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PubMed1993

Early hospitalization and disturbances of infant behavior and the mother-infant relationship.

The impact of brief early hospitalization was investigated in a controlled natural experiment of 14 children with cleft lip and palate (CLP) who were hospitalized for palatal repair at 9.5 months of age, and another 13 CLP children who were hospitalized at 12.5 months of age; 14 children without clefts who were not hospitalized served as controls. After hospitalization children were more likely to avoid their mothers both following a brief stressful separation at home and in the Strange Situation. It was suggested that CLP children may have learned to cope with stress by shifting the attention away from the mother.

Child, Hospitalized↗
PubMed1993

Adding objectivity to infant behavioral audiometry.

This article deals with the limitations of infant behavioral audiometry, which have led us to seek objective methods of audiometry for determining hearing sensitivity in infants. It describes efforts to add objectivity to (or reduce the subjectivity of) behavioral methods of infant audiometry. Several aspects of visual reinforcement audiometry (VRA), including the head turn response, the use of control trials, and adherence to the principles of operant conditioning, serve to reduce the subjectivity inherent in behavior observation audiometry. In addition, computer control of VRA procedures can relieve the examiner of potentially subjective decision-making during the course of evaluation and can facilitate testing with sophisticated algorithms that could not be done manually by a single examiner. Computer simulations to determine the best VRA test parameters are described.

Acoustic Stimulation↗
PubMed1992

Adult third ventricle width and infant behavioral arousal in groups at high and low risk for schizophrenia.

Previous research has demonstrated: (1) Subjects who are at genetic high risk for schizophrenia and who suffer delivery complications are at increased risk to evidence a widened third ventricle. (2) A widened third ventricle is related to decreased ANS arousal and, among schizophrenics, is related to negative symptom schizophrenia. (3) Adult schizophrenics evidence behavioral analogues of negative symptom schizophrenia premorbidly. This study compared adult CT scans to ratings of infant behavior in 179 subjects (104 at high genetic risk for schizophrenia) with the hypothesis that widened third ventricles would be related to underaroused infant behavior. Results of an ANOVA suggest that subjects who are at genetic high risk for schizophrenia and who evidence a widened third ventricle are more likely to have shown signs of behavioral underarousal as infants. Possible explanations, implications and limitations of the study are discussed.

Adolescent↗
PubMed1985

Nutrients, neurotransmitters and infant behavior.

In recent years, short-term effects of the composition of each meal on the synthesis of brain neurotransmitters have been studied. This paper reviews studies of the influence of dietary precursors such as tryptophan and other competing amino acids on serotonin synthesis and metabolism and emphasizes the important influence of insulin. The paper then focuses on assessment of newborn state behavior, since evidence in adult humans has suggested a relationship between sleep behavior and brain serotonin levels. Several studies are then summarized. First, a study of healthy full-term newborns examining the relationship between diet and sleep behavior showed that infants fed tryptophan entered active and quiet sleep sooner than infants fed valine and low carbohydrate. Other studies designed to examine the influence of hyperinsulinemia on this system are then described. An observational study of newborns of diabetic mothers during the first weeks of life showed that they were quieter babies, with difficulties in visual orientation and motor performance. Plasma amino acid ratios studied during a glucagon-stimulation test in an infant with hyperinsulinemia showed a marked increase in parallel with changes in insulin levels. The results suggest that infant sleep behavior can be a sensitive dependent variable in studies of behavioral effects of diet and suggests that variations in serotonin levels may play a modulating role.

Adult↗
PubMed1984

A longitudinal study of offspring born to methadone-maintained women. II. Dyadic interaction and infant behavior at 4 months.

