Infant Mental Health Journal最新文献

Reflective practice is a core component of Infant Mental Health (IMH) training and work in the form of reflective supervision/consultation (RS/C). RS/C supports and facilitates relationship-based practice, and is considered to help prevent burnout and promote work satisfaction. In response to an identified gap in empirical research on RS/C, this scoping review aimed to give an overview of the broad range of study designs and outcomes by systematically charting empirical studies on RS/C in IMH-based work with children and families. Searches of Academic Search Complete, CINAHL, MEDLINE, APA PsychArticles, APA PsycInfo, and Web of Science were supplemented with a Google Scholar search and citation searching. Following title/abstract screening (n = 233) and full-text review (n = 168), 35 reports met criteria for inclusion. Key findings were organized into four categories: Essential components and processes of RS/C; Experiences and outcomes of RS/C; Emerging issues in RS/C literature; and Measuring, researching, and reporting on RS/C. Results describe the components and experience of engaging in quality RS/C, and show that practitioners generally experience RS/C as supportive and beneficial. The existing literature has some methodological limitations and further empirical research is needed on outcomes of RS/C. Practice implications and potential future research directions are discussed.

While attention dysregulation is a promising early indicator of neurodevelopmental risk, in particular attention-deficit/hyperactivity disorder (ADHD), it is difficult to characterize clinical concern due to its developmental expectability at the transition to toddlerhood. Thus, explicating the typical:atypical continuum of risk indicators is among the key future directions for research to promote early identification and intervention, and prevent decrements in the attainment of developmental milestones into early childhood. In this paper, we present the Multidimensional Assessment Profiles—Attention Regulation Infant-Toddler (MAPS-AR-IT) Scale, a novel parent-report survey of dimensional, developmentally specified indicators of attention (dys)regulation. Item Response Theory was employed to characterize the typical:atypical spectrum of both normative and more concerning dysregulation (including the contexts in which behavior occurs). We provide evidence of the validity of this measure in capturing the full typical:atypical spectrum via a longitudinal sample of typically developing children at 12–18 months of age (baseline) via concurrent scores on well-validated temperament and clinical measures. We also examine longitudinal stability and predictive validity if the MAPS-AR-IT via a clinical interview of ADHD symptoms at 24–30 months (follow-up). While not diagnostic, we present evidence of the utility of the MAPS-AR-IT in explicating individual neurodevelopmental risk and elucidating the broader typicality of behaviors related to attention (dys)regulation.

Previous research suggests that the Ages and Stages Questionnaire—3rd ed. (ASQ) fine motor domain (FMD) may not be culturally relevant for developmental screening in a rural Guatemalan community, as the FMD accounts for 40% of all abnormal screenings after a needs assessment in this community. We hypothesize this is due to a lack of exposure to objects assessed in the questionnaire, such as blocks or light switches. The FMD scores of rural Guatemalan children (n = 56) participating in a child development program were compared with Spanish- and English-speaking Latinx-American children attending a US primary care clinic and screened at yearly well-child checks. Groups were matched for age gender, and socioeconomic status. Item-level analyses explored differences across the three groups. In the Guatemalan sample, the FMD abnormal score rates were 16%, 62%, and zero in the 12-, 24-, and 36-month-old children, respectively. Abnormal scores for the Guatemalan sample on the 24-month ASQ-3 significantly differed (p = .01) when compared to the Latinx-American groups. The 24-month questionnaire has more questions about objects than the 12- and 36-month questionnaires, which may explain the higher rates of abnormal scores. Developmental screening with ASQ-3 may not adequately capture the skills of children in similar communities.

The infant health movement was launched nearly 50 years ago with the publication of the now classic paper, Ghosts in the Nursery: A psychoanalytic approach to the problems of impaired infant-mother relationships, written by Selma Fraiberg, Edna Adelson, and Vivian Shapiro (1975). This paper offers us lessons for infant mental health practice that have been proven true time and again over the last 50 years. These lessons both underscore the factors essential to clinical progress across a range of interventions, and remind us of the significant challenges we face in these times of massive, global trauma and oppression, extreme economic hardship, and systemic racism. This commentary reviews the key lessons of Fraiberg and her colleagues’ classic paper, addresses some of the challenges inherent in retaining the breadth and substance of Fraiberg's model in contemporary practice, and proposes a model for conceptualizing infant and early childhood mental health practice that is geared toward building the relational foundations of reflection (Slade, 2023).

Caregiving relationships in the postnatal period are critical to an infant's development. Preterm infants and their parents face unique challenges in this regard, with infants experiencing separation from parents, uncomfortable procedures, and increased biologic vulnerability, and parents facing difficulties assuming caregiver roles and increased risk for psychological distress. To better understand the NICU parent-infant relationship, we conducted a review of the literature and identified 52 studies comparing observed maternal, infant, and dyadic interaction behavior in preterm dyads with full-term dyads. Eighteen of 40 studies on maternal behavior found less favorable behavior, including decreased sensitivity and more intrusiveness in mothers of preterm infants, seven studies found the opposite, four studies found mixed results, and 11 studies found no differences. Seventeen of 25 studies on infant behavior found less responsiveness in preterm infants, two studies found the opposite, and the remainder found no difference. Eighteen out of 14 studies on dyad-specific behavior reported less synchrony in preterm dyads and the remainder found no differences. We identify confounding factors that may explain variations in results, present an approach to interpret existing data by framing differences in maternal behavior as potentially adaptive in the context of prematurity, and suggest future areas for exploration.

