equations Modeling indicated that the fathers' alcohol problem was associated with lower paternal sensitivity (higher negative affect, lower positive engagement, and lower sensitive responding) during father–infant play interactions, and this in turn was associated with higher risk for infant attachment insecurity with fathers. The association between the fathers' alcohol problem and infant attachment security with the mother was mediated by maternal depression, and maternal alcohol problems and family conflict were associated with maternal sensitivity during play interactions. These results indicate that the fathers' alcoholism is associated with higher family risk including the quality of the parent–infant relationship; infant attachment develops in a family context; and this context has a significant association with attachment security.
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Salvadori, Eliala A., Cristina Colonnesi, Heleen S. Vonk, Frans J. Oort, and Evin Aktar. "Infant Emotional Mimicry of Strangers: Associations with Parent Emotional Mimicry, Parent-Infant Mutual Attention, and Parent Dispositional Affective Empathy." International Journal of Environmental Research and Public Health 18, no. 2 (January 14, 2021): 654. http://dx.doi.org/10.3390/ijerph18020654.

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Emotional mimicry, the tendency to automatically and spontaneously reproduce others’ facial expressions, characterizes human social interactions from infancy onwards. Yet, little is known about the factors modulating its development in the first year of life. This study investigated infant emotional mimicry and its association with parent emotional mimicry, parent-infant mutual attention, and parent dispositional affective empathy. One hundred and seventeen parent-infant dyads (51 six-month-olds, 66 twelve-month-olds) were observed during video presentation of strangers’ happy, sad, angry, and fearful faces. Infant and parent emotional mimicry (i.e., facial expressions valence-congruent to the video) and their mutual attention (i.e., simultaneous gaze at one another) were systematically coded second-by-second. Parent empathy was assessed via self-report. Path models indicated that infant mimicry of happy stimuli was positively and independently associated with parent mimicry and affective empathy, while infant mimicry of sad stimuli was related to longer parent-infant mutual attention. Findings provide new insights into infants’ and parents’ coordination of mimicry and attention during triadic contexts of interactions, endorsing the social-affiliative function of mimicry already present in infancy: emotional mimicry occurs as an automatic parent-infant shared behavior and early manifestation of empathy only when strangers’ emotional displays are positive, and thus perceived as affiliative.
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8

Riddell, Rebecca Pillai, David B. Flora, Sara Stevens, Saul Greenberg, and Hartley Garfield. "The Role of Infant Pain Behaviour in Predicting Parent Pain Ratings." Pain Research and Management 19, no. 5 (2014): e124-e132. http://dx.doi.org/10.1155/2014/934831.

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BACKGROUND: Research investigating how observers empathize or form estimations of an individual experiencing pain suggests that both characteristics of the observer (‘top down’) and characteristics of the individual in pain (‘bottom up’) are influential. However, experts have opined that infant behaviour should serve as a crucial determinant of infant pain judgment due to their inability to self-report.OBJECTIVE: To predict parents’ immunization pain ratings using archival data. It was hypothesized that infant behaviour (‘bottom up’) and parental emotional availability (‘top down’) would directly predict the most variance in parent pain ratings.METHODS: Healthy infants were naturalistically observed during their two-, four-, six- and/or 12-month immunization appointments. Cross-sectional latent growth curve models in a structural equation model context were conducted at each age (n=469 to n=579) to examine direct and indirect predictors of parental ratings of their infant’s pain.RESULTS: At each age, each model suggested that moderate amounts of variance in parent pain report were accounted for by models that included infant pain behaviours (R2=0.18 to 0.36). Moreover, notable differences were found for older versus younger infants with regard to parental emotional availability, infant sex, caregiver age and amount of variance explained by infant variables.CONCLUSIONS: The results of the present study suggest that parent pain ratings are not predominantly predicted by infant behaviours, especially before four months of age. Current results suggest that recognizing infant pain behaviours during painful events may be an important area of parent education, especially for parents of very young infants. Further work is needed to determine other factors that predict parent judgments of infant pain.
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Ullsten, Alexandra, Mats Eriksson, Maria Klässbo, and Ulrik Volgsten. "Singing, sharing, soothing – biopsychosocial rationales for parental infant-directed singing in neonatal pain management." Music & Science 1 (January 1, 2018): 205920431878084. http://dx.doi.org/10.1177/2059204318780841.

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Infant-directed singing is a medium for parents and infants to communicate in a mutual relationship. Parental infant-directed singing is a multisensory, biopsychosocial communication that applies to ill and vulnerable hospitalised infants. The primary musical features of infant-directed singing are ideal for emotional coordination and sharing between parent and infant without the risk of over-stimulation. In this article, we suggest that parental infant-directed singing is regarded as a nonpharmacological emotion regulation intervention, which may modify the painful experience for both the infant and the parent before, during and after painful procedures in the neonatal intensive care context. Parents have the biopsychosocial resources to alleviate their infant’s pain through infant-directed singing, if they are empowered to do so and coached in this process. A music therapist specialised in neonatal music therapy methods can mentor parents in how to use entrained and attuned live lullaby singing in connection to painful procedures. Pain and the vast amount of painful procedures early in infancy, combined with early parent–infant separation and lack of parental participation in the care of the infant during neonatal intensive care, place arduous strain on the new family’s attachment process and on the infant’s and parents’ mental health, both from a short and long-term perspective. Therefore, we argue with biopsychosocial rationales, that live parental infant-directed singing should be promoted in neonatal pain care worldwide. Consequently, parents should be welcomed round the clock and invited as prescribed pain management for their infant.
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Sakonidou, Susanna, Izabela Andrzejewska, James Webbe, Neena Modi, Derek Bell, and Chris Gale. "Interventions to improve quantitative measures of parent satisfaction in neonatal care: a systematic review." BMJ Paediatrics Open 4, no. 1 (March 2020): e000613. http://dx.doi.org/10.1136/bmjpo-2019-000613.