As part of a longitudinal study of offspring born to substance abusers, we assessed 17 methadone-exposed and 23 comparison 4-month-old infants using the Bayley Scales, and videotaped their interaction with their mothers. In analyzing the Bayley Infant Behavior Record we found that the methadone-exposed group differed from the comparison group on motor functioning but not significantly on social or cognitive behaviors; methadone-exposed infants were more tense, active, and poorly coordinated than comparisons. Using a scale we developed, we rated communicative functioning in dyadic interactions, and related mothers' interactive performance to their psychological and psychosocial resources and infants' interactive performance to their behavioral functioning as assessed on the Bayley Infant Behavior Record. Applying a multidimensional technique, Guttman's Partial Order Scalogram Analysis by Coordinates (POSAC), we found an intriguing relationship that generalized across drug and comparison groups: greater tension than activity, with high tension especially, related to poorer functioning, but tension lower than activity related to better functioning. Specifically, infants who were tense and not active were also poorest on social functioning (low responsiveness to people and low cooperativeness) and showed short attention span and low persistence combined with high interest in sights and sounds. On the other hand, infants who showed low-to-moderate tension and moderate-to-high activity were highly responsive and cooperative; some also had long attention span and high persistence coupled with interest in sights and sounds. Infants who were both very tense and very active were poor on social functioning. Furthermore, most infants with tension higher than activity did poorly in communicating with their mothers, while infants with tension lower than activity interacted well. The POSAC technique has enabled us to identify meaningful subgroups of infants who were not merely quantitatively but qualitatively different in their behavioral functioning. Cutting across drug and comparison groups, we found that mothers who performed poorly on interaction were likely to have poor resources for maternal functioning. Methadone was only one among the risk factors affecting interaction.

Child Behavior↗
PubMed1995

The effect of pain on infant behaviors.

Facial, body, and cry behaviors, heart rate, palmar sweating, and acoustic cry measures were compared across differing levels of infant pain. Eighty-eight infants were placed in a 16-cell matrix of 4 ages (0 to 3 mo., 4 to 6 mo., 7 to 9 mo., and 10 to 12 mo.) and levels of pain (LOP) (none, mild, moderate, severe) with 5 to 6 infants occupying each cell. Matrix placement was determined by agreement of > 75% among five pediatric clinical nurse specialists who viewed videotapes and read information about the infant's history, diagnosis, medical and/or surgical status, medications, and nutritional/fluid status. Coded infant behaviors and acoustic cry parameters were compared using a 2-level (LOP, age) MANOVA. Behaviors that differed across LOP were influenced by infant development. Facial expressions were clinically useful LOP indicators only for 0- to 3-month-old infants. Facial and body behaviors and cry measures that differed across LOP in younger infants did not differ in older infants due to the development of intentionality. Cry orientation and consolability may be useful clinical indicators of pain with older infants.

Age Factors↗
PubMed1984

Methodologic standards for controlled clinical trials of early contact and maternal-infant behavior.

To provide an objective evaluation of published studies on the effect of early contact on subsequent maternal-infant behavior, a set of 11 methodologic standards generally applicable to controlled clinical trials of perinatal care was developed. Sixteen reports of early contact trials were assessed and seven of the 11 standards were found to be satisfactorily fulfilled. The four "problem" standards were: adequate definition of subjects, randomization, subject bias, and treatment contamination (care giver) bias. Of the five best trials fulfilling eight or more of the standards, three reported a beneficial effect of early contact, while two demonstrated no effect. The evidence that early contact improves subsequent maternal-infant behavior thus remains inconclusive. It is urged that for future research in this domain more attention be given to adequate subject definition, strict randomization procedures, and safeguards against bias by the subjects or their care givers.

Child Behavior↗
PubMed1984

Phenobarbital prophylaxis for hyperbilirubinemia in preterm infants. A controlled study of bilirubin disappearance and infant behavior.

Phenobarbital (PB) has been used at several pediatric centers for prophylaxis against neonatal hyperbilirubinemia. However, few attempts have been made to evaluate this procedure quantitatively, and a variety of dose schedules has been proposed. Therefore, a randomized, controlled clinical trial was performed in which the effects on bilirubin disposition and on neonatal behavior was quantitated. Forty-three preterm infants were randomized into one of four dose groups and given 0, 4, 8, or 12 mg of PB per kg in a single dose within the first few hours after birth (mean 2.2 h). The total serum bilirubin disappearance rate was found to be significantly increased (p less than 0.01) only in the 12 mg/kg group. This effect was not evident until postnatal day 7. The 4 and 8 mg/kg groups were not significantly different from the control group at any time. Infant behavior was monitored by a non-invasive time-lapse filming technique. The time spent in quiet sleep was found to be proportional to the plasma PB concentration at one day of age (r = 0.61). The infants in the 12 mg group spent a larger proportion of time in quiet sleep than the other groups (p less than 0.05). The plasma half-lives, plasma clearances and volumes of distribution of PB were similar in the three dose groups. No correlation was found between the pharmacokinetics and the gestational age of the infant. It is concluded that in order to enhance the bilirubin disappearance rate, PB has to be administered in doses that will affect behavior.

