SOSIALE FERDIGHETER HOS SMÅ SPEDBARN - Undersøkelser av mødre og spedbarn i Double Video paradigme

Double Video paradigmet representerer en «lukket videosirkel» hvor mor og spedbarn sitter fysisk adskilt i hver sitt rom og kommuniserer med hverandre via video- og audio-kanaler hvor de er i en direkte interaksjon (Direkte), eller hvor mor eller spedbarnet får overført et opptak av partneren fra litt tidligere i interaksjonen (Opptak). Manipulasjonen skaper et brudd på sosial kontingens. Double Video paradigmet gjør det mulig å undersøke om spedbarn er sensitive til brudd på sosial kontingens, og om mødres interaksjonsatferd endres når spedbarna ikke lenger responderer aktivt på mors atferd. Double Video laboratoriet i Bergen bestod av 5 betingelser; Direkte 1-Opptak 1-Direkte 2-Opptak 2-Direkte 3. Våre undersøkelser av barnets blikkfokus og affektive uttrykk gir støtte for en sensitvitet til sosial kontingens hos to måneder gamle spedbarn. Resultater viser også at mødres vokaliseringer endres, avhengig av kvaliteten på interaksjonen med spedbarnet. Resultatene fra Double Video laboratoriet i Bergen gir empirisk støtte for at to måneder gamle spedbarn er sensitive til kvalitative endringer i mors atferd under interaksjon, og at mødre er avhengig av aktive bidrag fra spedbarnet for å opprettholde egen interaksjonsatferd. Dette tilbakeviser påstanden om at proto-dialog mellom spedbarn og omsorgsgiver er en enveis prosess som er drevet av omsorgsgiver

Infant Regulation of Distress: A longitudinal study of transactions between mothers and infants

Attachment theory has emphasised how important sensitive and prompt caregiving is for the development of attachment between the child and the caregiver, and how attachment-related processes contribute to the development of the child’s self-regulation skills. In contrast, theories of temperament has emphasised intra-individual differences, such as biological differences in reactivity and regulation. The transactional model describes the development of relational history between the caregiver and the infant as individual-environmental transactions that also involve the development of emotional regulation skills in the infant. These transactions were investigated in a sample of fifty mothers and infants who participated in five studies that took place from the infants were 2 to 17 months of age. To test the transactional model empirically, the project has focused on factors related to infants’ social skills and biological characteristics, sensitive caregiving, context, and on the interplay between these factors during distressing events. Early social communication skills in infants were evidenced as sensitivity to violation of social contingency during face-to-face communication with the mothers, but only among infants who expressed few signs of negative affect (Paper I). Then, mothers’ sensitivity to violation of social contingency during face-to-face interaction was investigated as a further test of infants’ social contribution to social interactions. Mothers’ Infant Directed speech was found to depend on the quality of infants’ responsiveness, which then suggests that infants are actively involved in early interaction (Paper II). It was then found a non-linear relation between maternal soothing and infants’ distress responses to acute pain, and early attentional control in the infants were found to correspond with maternal soothing behaviour. The results suggest that biological and context-dependent maternal and infant responses to distressing events are mutually regulated (Paper III). The transactional hypothesis was empirically confirmed when combining data from a short longitudinal time interval (data from the infants at 2 months and at 3 months), but not when prolonging the time interval of the longitudinal analyses to include the infants’ distress responses at 3-, 15-, and 17 months of age (Paper I, Paper II, Paper III, Study 4, Study 5). It is suggested that future research should explore combinations of early multiple factors involved in the development of infant regulation skills

Kartlegging av kompetanse: Forebygging, tidlig intervensjon og iverksetting av tiltak for barn i alderen 0-2 år

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Kartlegging av kompetanse. Prosjekt kartlegging av kompetanse i 1. linje. Forebygging, tidlig intervensjon og iverksetting av tiltak for barn i alderen 3-6 år.