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ObjectiveInterventions improving parent satisfaction can reduce parent stress, may improve parent-infant bonding and infant outcomes. Our objective was to systematically review neonatal interventions relating to parents of infants of all gestations where an outcome was parent satisfaction.MethodsWe searched the databases MEDLINE, EMBASE, PsychINFO, Cochrane Central Register of Controlled Trials, CINAHL, HMIC, Maternity and Infant Care between 1 January 1946 and 1 October 2017. Inclusion criteria were randomised controlled trials (RCT), cohort studies and other non-randomised studies if participants were parents of infants receiving neonatal care, interventions were implemented in neonatal units (of any care level) and ≥1 quantitative outcome of parent satisfaction was measured. Included studies were limited to the English language only. We extracted study characteristics, interventions, outcomes and parent involvement in intervention design. Included studies were not sufficiently homogenous to enable quantitative synthesis. We assessed quality with the Cochrane Collaboration risk of bias tool (randomised) and the ROBINS-I tool (Risk Of Bias In Non-randomised Studies - of Interventions) (non-randomised studies).ResultsWe identified 32 studies with satisfaction measures from over 2800 parents and grouped interventions into 5 themes. Most studies were non-randomised involving preterm infants. Parent satisfaction was measured by 334 different questions in 29 questionnaires (only 6/29 fully validated). 18/32 studies reported higher parent satisfaction in the intervention group. The intervention theme with most studies reporting higher satisfaction was parent involvement (10/14). Five (5/32) studies reported involving parents in intervention design. All studies had high risk of bias.ConclusionsMany interventions, commonly relating to parent involvement, are reported to improve parent satisfaction. Inconsistency in satisfaction measurements and high risk of bias makes this low-quality evidence. Standardised, validated parent satisfaction measures are needed, as well as higher quality trials of parent experience involving parents in intervention design.PROSPERO registration numberCRD42017072388.
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Lemmon, Monica E., Pamela K. Donohue, Charlamaine Parkinson, Frances J. Northington, and Renee D. Boss. "Parent Experience of Neonatal Encephalopathy." Journal of Child Neurology 32, no. 3 (December 8, 2016): 286–92. http://dx.doi.org/10.1177/0883073816680747.

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We aimed to characterize the parent experience of caring for an infant with neonatal encephalopathy. In this mixed-methods study, we performed semistructured interviews with parents whose infants were enrolled in an existing longitudinal cohort study of therapeutic hypothermia between 2011 and 2014. Thematic saturation was achieved after 20 interviews. Parent experience of caring for a child with neonatal encephalopathy was characterized by 3 principal themes. Theme 1: Many families described cumulative loss and grief throughout the perinatal crisis, critical neonatal course, and subsequent missed developmental milestones. Theme 2: Families experienced entangled infant and broader family interests. Theme 3: Parents evolved into and found meaning in their role as an advocate. These data offer insight into the lived experience of parenting an infant with neonatal encephalopathy. Primary data from parents can serve as a useful framework to guide the development and interpretation of parent-centered outcomes.
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Pedersen, Marlene Rosager Lund, Bjarne Ibsen, Danae Dinkel, Niels Christian Møller, and Lise Hestbæk. "The Effect of a Parent-Directed Program to Improve Infants’ Motor Skills." International Journal of Environmental Research and Public Health 20, no. 3 (January 21, 2023): 1999. http://dx.doi.org/10.3390/ijerph20031999.

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Poor motor skills are associated with several factors that might delay children’s development. Therefore, early programs to promote a child’s motor development are essential. Within the first year of life, parents have a critical role in promoting their infant’s motor development. However, little research has explored parent-directed programs that promote infant development in a Scandinavian context. This study aimed to evaluate the effectiveness of a parent-directed program to improve infant motor development. Methods: Parents of infants received a parent-directed program that included guidance from health visitors on ways to promote motor development, videos with motor development activities and a bag with related materials. Two municipalities in Denmark took part in the study (one intervention, one control). Health visitors in both municipalities measured the infants’ age-appropriate motor skills once when the infants were between 9–11 months of age. A logistic regression model was used to analyze the data. Results: No difference was detected in motor development over time in the two municipalities regarding the proportion of children with age-appropriate motor skills. Conclusions: A parent-directed program in which parents were guided to play and encourage motor development with their infant showed no effect on infants’ age-appropriate motor skills at 9–11 months.
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Agostini, Francesca, Federica Andrei, Erica Neri, Elena Trombini, Francesca Nuccini, Maria Teresa Villani, Lorenzo Aguzzoli, and Marcella Paterlini. "Characteristics of Early Mother–Infant and Father–Infant Interactions: A Comparison between Assisted Reproductive Technology and Spontaneous Conceiving Parents." International Journal of Environmental Research and Public Health 17, no. 21 (November 6, 2020): 8215. http://dx.doi.org/10.3390/ijerph17218215.

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This study aims to describe parents’ and infant’s interactive styles after assisted reproduction treatments (ART), to compare them with parent–infant interactions after spontaneous conception (SC), and to assess the effect of specific ART variables (cause of infertility, treatment type, and previous ART attempts) on interaction quality. The sample included 25 ART conceiving couples and 31 SC couples with their 3-months-old babies. Free parent–infant interactions (3–5 min) were coded using the CARE-Index, a video-based assessment scale that gives both dimensional (e.g., sensitivity, control, passivity) and categorical scores (sensitive, inept, at-risk) for parents and infants. Results showed a global similarity between groups in CARE-Index dimensions. Nevertheless, differences emerged in categorical scores, as the interactive patterns of ART parents were more frequently classified as “inept” and “at-risk” compared to SC parents. With regards to ART dyads only, infants conceived through intracytoplasmic sperm injection scored significantly lower to the dimension compulsivity and higher to passivity, compared to infants conceived through in vitro fertilization. Yet, infants conceived at the first ART cycle had significantly lower levels of difficulty than infants conceived after one ART attempt. These results speak about the existence of important parent–infant interactive differences related to conception modality and ART technique and suggest the need to implement support programs to promote more sensitive parenting styles.
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van Veenendaal, Nicole R., Jennifer N. Auxier, Sophie R. D. van der Schoor, Linda S. Franck, Mireille A. Stelwagen, Femke de Groof, Johannes B. van Goudoever, et al. "Development and psychometric evaluation of the CO-PARTNER tool for collaboration and parent participation in neonatal care." PLOS ONE 16, no. 6 (June 9, 2021): e0252074. http://dx.doi.org/10.1371/journal.pone.0252074.

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Background Active parent participation in neonatal care and collaboration between parents and professionals during infant hospitalization in the neonatal intensive care unit (NICU) is beneficial for infants and their parents. A tool is needed to support parents and to study the effects and implementation of parent-partnered models of neonatal care. Methods We developed and psychometrically evaluated a tool measuring active parent participation and collaboration in neonatal care within six domains: Daily Care, Medical Care, Acquiring Information, Parent Advocacy, Time Spent with Infant and Closeness and Comforting the Infant. Items were generated in focus group discussions and in-depth interviews with professionals and parents. The tool was completed at NICU-discharge by 306 parents (174 mothers and 132 fathers) of preterm infants. Subsequently, we studied structural validity with confirmatory factor analysis (CFA), construct validity, using the Average Variance Extracted and Heterotrait-Monotrait ratio of correlations, and hypothesis testing with correlations and univariate linear regression. For internal consistency we calculated composite reliability (CR). We performed multiple imputations by chained equations for missing data. Results A 31 item tool for parent participation and collaboration in neonatal care was developed. CFA revealed high factor loadings of items within each domain. Internal consistency was 0.558 to 0.938. Convergent validity and discriminant validity were strong. Higher scores correlated with less parent depressive symptoms (r = -0.141, 95%CI -0.240; -0.029, p = 0.0141), less impaired parent-infant bonding (r = -0.196, 95%CI -0.302; -0.056, p<0.0001), higher parent self-efficacy (r = 0.228, 95%CI 0.117; 0.332, p<0.0001), and higher parent satisfaction (r = 0.197, 95%CI 0.090; 0.308, p = 0.001). Parents in a family integrated care model had higher scores than in standard care (beta 6.020, 95%CI 4.144; 7.895, p<0.0001) and mothers scored higher than fathers (beta 2.103,95%CI 0.084; 4.121, p = 0.041). Conclusion The CO-PARTNER tool explicitly measures parents’ participation and collaboration with professionals in neonatal care incorporating their unique roles in care provision, leadership, and connection to their infant. The tool consists of 31 items within six domains with good face, content, construct and structural validity.
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Wan, Ming Wai, Jonathan Green, and Jordan Scott. "A systematic review of parent–infant interaction in infants at risk of autism." Autism 23, no. 4 (July 11, 2018): 811–20. http://dx.doi.org/10.1177/1362361318777484.