Bilirubin↗
PubMed1980

Bayley's infant behavior record: behavioral components and twin analyses.

Factor analysis of 25 rating scales from Bayley's infant behavior record were performed for a sample of about 300-400 infant twins tested at 1 or more of the following ages: 3, 6, 9, 12, 18, and 24 months. The analysis provided 5 major factors and 2 minor factors that were considerably consistent at all ages. As defined by the scales with the strongest loadings, the major factors were denoted as task orientation, affect-extraversion, activity, auditory-visual awareness, and motor coordination, and the minor factors were denoted as kinds of mouthing behaviors. Further analyses by twin pairs generally provided higher concordance for identical pairs than for same-sex fraternal pairs, and the differences in concordance became more evident with an increase in age. Among the factors, task orientation showed the most persistent differences between identical and fraternal pairs. Profile analyses for all factors extracted at each age indicated that the profiles within identical pairs were more similar than profiles within fraternal pairs. Overall, the findings delineate some of the dimensions of temperament observed during testing and suggest that there are genetic influences on several behavioral characteristics and the organization of those characteristics during infancy.

Child Behavior↗
PubMed1986

Infant behavior and development in relation to fetal movement and habituation.

Fetal movement and habituation were examined in relation to behavior and development in early infancy. 39 fetuses were evaluated between 28 and 37 weeks gestation. A vibrating stimulus was repeatedly applied to the maternal abdomen until the fetus habituated (i.e., ceased moving in response). Fetal movements were observed on an ultrasound monitor by 2 observers who recorded their observations onto a strip chart. Using a median split, fetuses were placed into high- or low-movement groups and fast- or slow-habituating groups. The groups were compared after birth on the Brazelton Neonatal Behavior Assessment Scale and the Bayley Scales of Infant Development. Preliminary evidence is presented that fetal rate of habituation predicts some aspects of infant behavior and development.

Adolescent↗
PubMed1992

Validity and reliability of the infant behavioral summarized evaluation (IBSE): a rating scale for the assessment of young children with autism and developmental disorders.

The Infant Behavioral Summarized Evaluation (IBSE) is a rating scale adapted from the Behavioral Summarized Evaluation (BSE) and specifically related to the assessment of behaviors of young children having autistic disorders. Content validity and reliability studies described in the paper were made from behavior ratings of videotapes for 89 children aged from 6 to 48 months. Results show a significant group of 19 items including some characteristic early autistic behaviors (communicative and social abnormalities) and some that are less commonly described in the syndrome (attentional, perceptive, and adaptive disorders). The value of the use of this scale for clinicians and professionals involved in behavioral evaluations and treatment of young children with developmental disorders and the necessity for further psychometric investigations are discussed.

Autistic Disorder↗
PubMed1975

A comparison of live and videorecord viewing of infant behavior under sound stimulation. II. Six-week-old infants.

Ten clinically normal 6-week old infants were presented with a series of sound stimuli while their behavior was assessed live by 2 sound-masked observers and simultaneously videorecorded. Two weeks later the same observers assessed the behavior from the videorecords. In both situations, observers were permitted to see the babies for 10 sec at each trial. The first 5 sec was a prestimulus observation period, and the second 5 sec might have contained a sound stimulus. Between trials the observers were allowed 20 sec in which to note (1) prestimulus activity, (2) confidence in response, and (3) facial, digit, and limb movements, and "wholistic" impressions (e.g., "stilling"). The agreement between the live and video situations was fair for prestimulus activity, modest for confidence in response, and fair to good for movement items. The use of videorecorded material for 6-week old infants generally caused rather small losses of relevant information and apparently will not overly distort the findings of experimental or clinical work. This outcome was rather similar to that of our earlier study of neonates.

Acoustic Stimulation↗
PubMed1987

Prenatal alcohol exposure and infant behavior: immediate effects and implications for later development.