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Måleegenskaper ved den norske versjonen av Alarm Distress Baby Scale (ADBB)

-Alarm Distress Baby Scale (ADBB) er utviklet for å observere og måle vedvarende sosial tilbaketrekking hos spedbarn i alderen 2-24 måneder. Skalaene består av åtte delområder, og det tar 10-15 minutter å gjennomføre en vurdering av spedbarnet. Målgruppen for bruk av ADBB skalaen er fagpersoner som jobber klinisk med sped- og småbarn, men den kan også benyttes i forskningssammenheng. Den norske oversettelsen av skalaen var ferdig i 2008 og er godkjent av Guedeney som utviklet skalaen sammen med Fermanian (Guedeney & Fermanian, 2001). Systematiske litteratursøk etter dokumentasjon for skandinaviske versjoner av ADBB resulterte i 0 treff, men vi inkluderte en artikkel etter innspill fra førsteforfatter av denne artikkelen. Denne publikasjonen rapporterte data fra en norsk prospektiv kohortstudie med til sammen 302 spedbarn og deres mødre (to grupper: 64 premature spedbarn og deres mødre og 238 spedbarn født til termin og deres mødre). Den inkluderte studien rapporterte gjennomsnittsskårer, median for ADBB total og forskjell i prevalens av forhøyet ADBB total skåre ved 3, 6, og 9 måneder for premature og spedbarn født til termin, samt gruppeforskjeller ved 3, 6, og 9 måneder. Datagrunnlaget for å vurdere måleegenskaper ved den norske versjonen av ADBB skalaen er mangelfull og utilstrekkelig. Fremtidig forskning hvor man benytter den norske ADBB skalaen bør legge vekt på psykometriske egenskaper

Maternal DHA status during pregnancy has a positive impact on infant problem solving: A Norwegian prospective observation study

Docosahexaenoic acid (DHA, 22:6, n-3) is a long-chain polyunsaturated fatty acid necessary for normal brain growth and cognitive development. Seafood and dietary supplements are the primary dietary sources of DHA. This study addresses the associations between DHA status in pregnant women and healthy, term-born infant problem-solving skills assessed using the Ages and Stages Questionnaire. The fatty acid status of maternal red blood cells (RBCs) was assessed in the 28th week of gestation and at three months postpartum. The infants’ fatty acid status (RBC) was assessed at three, six, and twelve months, and problem-solving skills were assessed at six and twelve months. Maternal DHA status in pregnancy was found to be positively associated with infants’ problem-solving skills at 12 months. This association remained significant even after controlling for the level of maternal education, a surrogate for socio-economic status. The infants’ DHA status at three months was associated with the infants’ problem solving at 12 months. The results accentuate the importance for pregnant and lactating women to have a satisfactory DHA status from dietary intake of seafood or other sources rich in DHA

Low omega-3 index in pregnancy is a possible biological risk factor for postpartum depression.

Depression is a common disorder affecting 10-15% women in the postpartum period. Postpartum depression can disrupt early mother-infant interaction, and constitutes a risk factor for early child development. Recently, attention has been drawn to the hypothesis that a low intake of seafood in pregnancy can be a risk factor for postpartum depression. Seafood is a unique dietary source of the marine omega-3 fatty acids and is a natural part of a healthy balanced diet that is especially important during pregnancy.In a community based prospective cohort in a municipality in Western Norway, we investigated both nutritional and psychological risk factors for postpartum depression. The source population was all women who were pregnant within the period November 2009 - June 2011. The fatty acid status in red blood cells was assessed in the 28(th) gestation week and participants were screened for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) three months after delivery. The aim of the present study was to investigate if a low omega-3 index in pregnancy is a possible risk factor for postpartum depression.In a simple regression model, the omega-3 index was associated with the EPDS score in a nonlinear inverse manner with an R square of 19. Thus, the low omega-3 index explained 19% of the variance in the EPDS score. The DPA content, DHA content, omega-3 index, omega-3/omega-6 ratio, total HUFA score, and the omega-3 HUFA score were all inversely correlated with the EPDS score. The EPDS scores of participants in the lowest omega-3 index quartile were significantly different to the three other omega-3 index quartiles.In this study population, a low omega-3 index in late pregnancy was associated with higher depression score three months postpartum