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Social communicative precursors to autism spectrum disorder may influence how infants who are later diagnosed with autism spectrum disorder interact with their social partners and the responses they receive, thus bidirectionally influencing early social experience. This systematic review aimed to identify a developmental timeline for parent–infant interaction in the first 2 years of life in at-risk infants and in emergent autism spectrum disorder, and to examine any parent–infant interaction associations with later social-communicative outcomes. In total, 15 studies were identified investigating parent–infant interaction in infants at familial autism risk (i.e. with an older sibling with autism spectrum disorder). Starting from the latter part of the first year, infants at risk of autism spectrum disorder (and particularly infants with eventual autism spectrum disorder) showed parent–infant interaction differences from those with no eventual autism spectrum disorder, most notably in infant gesture use and dyadic qualities. While parental interactions did not differ by subsequent child autism spectrum disorder outcome, at-risk infants may receive different ‘compensatory’ socio-communicative inputs, and further work is needed to clarify their effects. Preliminary evidence links aspects of parent–infant interaction with later language outcomes. We discuss the potential role of parent–infant interaction in early parent-mediated intervention.
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Festante, F., C. Antonelli, O. Chorna, G. Corsi, and A. Guzzetta. "Parent-Infant Interaction during the First Year of Life in Infants at High Risk for Cerebral Palsy: A Systematic Review of the Literature." Neural Plasticity 2019 (April 15, 2019): 1–19. http://dx.doi.org/10.1155/2019/5759694.

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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.
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Wheeler, Anne C., Katherine C. Okoniewski, Samantha Scott, Anne Edwards, Emily Cheves, and Lauren Turner-Brown. "Pilot protocol for the Parent and Infant Inter(X)action Intervention (PIXI) feasibility study." PLOS ONE 18, no. 5 (May 4, 2023): e0270169. http://dx.doi.org/10.1371/journal.pone.0270169.

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This paper provides the detailed protocol for a pilot study testing the feasibility, acceptability, and initial efficacy of a targeted two-phase, remotely delivered early intervention program for infants with neurogenetic conditions (NGC) and their caregivers. The Parent and Infant Inter(X)action Intervention (PIXI) is designed to support parents and infants with a NGC diagnosed in the first year of life. PIXI is implemented in two phases, with the first phase focusing on psychoeducation, parent support, and how to establish routines for supporting infant development. Phase II helps parents learn targeted skills to support their infant’s development as symptoms may begin to emerge. The proposed non-randomized feasibility pilot study will establish the feasibility of a year-long virtually implemented intervention program to support new parents of an infant diagnosed with an NGC.
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Kehl, Selina M., Pearl La Marca-Ghaemmaghami, Marina Haller, Elisabeth Pichler-Stachl, Hans Ulrich Bucher, Dirk Bassler, and Friederike B. Haslbeck. "Creative Music Therapy with Premature Infants and Their Parents: A Mixed-Method Pilot Study on Parents’ Anxiety, Stress and Depressive Symptoms and Parent–Infant Attachment." International Journal of Environmental Research and Public Health 18, no. 1 (December 31, 2020): 265. http://dx.doi.org/10.3390/ijerph18010265.

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Premature birth is stressful for infants and parents and can adversely affect the parent–infant dyad. This mixed-methods pilot study evaluates whether creative music therapy (CMT) can alleviate anxiety, stress, and depressive symptoms in parents and support the bonding process with their infant. Sixteen parent couples were included. Ten couples were randomly allocated to the music therapy group (MTG) and six to the control group (CG). All couples completed psychological questionnaires measuring anxiety and depressive symptoms as well as an implicit measure of parent–infant attachment at two weeks postpartum (T1), at approximate neonatal intensive care unit (NICU) hospitalization halftime (T2), and two weeks after the infant had been discharged (T3). At T1 and T2, the parents additionally completed a questionnaire assessing the degree of stress they experienced at the NICU. Qualitative data were collected through a semi-structured, problem-centered interview with MTG parents at T3. The results of the quantitative analyses revealed reductions in anxiety levels from T1 to T2 (p = 0.002) as well as decreases in depressive symptoms from T2 to T3 (p = 0.022). No such changes were apparent in the CG. In fact, parental stress increased from T1 to T2 (p = 0.016). Significant increases in attachment across time were also observed within the MTG, but not in the CG. The qualitative inquiry confirmed that CMT can support the parent–infant relationship. Being in musical interaction evoked feelings of joy and relaxation in the parents and encouraged them to interact more profoundly with their infant. The results call for a more extensive powered follow-up study to further investigate CMT’s potential for parental well-being and parent–infant bonding.
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Miller, Jennifer L., Amanda Lossia, Catalina Suarez-Rivera, and Julie Gros-Louis. "Toys that squeak: Toy type impacts quality and quantity of parent–child interactions." First Language 37, no. 6 (June 21, 2017): 630–47. http://dx.doi.org/10.1177/0142723717714947.

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Given the dependent nature of parent–infant interactions necessary for language development, it is important to understand how context may influence these interactions. This study examines how contextual variables influence communicative, cognitive and social measures of parent–infant interactions. Specifically, how do feedback toys and traditional toys associate with important parent and child measures necessary for learning and development? Here we report evidence that toy type is associated with quality and quantity of parent–child interactions. Condition 1 examined parent–child interactions during two separate play sessions; one contained feedback toys and the other contained traditional toys. Condition 2 combined the toys so dyads had access to both types at the same time. Infants produced higher levels of directed vocalizations and directed gestures, but had shorter durations of sustained attention, when interacting with traditional toys compared to feedback toys. Parents responded more to infants’ vocalizations and gestures when interacting with traditional toys. In general, these results suggest that toy properties can play a significant role in parent–infant interactions.
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Lilliesköld, Siri, Karoline Lode-Kolz, Siren Rettedal, Johanna Lindstedt, Agnes Linnér, Hanne Markhus Pike, Sari Ahlqvist-Björkroth, Ulrika Ådén, and Wibke Jonas. "Skin-to-Skin Contact at Birth for Very Preterm Infants and Mother-Infant Interaction Quality at 4 Months." JAMA Network Open 6, no. 11 (November 30, 2023): e2344469. http://dx.doi.org/10.1001/jamanetworkopen.2023.44469.