Infants exposed to alcohol prenatally, even when they do not suffer from fetal alcohol syndrome (FAS), may be at high risk for many of the negative outcomes typically found among children of alcoholics including hyperactivity and other behavioral and learning problems. A series of studies are described designed to investigate the incidence and persistence of central nervous system (CNS) related behavioral alterations in three groups of infants born to low SES black women: (1) those who never drank in pregnancy; (2) those who drank at an average of 12 ounces of absolute alcohol (AA) per week throughout pregnancy; and (3) those who drank an equivalent amount but stopped by the second trimester of pregnancy. Only healthy, full-term infants were examined for the physical dysmorphic features associated with FAS and for behavioral alterations that could be assessed using the Brazelton Neonatal Behavioral Assessment Scale. One hundred and three neonates were examined at three days; those who had been exposed to alcohol were found to be less optimal in neurobehavioral responses. Infants whose mothers continued to drink were significantly lower on their orientation toward auditory and visual stimuli, motor performance, and autonomic regulation than the nonexposed infants. Although a second study found that some of these effects were related to neonatal withdrawal syndrome, a follow-up to 30 days of age in a subsample of the original group found that there were persistent behavioral alterations. Infants in the stopped-drinking group showed more recovery over the first month than did those in the continued-drinking group in reflexive behavior and autonomic control. A reassessment at six months of 60 of the infants who had been tested at three days indicated that differences in orientation, motor performance, reflexive behavior and autonomic control were predictive of mental and motor performance on the Bayley Scales of Infant Development. This series of studies supports the contention that the negative effects on infant behavior of prenatal alcohol exposure are both immediate and persistent.

Alcohol Drinking↗
PubMed1995

Effectiveness of individualized developmental care for low-risk preterm infants: behavioral and electrophysiologic evidence.

OBJECTIVE: We assessed the effectiveness of individualized developmental support in the special care nursery for low-risk preterm infants. SETTING: A university-affiliated teaching hospital. PARTICIPANTS: Twelve healthy full-term infants, and 24 low-risk preterm infants randomly assigned to a control or an experimental group. DESIGN: The preterm control group received standard care and the preterm experimental group received individualized developmental care at the same special care nursery. OUTCOME MEASURES: Medical, behavioral (Assessment of Preterm Infants' Behavior and Prechtl's Neurological Examination of the Full-Term Newborn Infant), and electrophysiologic outcome (using quantitative electroencephalography with topographic mapping) of all three groups was assessed 2 weeks after the expected due date. RESULTS: No between- or among-group medical differences were seen for this low-risk, healthy sample. The preterm experimental group showed behavioral and electrophysiologic performances comparable to those of the full-term group, whereas the preterm control group performed significantly less well. Behavioral measures suggested significantly poorer attentional functioning for the preterm control group. Electrophysiologic results implicated the frontal lobe. CONCLUSIONS: Individualized developmental intervention supports neurobehavioral functioning as measured at 2 weeks post-term. It appears to prevent frontal lobe and attentional difficulties in the newborn period, the possible causes of behavioral and scholastic disabilities often seen in low-risk preterm infants at later ages.

Child Development↗
PubMed1986

The effects of maternal anemia on infant behavior.

Little is known about the adverse consequences of anemia during infancy or maternal anemia during pregnancy on the behavioral development of the infant. The present research investigates one aspect of these relationships.

Adolescent↗
PubMed1993

Breastfeeding patterns: comparing the effects on infant behavior and maternal satisfaction of using one or two breasts.

In the Western world advice given by breastfeeding consultants about the use of one or two breasts at each feed has resulted in apparently arbitrary changes over time. This study compared 1-month-old breastfed infants' reactions to single- and two-breast feeds in terms of restlessness, crying, sleeping, and frequency of feeds, wet diapers, and loose stools. Eighty mothers were randomly assigned at the maternity ward, 44 to the single-breast group and 36 to the two-breast group. At one-month follow-up no differences between the groups were seen regarding any infant behavior variables, or in terms of maternal satisfaction, confidence, and mood throughout the full 24-hour observation period or during a 6-hour period in the evening. Compliance with the assigned feeding method was better in the two-breast than in the one-breast group. This may partly be due to tradition, since the two-breast practice has been recommended by child health nurses in Sweden for over 50 years. It seems reasonable that a baby should be allowed to finish the first breast and, if still hungary, be offered the second breast. The baby's appetite is the deciding factor.

Adolescent↗