For new fathers, parenting stress is a risk factor for impaired early parenting and child maltreatment perpetration. Predictors of parenting stress, including fathers’ own experiences of trauma, could be useful intervention targets to support new fathers. We aim to examine associations between new fathers’ own histories of child maltreatment, and their perinatal mental health, relationships, and parenting stress. We recruited 298 first-time fathers for a survey that measured child maltreatment history, trauma sequelae including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), interpersonal reactivity, substance use, anger expression, coparenting quality, and parenting stress. On the Parenting Stress Index (PSI) (from 36 to 180), bivariate analysis demonstrated that new fathers who experienced child maltreatment (n = 94) had significantly higher parenting stress (x̅ = 85.3, σ = 18.7) than those who did not (n = 204; x̅ = 76.0, σ = 16.6; P < .000). Hierarchical linear regression modeling indicated that a child maltreatment history, PTSD, and MDD were significantly associated with parenting stress. The strongest predictors of parenting stress were coparenting quality and complex trauma sequelae—interpersonal reactivity and anger expression. Interventions to reduce fathers’ parenting stress by targeting known mental health and relationship sequelae of maltreatment are promising avenues to breaking intergenerational transmission of child maltreatment and psychiatric vulnerability.

Early detection of behavioral disorders in children is necessary for intervention. Available data show a high prevalence of child and adolescent psychiatric disorders in Chile (22.5%), but behavioral problems in younger children have not been evaluated. This work assesses behavioral disorders in preschoolers and their association with sociodemographic variables of the family and the child. The data was collected during the impact assessment of the Biopsychosocial Development Support Program “Chile Crece Contigo”, using a multistage and representative random sample of 1377 preschoolers, aged between 30 and 48 months, who attended public health services. Homes were visited to apply a questionnaire and the Child Behavior Checklist (CBCL, 1.5–5 years). Results: Multivariable regression model for total raw scores shows that child's age, the number of chronic diseases in the child, and history of exposure to mother's alcohol consumption in pregnancy, remain significant when adjusted for all variables included (R² of 17.8% and η² of .19 (95% CI: .14–.22)). In externalizing and internalizing explanatory models, child's chronic diseases and a higher score of authoritarian beliefs about parenting show the two largest effect sizes. These results add to the evidence of urgent problems in preschool mental health.

In this study, we investigated the influence of parental sensitivity and family alliance on infants’ vagal tone, considered as a physiological indicator of emotion regulation. Studies on mother–infant interactions have shown that vagal tone can be influenced by the quality of the interaction, such as interacting with a sensitive mother. To date, no study has investigated the influence of paternal sensitivity or family alliance on infants’ vagal tone. We hypothesized that maternal sensitivity, paternal sensitivity, and family alliance would be associated with infants’ vagal tone during dyadic and triadic interactions. We also explored if family alliance would act as a moderator on the association between parental sensitivity and vagal tone and if the sensitivity of both parents would act as a moderator on the association between family alliance and vagal tone. This study took place in Switzerland and included 82 families with their 3–4-month-old infants. Results showed that maternal sensitivity and family alliance were associated with infants’ vagal tone, but paternal sensitivity was not. We found no significant moderation effect. However, result tendencies suggested that the contribution of paternal sensitivity to infants’ emotion regulation could be influenced by family alliance, whereas maternal sensitivity and family alliance have a unique contribution.

When working with families of infants and toddlers, intentionally looking beyond dyadic child-parent relationship functioning to conceptualize the child's socioemotional adaptation within their broader family collective can enhance the likelihood that clinical gains will be supported and sustained. However, there has been little expert guidance regarding how best to frame infant-family mental health therapeutic encounters for the adults responsible for the child's care and upbringing in a manner that elevates their mindfulness about and their resolve to strengthen the impact of their coparenting collective. This article describes a new collaborative initiative organized by family-oriented infant mental health professionals across several different countries, all of whom bring expansive expertise assessing and working with coparenting and triangular family dynamics. The Collaborative's aims are to identify a means for framing initial infant mental health encounters and intakes with families with the goal of assessing and raising family consciousness about the relevance of coparenting. Initial points of convergence and growing points identified by the Collaborative for subsequent field study are addressed.

This two-part study seeks to evidence art therapy intervention for parent-infant attachment relationships, looking at improvements to wellbeing and relationships. Study one was a controlled trial with 105 participating parent/caregivers and their infants (0–3-years), identified due to concerns about their relationship. They were quasi-randomized to attend a 12-week art therapy group or treatment as usual. Measures focused on parents’ wellbeing and their perceptions of their relationship with their infant. In study 2 we analyzed video footage from the first and penultimate sessions of a sample of 37 dyads, looking for observable changes in the different channels of communication upon which attachments are predicated. The controlled trial showed intervention participants had significantly improved parental wellbeing, significant increases in attachment warmth and significant decreases in intrusion. This contrasted with the control sample who showed a significant decrease in wellbeing, stable warmth, and significant increases in intrusion. The observation study showed that there was a significant increase in the communicative behaviors from the parents to the infant which would support attachments between the first and penultimate sessions. We conclude that these results make a robust case for the inclusion of art therapy within the range of interventions available for at risk early relationships