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ImportanceGood-quality parent-infant interactions have protective effects on infant socio-emotional and behavioral development. These interactions are especially critical for very preterm infants at risk of vulnerabilities related to immaturity. Skin-to-skin contact (SSC) has been found to improve mother–preterm infant interaction behaviors, but few studies exist regarding its benefits when initiated immediately after birth.ObjectiveTo determine the effect of immediate SSC at birth for very preterm infants on mother-infant interaction quality at 4 months of corrected age.Design, Setting, and ParticipantsThis secondary analysis used data from the Immediate Parent-Infant Skin-to-Skin Study (IPISTOSS), a randomized clinical trial conducted between April 1, 2018, and June 30, 2021, at 3 neonatal units in Sweden and Norway. Participants included very preterm infants (28-33 gestational weeks of age) and their parents. Four-month follow-up was concluded in December 2021. Data analyses were performed on March 16 and September 18, 2023.InterventionInfants were allocated to standard incubator care or SSC with either parent initiated at birth and continued throughout the first 6 hours after birth.Main Outcomes and MeasuresThe primary outcome was mother-infant interaction quality as measured with the Parent–Child Early Relational Assessment (PCERA), based on video recordings of a 5-minute free-play situation with mother-infant dyads at 4 months of corrected age. A multilevel regression analysis was performed.ResultsThis analysis included 71 infants (31 twins [44%]) and 56 mothers. Infants had a mean (SD) gestational age of 31 weeks 3 (1.3) days, and more than half were male (42 [59%]); mothers had a mean (SD) age of 32 (4.9) years. There were 37 infants allocated to standard care and 34 to SSC with either parent after birth. During the first 6 hours after birth, fathers provided more SSC than mothers, with a median (IQR) of 3.25 (2.25-4.5) and 0.75 (0-2.5) hours, respectively. A statistically significant difference in 1 of 5 PCERA subscales (subscale 3: infant positive affect, communicative and social skills) was observed, with higher-quality mother-infant interaction in the SSC group at 4 months (Cohen d = 0.67 [95% CI, 0.17 to 1.17]; P = .01). This effect remained significant when adjusting for primiparity, child sex, and observation setting.Conclusions and RelevanceIn this study of the effect of immediate parent-infant SSC after very preterm birth, SSC was beneficial for the mother-infant relationship. These findings suggest that immediate SSC should be supported in the clinical setting.Trial RegistrationClinicalTrials.gov Identifier: NCT03521310
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Haley, David W., Jennifer Cordick, Sarah Mackrell, Immaculate Antony, and Maireanne Ryan-Harrison. "Infant anticipatory stress." Biology Letters 7, no. 1 (August 25, 2010): 136–38. http://dx.doi.org/10.1098/rsbl.2010.0565.

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In humans, anticipatory stress involves activation of the limbic–hypothalamic–pituitary–adrenal axis, which releases stress hormones such as cortisol in response to an impending stressor. Conditioning of the stress response to anticipate and prepare for future challenges is a hallmark of adaptation. It is unknown whether human infants in the first year of life have developed the neural circuitry to support the anticipation of stressful events in an attachment context. Here, we show that human infants at six months of age produce an anticipatory stress response, as indicated by the release of stress hormones, when re-exposed after 24 h to a context in which they demonstrated a stress response to a disruption in the parent–infant relationship. Although infant stress response (cortisol elevation) was greater to the stressful event (parent unresponsiveness) than to the second exposure to the stress context (room, chair, presence of parent and experimenter, etc.), it was greater in the stress group than in the control group on both days. Results suggest that human infants have the capacity to produce an anticipatory stress response that is based on expectations about how their parents will treat them in a specific context.
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Joseph, Rachel, Amelia Wellings, and Grace Votta. "Mindfulness-Based Strategies: A Cost-Effective Stress Reduction Method for Parents in the NICU." Neonatal Network 38, no. 3 (May 1, 2019): 135–43. http://dx.doi.org/10.1891/0730-0832.38.3.135.

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Stress in parents who have an infant in the NICU is well documented in literature. Prematurity and related comorbid conditions, high-tech NICU environments, presence of multidisciplinary health care professionals, altered parenting roles, and concerns of health outcomes in the infant are common stress factors. Further, inadequate management of stress can result in poor parent–infant bonding, poor infant outcome, and postpartum depression in parents. Effective stress management strategies may help parents adapt to their parental role thereby improving infant outcomes. Research has shown mindfulness-based strategies help reduce stress in the general population. Can this strategy be applied in the context of parents of infants in the NICU? Literature is scant on the impact of mindfulness-based strategies on parents of infants in the NICU and on the infant's health outcomes. This article explores the application of mindfulness-based strategies to reduce stress in parents of infants in the NICU.
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Pados, Britt F., Hayley H. Estrem, Suzanne M. Thoyre, Jinhee Park, and Cara McComish. "The Neonatal Eating Assessment Tool: Development and Content Validation." Neonatal Network 36, no. 6 (2017): 359–67. http://dx.doi.org/10.1891/0730-0832.36.6.359.

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AbstractPurpose: To develop and content validate the Neonatal Eating Assessment Tool (NeoEAT), a parent-report measure of infant feeding.Design: The NeoEAT was developed in three phases. Phase 1: Items were generated from a literature review, available assessment tools, and parents’ descriptions of problematic feeding in infants. Phase 2: Professionals rated items for relevance and clarity. Content validity indices were calculated. Phase 3: Parent understanding was explored through cognitive interviews.Sample: Phase 1: Descriptions of infant feeding were obtained from 12 parents of children with diagnosed feeding problems and 29 parents of infants younger than seven months. Phase 2: Nine professionals rated items. Phase 3: Sixteen parents of infants younger than seven months completed the cognitive interview.Main Outcome Variable: Content validity of the NeoEAT.Results: Three versions were developed: NeoEAT Breastfeeding (72 items), NeoEAT Bottle Feeding (74 items), and NeoEAT Breastfeeding and Bottle Feeding (89 items).
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Yakobson, Dana, Shmuel Arnon, Christian Gold, Cochavit Elefant, Ita Litmanovitz, and Bolette Daniels Beck. "Music Therapy for Preterm Infants and Their Parents: A Cluster-Randomized Controlled Trial Protocol." Journal of Music Therapy 57, no. 2 (2020): 219–42. http://dx.doi.org/10.1093/jmt/thaa002.