The feasibility of the full and modified versions of the Alarm Distress Baby Scale (ADBB) and the prevalence of social withdrawal in Infants in Nepal

Background: Sustained social withdrawal in infancy may have organic and nonorganic causes and could hinder normal development. The Alarm Distress Baby (ADBB) scale is a widely validated screening tool of social withdrawal in children 2-24 months. The aim of the current study was to evaluate the full and modified ADBB in Nepalese infants in a community-based study. Methods: We enrolled 600 infants who were video recorded during a pediatric examination. The 36 infants first enrolled were scored by an expert rater, and the subsequent 64 infants were scored by two trained staff with the full ADBB scale. Of the 600 enrolled infants, 597 videos (including the 100 infants scored with the full ADBB) were scored with the modified ADBB (m-ADBB) scale by the trained staff, with 7% double scoring. We measured the interrater agreement and psychometric properties of both scales. Results: In the 64 infants scored with the full ADBB by two raters, the concordance correlation coefficients (CCCs) indicated poor interrater agreement. For the m-ADBB, the CCCs were better indicating acceptable agreement between raters. The greatest lower bound (GLB) for reliability coefficient for the full ADBB scored by an expert rater indicated good internal consistency, whereas the GLB coefficient for the m-ADBB indicated poorer internal consistency. The Spearman correlation coefficient between the total scores of the two versions was 0.82 (P < 0.001). Among the infants scored with the full ADBB, 25% had a score above cutoff (≥5). Scored with the m-ADBB in the full sample, 11.4% of the infants had a score above the suggested cutoff (≥2). In both versions, children achieved high scores on vocalization. Conclusion: Our findings suggest that the m-ADBB is an acceptable approach to achieve adequate interrater agreement in a large community-based study in Nepal. Results indicate high prevalence of social withdrawal in this population. There are, however, uncertainties on the internal consistency of the scales in this setting, and the validity of the scales needs to be investigated further. More effective training strategies for administration and additional cultural-specific instructions could be important measures to explore before implementing the scale further in this setting. Keywords: ADBB; Nepal; feasibility; infant; social withdrawal. Copyright © 2020 Ulak, Ranjitkar, Shrestha, Braarud, Chandyo, Shrestha, Guedeney, Strand and Kvestad

Precursors of social emotional functioning among full-term and preterm infants at 12 months: Early infant withdrawal behavior and symptoms of maternal depression

This study forms part of a longitudinal investigation of early infant social withdrawal, maternal symptoms of depression and later child social emotional functioning. The sample consisted of a group of full-term infants (N = 238) and their mothers, and a group of moderately premature infants (N = 64) and their mothers. At 3 months, the infants were observed with the Alarm Distress Baby Scale (ADBB) and the mothers completed the Edinburgh Postnatal Depression Scale (EPDS). At 12 months, the mothers filled out questionnaires about the infants social emotional functioning (Infant Toddler Social Emotional Assessment and the Ages and Stages Questionnaire-Social Emotional). At 3 months, as we have previously shown, the premature infants had exhibited more withdrawal behavior and their mothers reported elevated maternal depressive symptoms as compared with the full-born group. At 12 months the mothers of the premature infants reported more child internalizing behavior. These data suggest that infant withdrawal behavior as well as maternal depressive mood may serve as sensitive indices of early risk status. Further, the results suggest that early maternal depressive symptoms are a salient predictor of later child social emotional functioning. However, neither early infant withdrawal behavior, nor gestational age, did significantly predict social emotional outcome at 12 months. It should be noted that the differences in strength of the relations between ADBB and EPDS, respectively, to the outcome at 12 months was modest. An implication of the study is that clinicians should be aware of the complex interplay between early infant withdrawal and signs of maternal postpartum depression in planning ports of entry for early intervention. (C) 2016 Elsevier Inc. All rights reserved

Flow chart of the study design.

<p>* Of which one respondent did not provide a blood sample ** Of which 54 responders and 15 non-responders to the electronic questionnaire *** Of which 35 responders and 8 non-responders to the electronic questionnaire. 26 participants were not screened for depression 3 months postpartum due to drop out or losses to follow up.</p