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Abstract Music therapy (MT) interventions and skin-to-skin care (SSC) both aim to address the varied needs of preterm infants, including sensory regulation and stress reduction, inclusion of parents in their infant’s care, support of parents’ emotional state, and enhancing the parent–infant attachment process. Few studies have investigated the combination of both modalities through randomized controlled trials. Evidence of longer-term effects is missing. This article presents a study protocol that will investigate the effects of combined family-centered MT intervention and SSC on preterm-infants’ autonomic nervous system (ANS) stability, parental anxiety levels, and parent–infant attachment quality. 12 clusters with a total of 72 preterm infants, with their parents, will be randomized to one of two conditions: MT combined with SSC or SSC alone. Each parent–infant dyad will participate in 3 sessions (2 in the hospital and a 3-month follow-up). The primary outcome of preterm infants’ ANS stability will be measured by the high frequency power of their heart rate variability. Secondary outcomes will be physiological measures and behavioral states in infants and anxiety and attachment levels of parents. This trial will provide important, evidence-based knowledge on the use of the “First Sounds: Rhythm, Breath, and Lullaby” model of MT in neonatal care, through an intervention that is in line with the Newborn Individualized Developmental Care and Assessment Program model for supportive developmental care of preterm infants and their parents. Ethical approval (no. 0283-15) was granted from the local Institutional Review Board in April 2017. This trial is registered in ClinicalTrials.gov, NCT03023267.
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Nabaweesi, Rosemary, Leanne Whiteside-Mansell, Samantha H. Mullins, Mallikarjuna R. Rettiganti, and Mary E. Aitken. "Field assessment of a safe sleep instrument using smartphone technology." Journal of Clinical and Translational Science 4, no. 5 (December 19, 2019): 451–56. http://dx.doi.org/10.1017/cts.2019.446.

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AbstractIntroduction:Sudden unexpected infant death is the leading cause of infant mortality with black: white infant mortality remaining at 2:1 for the last decade. Smartphone technology provides a convenient and accessible tool for injury prevention anticipatory guidance among at-risk communities.Materials and Methods:A convenience sample of pregnant teen mothers who own a smartphone. During a 1-month postnatal home visit, a safe sleep environment survey was administered, infant sleep practices were observed, and mothers trained to take and submit standard infants’ sleep environment photographs. Photographs were independently assessed for inter-rater reliability (IRR) across five sleep safety domains (primary outcome): sleep location, surface, position, presence of soft items, and hazards near the sleep area. Expert and novice coders IRR was measured using Cohen’s kappa coefficient (K). Sleep safety correlation between photographs and observation, and parent report and observation was determined.Results:Sixteen (57.1%) mothers completed the home visit. Most parents reported infants sleeping supine (78.5) in parents’ bedroom (85.9%). Photographs demonstrated sleep position, soft items without the baby present, and hanging toys had perfect agreement across all three coder pairs. Safe sleep experts’ IRR demonstrated perfect agreement for sleep location, position, and soft items. While 83.8% of parents were observed putting their infants down to sleep on their back, 78.5% of parents reported doing the same and 82.4% of the photographs demonstrated supine infant sleep position.Conclusion:Using photographs, coders can reliably categorize some key infant sleep safety aspects, and photograph sleep safety is comparable to parent report and direct observation.
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Spence, Christine M., Corri L. Stuyvenberg, Audrey E. Kane, Jennifer Burnsed, and Stacey C. Dusing. "Parent Experiences in the NICU and Transition to Home." International Journal of Environmental Research and Public Health 20, no. 11 (June 4, 2023): 6050. http://dx.doi.org/10.3390/ijerph20116050.

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Families (n = 12) with infants born at <29 weeks gestation shared their experiences while in the NICU and transitioning home. Parents were interviewed 6–8 weeks after NICU discharge, including some during the acute phase of the COVID-19 pandemic. Findings regarding the parent experience in the NICU were focused around challenges navigating parent-infant separation, social isolation, communication difficulties, limited knowledge of preterm infants, mental health challenges. Parents also discussed supports that were present and supports they wished were present, as well as the impact of COVID-19 on their experiences. In the transition to home, primary experiences included the sudden nature of the transition, anxiety around discharge preparation, and the loss of the support from nursing staff. During the first few weeks at home, parents expressed joy and anxiety, particularly around feeding. The COVID-19 pandemic limited emotional, informational, and physical support to parents and resulted in limited mutual support from other parents of infants in the NICU. Parents of preterm infants in the NICU present with multiple stressors, rendering attending to parental mental health crucial. NICU staff need to address logistical barriers and familial priorities impacting communication and parent-infant bonding. Providing multiple opportunities for communication, participating in caretaking activities, and meeting other families can be important sources of support and knowledge for parents of very preterm infants.
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Horner, Susan. "Impact of Parent Presence and Engagement on Stress in NICU Infants." Advances in Neonatal Care 24, no. 2 (February 7, 2024): 132–40. http://dx.doi.org/10.1097/anc.0000000000001146.

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Background: Infants in neonatal intensive care units (NICUs) are exposed to frequent stressors that impact their neurodevelopmental outcomes. Parent presence and engagement are considered critical to improving infant outcomes, yet associations between cumulative NICU parent presence, engagement, and infant stress are infrequently examined. Purpose: To examine associations between NICU infant stress and the amount (hours per week) or frequency (days per week) of parent presence and skin-to-skin care (SSC). Methods: A secondary analysis of a data set representing 78 NICU families was conducted. Infant acuity was measured using Neonatal Medical Index (NMI) scores. Parent presence and SSC data were collected from electronic medical records. Infant stress was measured using resting salivary cortisol levels collected at NICU discharge (median = 33 days of life). Results: More cumulative SSC was associated with lower discharge cortisol in NICU infants for SSC measured in hours per week (P = .03) or days per week (P = .05). Cumulative parent presence was not significantly associated with infant cortisol at discharge. Hierarchical regression analyses examining timing of parent presence supported a model including admission cortisol, NMI score, and parent presence during weeks 1 to 4 of life for explaining infant stress at discharge (R 2 = 0.44, P = .004). Analyses examining timing of SSC supported a model including admission cortisol, NMI score, and frequency of SSC during week 1 for explaining infant stress at discharge (R 2 = 0.21, P = .04). Implications for Practice and Research: Early, frequent SSC to mitigate stress in NICU infants was supported. Results suggested that timing of parent presence impacts NICU infant stress; however, additional study is recommended.
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Falceto, Olga Garcia, Elsa R. J. Giugliani, and Carmen Luiza C. Fernandes. "Problematic parent-infant relationships in two-parent families: prevalence and risk factors in a Brazilian neighborhood." Trends in Psychiatry and Psychotherapy 34, no. 3 (September 2012): 139–46. http://dx.doi.org/10.1590/s2237-60892012000300005.

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Introduction: Although the quality of parent-child relationships is known to be associated with the offspring's mental health, little is known about the prevalence of problematic relationships in this scenario. This cross-sectional study aims to investigate the prevalence and risk factors of different types of early parent-infant relationships in a Brazilian population group. Methods: During 1 year, all families (n = 230) from an urban community of Porto Alegre, southern Brazil, with 4-month-old infants born in public hospitals were identified, and 148 were fully investigated by two family therapists. This study describes data on the 116 infants with two-parent families. Demographic, obstetric, and relational variables were collected through questionnaires and scales (Parent-Infant Relationship Global Assessment Scale, Global Assessment of Relational Functioning, and Self-Report Questionnaire). Prevalence ratios were calculated, and Poisson regression with robust variance was performed to adjust for covariates. Results: Almost 10% of mothers and 12% of fathers showed at least a significantly perturbed relationship with their 4-month-old infants. Inadequate mother-infant bonding coincided with evidence of paternal mental disorder, poor maternal social network, and discontinuation of breastfeeding at 4 months. A problematic father-infant relationship was associated with a dysfunctional couple relationship and with low infant birth weight. Conclusions: There is a high prevalence of early parent-child relationship problems, suggesting a need for health system interventions. Parent-infant relational problems are prevalent very early in life and more associated with other relational problems than with socioeconomic burden.
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Tinsley, Barbara J., and Ross D. Parke. "Grandparents as Interactive and Social Support Agents for Families with Young Infants." International Journal of Aging and Human Development 25, no. 4 (December 1987): 259–77. http://dx.doi.org/10.2190/91m7-1jma-uqv6-0vh3.

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The role of grandparents in infancy was examined in a comparative analysis of grandparent-infant grandchild and parent-infant interaction patterns. A second focus of the study was an exploration of the extent to which grandparents function as social support agents for their adult children and infant grandchildren. Grandparents (30 grandmothers and 21 grandfathers) and parents (30 mothers and 30 fathers) of seven-month-old infants were observed in individual five-minute dyadic play sessions with the infant in the parents' homes, yielding twenty minutes of agent-infant interaction. The observations were scored using both time-sampling and global coding schemes. Information on grandparental support to the young parents and infants, relative to other social support sources, were also obtained from grandparents and parents. Results indicated that both grandmothers and grandfathers are active interactive and support agents, with a pattern of similarities and differences in interactive style across generation and gender. Although there was a high degree of overlap in parent and grandparent interaction styles, parents were rated as more competent. Gender consistencies were found between female agents (mothers and grandmothers) and male agents (fathers and grandfathers). High levels of intergenerational contact were reported, with both parents and grandparents highly satisfied with the contact. The results of this study support an expanded view of the effects of various agents in young children's social environment.
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Dusing, Stacey C., Emily C. Marcinowski, Nelci A. C. F. Rocha, Tanya Tripathi, and Shaaron E. Brown. "Assessment of Parent-Child Interaction Is Important With Infants in Rehabilitation and Can Use High-Tech or Low-Tech Methods." Physical Therapy 99, no. 6 (June 1, 2019): 658–65. http://dx.doi.org/10.1093/ptj/pzz021.

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Abstract Parents are their infant's first teachers and play a very important role in early development. Early intervention strives to enhance infant participation in the family, and regulations require the engagement of families in assessment and intervention. Infants born preterm or with motor impairments demonstrate altered social engagements that can influence parent-child interaction and the efficacy of therapy services. However, in research focused on the efficacy of interventions or in clinical practice, therapists rarely assess or report on the quality of parent-infant interaction. Understanding these interactions can help determine what perceptual motor opportunities parents provide that can enhance learning. This Perspective article will: (1) present evidence on the need for early assessment and ongoing measurement of parent-infant interaction; (2) describe an example of each of 3 methods for assessment of parent-child interaction—low-tech, low-resource (Dyadic Mutuality Code), low-tech, high-resource (Parent Children Early Relational Assessment), and high-tech, high-resource (customized behavioral coding); (3) compare 3 approaches theoretically highlighting the strengths and weaknesses of each assessment; and (4) reflect on the challenges and value of adding these measures to future research on the efficacy of interventions and clinical practice.
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Ghetti, Claire M., Bente Johanne Vederhus, Tora Söderström Gaden, Annette K. Brenner, Łucja Bieleninik, Ingrid Kvestad, Jörg Assmus, and Christian Gold. "Longitudinal Study of Music Therapy’s Effectiveness for Premature Infants and Their Caregivers (LongSTEP): Feasibility Study With a Norwegian Cohort." Journal of Music Therapy 58, no. 2 (January 15, 2021): 201–40. http://dx.doi.org/10.1093/jmt/thaa023.

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Abstract Premature infants and their parents experience significant stress during the perinatal period. Music therapy (MT) may support maternal–infant bonding during this critical period, but studies measuring impact across the infant’s first year are lacking. This nonrandomized feasibility study used quantitative and qualitative methods within a critical realist perspective to evaluate the feasibility, acceptability, and suitability of the treatment arm of the Longitudinal Study of music Therapy’s Effectiveness for Premature infants and their caregivers (LongSTEP) (NCT03564184) trial with a Norwegian cohort (N = 3). Families were offered MT emphasizing parent-led infant-directed singing during neonatal intensive care unit (NICU) hospitalization and across 3 months post-discharge. We used inductive thematic analysis of semi-structured interviews with parents at discharge from NICU and at 3 months and analyzed quantitative variables descriptively. Findings indicate that: (1) parents of premature infants are willing to participate in MT research where parental voice is a main means of musical interaction; (2) parents are generally willing to engage in MT in NICU and post-discharge phases, finding it particularly interesting to note infant responsiveness and interaction over time; (3) parents seek information about the aims and specific processes involved in MT; (4) the selected self-reports are reasonable to complete; and (5) the Postpartum Bonding Questionnaire appears to be a suitable measure of impaired maternal–infant bonding. Parents reported that they were able to transfer resources honed during MT to parent–infant interactions outside MT and recognized parental voice as a central means of building relation with their infants. Results inform the implementation of a subsequent multinational trial that will address an important gap in knowledge.
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Whittingham, Koa, Jeanie Sheffield, Catherine Mak, Corrine Dickinson, and Roslyn N. Boyd. "Early Parenting Acceptance and Commitment Therapy ‘Early PACT’ for parents of infants with cerebral palsy: a study protocol of a randomised controlled trial." BMJ Open 10, no. 10 (October 2020): e037033. http://dx.doi.org/10.1136/bmjopen-2020-037033.

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IntroductionNew international clinical practice guidelines exist for identifying infants at high risk of cerebral palsy (CP) earlier: between 12 to 24 weeks corrected age, significantly earlier than previous diagnosis windows in Australia at 19 months. The earlier detection of infants at high risk of CP creates an opportunity for earlier intervention. The quality of the parent-infant relationship impacts various child outcomes, and is leveraged in other forms of intervention. This paper presents the protocol of a randomised controlled trial of an online parent support programme, Early Parenting Acceptance and Commitment Therapy (Early PACT) for families of infants identified as at high risk of CP. We predict that participating in the Early PACT programme will be associated with improvements in the parent-infant relationship, in parent mental health and well-being as well as infant behaviour and quality of life.Methods and analysisThis study aims to recruit 60 parents of infants (0 to 2 years old corrected age) diagnosed with CP or identified as at high risk of having CP. Participants will be randomly allocated to one of two groups: Early PACT or waitlist control (1:1). Early PACT is an online parent support programme grounded in Acceptance and Commitment Therapy (ACT). It is delivered as a course on an open source course management system called edX. Early PACT is designed to support parental adjustment and parent-infant relationship around the time of early diagnosis. Assessments will be conducted at baseline, following completion of Early PACT and at 6-month follow-up (retention). The primary outcome will be the quality of parent-child interactions as measured by the Emotional Availability Scale. Standard analysis methods for randomised controlled trial will be used to make comparisons between the two groups (Early PACT and waitlist control). Retention of effects will be examined at 6-month follow-up.Ethics and disseminationThis study is approved through appropriate Australian and New Zealand ethics committees (see in text) with parents providing written informed consent. Findings from this trial will be disseminated through peer-reviewed journal publications and conference presentations.Trial registration detailsThis trial has been prospectively registered on 12 June 2018 to present (ongoing) with the Australian New Zealand Clinical Trials Registry (ACTRN12618000986279); https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=3 74 896
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Cai, Qian, Hua Wang, Danqi Chen, Wenli Xu, Rui Yang, and Xinfen Xu. "Effect of family-centred care on parental mental health and parent–infant interactions for preterm infants: a systematic review protocol." BMJ Open 12, no. 10 (October 2022): e062004. http://dx.doi.org/10.1136/bmjopen-2022-062004.

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IntroductionUnexpected premature delivery and separation from preterm infants are common problems that parents of preterm infants must handle with. Parents of preterm infants may suffer from severe psychological distress. Family-centred care (FCC) can effectively ease parents’ psychological distress and strengthen connections between parents and their preterm infants. The purpose of this systematic review will be to systematically review and evaluate the impacts of FCC interventions on the mental health of parents of preterm infants and the parent–infant relationship.Methods and analysisThis protocol for this systematic review will be conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol. We will search databases including PubMed, Embase, The Cochrane Library, CINAHL, Web of Science, PsycINFO, Scopus and ProQuest, CNKI, SinoMed and Wanfang Data from 1 July 2012 to 1 July 2022. An additional search of OpenGrey will be conducted to identify grey literature. Randomised controlled trials related to FCC inventions for preterm infants≤37 weeks’ gestational age and their parents will be included, and the outcome measures will be parental mental health and parent–infant interaction. Two reviewers will independently conduct title and abstract screening, full-text screening, data extraction and study quality assessment. Risk of bias for the studies will be evaluated using the Cochrane Collaboration Risk of Bias V.2.0. Any disagreements will be solved by a third reviewer to reach a consensus. If appropriate, a meta-analysis will be conducted to assess the effect of FCC on parental mental health and parent–infant relationship.Ethics and disseminationResearch ethics approval will not be required for this review since it will not involve the collection of primary data and will only use published literature. The results will be disseminated in a peer-reviewed journal through publication or by presentation at relevant academic conference.PROSPERO registration numberCRD42022299203.
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Rodd, Celia, Sonia Jean-Philippe, Catherine Vanstone, and Hope Weiler. "Comparison of 2 vitamin D supplementation modalities in newborns: adherence and preference." Applied Physiology, Nutrition, and Metabolism 36, no. 3 (June 2011): 414–18. http://dx.doi.org/10.1139/h11-018.

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Lack of adherence with vitamin D supplementation is still a risk factor for rickets. In a randomized cross-over design, infants received 400 IU cholecalciferol by dropper (1 mL syrup) or filmstrip. Infant and parent preference scores and adherence were then compared. Forty-three parents of healthy infants preferred the filmstrip (85.4% of parents; 95% confidence interval of 70.1%–93.9%; p < 0.001), a result that was corroborated by higher infant and parental scores and compliance. Ease of administration of supplements with improved acceptance may improve adherence.
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Flynn, Catherine, Patricia Coker-Bolt, and Courtney Jarrard. "Helping Infants With Congenital Heart Defects: Enhancing Parent with Therapist Engagement Through Infant Massage." American Journal of Occupational Therapy 76, Supplement_1 (July 1, 2022): 7610510174p1. http://dx.doi.org/10.5014/ajot.2022.76s1-po174.

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Abstract Date Presented 03/31/2022 Infant massage is a beneficial intervention for infants with cardiac defects. No studies have explored how to promote parent engagement in infant massage with these fragile infants. The purpose of this study was to gain an understanding of parent and staff perceptions of infant massage for infants born with congenital heart defects. The results support the need for additional education about the purpose of infant massage, protocols, and how to safely deliver massage to critically ill infants. Primary Author and Speaker: Catherine Flynn Contributing Authors: Patricia Coker-Bolt, Courtney Jarrard
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Davis, Maya I., Camille M. Delfosse, and Alison K. Ventura. "Infant Age Moderates Associations between Infant Temperament and Maternal Technology Use during Infant Feeding and Care." International Journal of Environmental Research and Public Health 19, no. 19 (October 7, 2022): 12858. http://dx.doi.org/10.3390/ijerph191912858.

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Previous research illustrated that infants’ temperamental traits shape parents’ behaviors, but parents’ behaviors can also elicit or intensify infants’ behaviors in ways that shape temperament. One understudied aspect of parenting that may exhibit bidirectional influences with temperament is parent technology use (e.g., use of mobile devices) within family contexts. To date, few studies have examined whether maternal technology use is associated with infant temperament and whether age-related differences in these associations exist. The present study was a secondary analysis of pooled data from three infant feeding studies. Mothers (n = 374) of young infants (age 16.2 ± 6.2 weeks) completed measures of maternal technology use during infant feeding and care interactions, infant temperament, and family demographics. Maternal technology use was positively associated with negative affectivity and negatively associated with orienting/regulatory capacity but was not associated with positive affectivity/surgency. The association between maternal technology use and negative affectivity was stronger for younger infants than older infants, while the association between maternal technology use and orienting/regulatory capacity was not significant for younger infants but was for older infants. Findings suggest maternal technology use is associated with infant negative affectivity and orienting/regulatory capacity, but the strength of these associations may change with infant age. Further longitudinal research is needed to verify this interpretation and understand mechanisms underlying these associations.
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Zhang, Zhiguang, Madison Predy, Kylie D. Hesketh, Lesley Pritchard, and Valerie Carson. "Demographic Correlates of Movement Behaviors in Infants: A Longitudinal Study." Journal of Physical Activity and Health 19, no. 3 (March 1, 2022): 177–85. http://dx.doi.org/10.1123/jpah.2021-0570.

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Background: Demographic correlates of movement behaviors in infants are unclear. This study examined the longitudinal associations between demographic correlates and movement behaviors in infants. Methods: Participants were 411 parents of infants from the Early Movers project in Edmonton, Canada. Movement behaviors, infant and parental age, and nonparental care time were assessed using a parental questionnaire at 2, 4, and 6 months of age. Other infant and parental demographic variables were assessed at 2 months of age. Linear and generalized linear mixed models were conducted. Results: Infant age was associated with all movement behaviors except for restrained time. White infants and those with older parents had less tummy time but increased odds of having reading time. Infants of the most educated parents also had lower tummy time. Higher parental education and more siblings were associated with no screen time and longer infant sleep time. Infants with immigrant parent(s) were less likely to have reading time. No associations were found for infant sex, time spent in nonparental care, and parental marital status. Conclusion: Since no single demographic group demonstrated healthy patterns for all movement behaviors, promotion of a healthy balance of movement behaviors may be needed universally for all infants.
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Frazier, Katheryn F., and Rebecca J. Scharf. "Parent-Infant Attachment." Pediatrics in Review 36, no. 1 (January 2015): 41–42. http://dx.doi.org/10.1542/pir.36-1-41.

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Frazier, Katheryn F., and Rebecca J. Scharf. "Parent-Infant Attachment." Pediatrics In Review 36, no. 1 (January 1, 2015): 41–42. http://dx.doi.org/10.1542/pir.36.1.41.

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Feldman, Ruth. "Parent–Infant Synchrony." Current Directions in Psychological Science 16, no. 6 (December 2007): 340–45. http://dx.doi.org/10.1111/j.1467-8721.2007.00532.x.

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Smith, D. P. "Parent Infant Program." Journal of Visual Impairment & Blindness 87, no. 6 (June 1993): 208–9. http://dx.doi.org/10.1177/0145482x9308700621.

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Masur, Corinne. "Parent-Infant Psychotherapy." Journal of the American Psychoanalytic Association 57, no. 2 (April 2009): 467–73. http://dx.doi.org/10.1177/0003065109334745.

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Hopkins, Juliet. "Infant-parent psychotherapy." Journal of Child Psychotherapy 18, no. 1 (January 1992): 5–17. http://dx.doi.org/10.1080/00754179208259360.

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Brooks, Rebecca. "Parent-Infant Communication." Ear and Hearing 8, no. 2 (April 1987): 124–25. http://dx.doi.org/10.1097/00003446-198704000-00017.

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45

Schuyler, Valerie, and Nancy Rushmer. "Parent-Infant Habilitation." Ear and Hearing 9, no. 4 (August 1988): 223. http://dx.doi.org/10.1097/00003446-198808000-00018.

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46

Rabon Jr., David R., D. Kim Sawrey, and Wm David Webster. "Infant ultrasonic vocalizations and parental responses in two species of voles (Microtus)." Canadian Journal of Zoology 79, no. 5 (May 1, 2001): 830–37. http://dx.doi.org/10.1139/z01-043.

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When separated from conspecifics, the young of many rodent species produce ultrasonic vocalizations (USVs) that may facilitate parental approach. Ultrasounds were recorded from infants (0–14 days post partum) of two closely related species that exhibit different social systems, the montane vole (Microtus montanus) and the prairie vole (Microtus ochrogaster). Infant prairie voles emitted a greater number of USVs when isolated from conspecifics than did infant montane voles. Infant prairie voles also emitted a greater number of USVs in the presence of a parent than did infant montane voles. For both species, parental responses to individual infants were most rapid when pups were at those ages when they emitted the greatest numbers of USVs. Prairie vole parents approached pups most rapidly on days 6–8, whereas montane vole parents approached pups most rapidly on days 12–14. There were no differences between sires and dams of either species in their latencies to approach and contact pups. In general, however, infants of both species were retrieved more rapidly by dams than by sires. We suggest that differences in ultrasound production among vole species may correlate with differences in their species-specific social systems. It appears that the number of USVs produced by pups may vary with the amount of parent-pup contact typical of each species.
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47

Swain, James E., and S. Shaun Ho. "Baby smile response circuits of the parental brain." Behavioral and Brain Sciences 33, no. 6 (December 2010): 460–61. http://dx.doi.org/10.1017/s0140525x10001615.

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AbstractThe parent-infant dyad, characterized by contingent social interactions that develop over the first three months postpartum, may depend heavily on parental brain responses to the infant, including the capacity to smile. A range of brain regions may subserve this social key function in parents and contribute to similar capacities in normal infants, capacities that may go awry in circumstances of reduced care.
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48

Brock, Rebecca L., and Grazyna Kochanska. "Anger in infancy and its implications: History of attachment in mother–child and father–child relationships as a moderator of risk." Development and Psychopathology 31, no. 04 (October 26, 2018): 1353–66. http://dx.doi.org/10.1017/s0954579418000780.

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AbstractGrowing research has documented distinct developmental sequelae in insecure and secure parent–child relationships, supporting a model of early attachment as moderating future developmental processes rather than, or in addition to, a source of direct effects. We explored maladaptive developmental implications of infants’ anger proneness in 102 community families. Anger was assessed in infancy through observations in the Car Seat episode and parents’ ratings. Children's security with parents was assessed in the Strange Situation paradigm at 15 months. At preschool age, child negativity (defiance and negative affect) was observed in interactions with the parent, and at early school age, oppositionality was rated by parents and teachers. Security was unrelated to infant anger; however, it moderated associations between infant anger and future maladaptive outcomes, such that highly angry infants embarked on a negative trajectory in insecure, but not in secure, parent–child dyads. For insecure, but not secure, mother–child dyads, infants’ mother-rated anger predicted negativity at preschool age. For insecure, but not secure, father–child dyads, infants’ anger in the Car Seat predicted father- and teacher-rated oppositional behavior at early school age. Results highlight the developmentally complex nature of the impact of attachment, depending on the relationship with mother versus father, type of measure, and timing of effects.
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Garne Holm, Kristina, Anne Brødsgaard, Gitte Zachariassen, Anthony C. Smith, and Jane Clemensen. "Parent perspectives of neonatal tele-homecare: A qualitative study." Journal of Telemedicine and Telecare 25, no. 4 (May 23, 2018): 221–29. http://dx.doi.org/10.1177/1357633x18765059.

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Introduction Neonatal homecare for preterm infants is a method of supporting families and monitoring infant growth in the home setting. Telehealth may be used to deliver specialist neonatal care remotely, using online communication methods. This study explored parental experiences with neonatal tele-homecare (NTH). Methods Semi-structured interviews were conducted with 49 parents whose preterm infants had received NTH from a neonatal intensive care unit (NICU) in Denmark. Interview transcripts were analysed using Malterud’s systematic text condensation. Results Parents experienced NTH as a personalised method for linking to specialist staff in the NICU. NTH promoted the parent’s role as the primary care provider, further strengthening the parent–infant relationship. Discussion From the perspective of parents with preterm infants requiring specialist care, NTH is a useful method of supporting families in the home. Telehealth provides effective communication links with NICU specialists and encourages family-centred care.
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Ferrier-Lynn, Melissa, and Helen Skouteris. "Parent Cognitions and Parent–Infant Interaction." Australasian Journal of Early Childhood 33, no. 2 (June 2008): 17–26. http://dx.doi.org/10.1177/183693910803300204.

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