Maternal Cocaine Use and Infant Behavior

This study examined the impact of maternal cocaine use and associated risk factors such as polysubstance use, maternal functioning, and caregiving on affect regulation during infancy. Participants were 45 mother‐infant dyads (19 cocaine exposed and 26 control infants) recruited at birth. Observations and maternal reports of infant behavior were obtained at 2 and 7 months of age, along with measures of pre‐ and postnatal substance use, maternal functioning, and caregiving stability. Maternal cocaine use accounted for significant variance in infant positive affect at 2 months. Other substance use and gestational age predicted infant distress to novelty and arousal during developmental assessments. At 7 months, the impact of prenatal cocaine exposure on infant affect regulation was mediated by postnatal alcohol use and caregiving stability. These findings, if replicated, suggest that 1 pathway to later problem behavior reported among substance‐exposed children may be through early regulatory problems and the quality of postnatal caregiving.     

Further evidence for the multidimensional nature of maternal sensitivity: differential links with child socioemotional functioning at preschool age

There has been increasing scholarly attention to the study of maternal sensitivity as a multidimensional construct. This report investigated the predictive value of three dimensions of sensitivity during mother–infant interactions in an effort to gain greater understanding of how specific facets of sensitivity relate to child socioemotional outcomes. Maternal cooperation/attunement (accurate interpretation of infant cues and capacity to adjust the interaction correspondingly), positivity (positive attitude toward the infant), and accessibility/availability (consistent attentiveness) were assessed observationally in 195 mothers of 1-year-old infants. Child socioemotional functioning was assessed using behavioral tasks and maternal and teacher reports when children were 4 years of age. The results revealed that maternal accessibility/availability was predictive of less externalizing behavior, more prosocial behavior (mother- and teacher-reported), and better theory of mind, while maternal positivity predicted effortful control. These results highlight the advantages of a multidimensional assessment in understanding how sensitivity predicts different developmental outcomes.     

Families by Adoption and Birth: I. Mother-Infant Socioemotional Interactions

The role of adoptive family dynamics in the etiology of both resilient and adverse developmental outcomes is not well understood. In this study, socioemotional aspects of the mother-infant relationship were examined in families by adoption and by birth. Matched groups of mothers and their 5-month-old first babies were observed in the home setting. Dyads in the two groups were comparable in the frequency and ranking of a full array of age-appropriate behaviors. Group differences emerged for selected infant and maternal behaviors; infants by birth were in an alert state and smiled more often than infants by adoption, and adoptive mothers nourished and caressed their infants more than did mothers by birth. While the structure of the infant's behavior repertoire was similar for both groups, there were twice as many significant correlations among maternal behaviors for the birth group than for the adoptive group. There were also more correlations between maternal and infant behaviors for dyads by birth than for dyads by adoption, and the nature of the correlations differed for the two groups. It is argued that both groups of mothers and babies were functioning in the adaptive, healthy range and that observed differences between them reflect subtle differences in behavioral emphasis, possibly related to the unique paths to parenthood represented by adoption and birth.     

Maternal Lifetime Trauma Exposure,Prenatal Cortisol,and Infant Negative Affectivity

Little research has examined the impact of maternal lifetime trauma exposure on infant temperament. We examined associations between maternal trauma history and infant negative affectivity and modification by prenatal cortisol exposure in a sociodemographically diverse sample of mother–infant dyads. During pregnancy, mothers completed measures of lifetime trauma exposure and current stressors. Third‐trimester cortisol output was assessed from maternal hair. When infants were 6 months old, mothers completed the Infant Behavior Questionnaire‐Revised. In analyses that controlled for infant sex and maternal age, education, race/ethnicity, and stress during pregnancy, greater maternal trauma exposure was associated with increased infant distress to limitations and sadness. Higher and lower prenatal cortisol exposure modified the magnitude and direction of association between maternal trauma history and infant rate of recovery from arousal. The association between maternal trauma history and infant distress to limitations was somewhat stronger among infants exposed to higher levels of prenatal cortisol. The analyses suggested that maternal lifetime trauma exposure is associated with several domains of infant negative affectivity independently of maternal stress exposures during pregnancy and that some of these associations may be modified by prenatal cortisol exposure. The findings have implications for understanding the intergenerational impact of trauma exposure on child developmental outcomes.     

Stabilities of infant behaviors and maternal responses to them

Consistency in the order of individuals in a group across substantial lengths of time—stability—is a central concept in developmental science for several reasons. Stability underscores the meaningfulness of individual differences in psychological phenomena; stability informs about the origins, nature, and overall developmental course of psychological phenomena; stability signals individual status and so affects the environment, experience, and development; stability has both theoretical and clinical implications for individual functioning; and stability helps to establish that a measure constitutes a consequential individual‐differences metric. In this three‐wave prospective longitudinal study (Ns = 40 infants and mothers), we examined stabilities of individual variation in multiple infant behaviors and maternal responses to them across infant ages 10, 14, and 21 months. Medium to large effect size stabilities in infant behaviors and maternal responses emerged, but both betray substantial amounts of unshared variance. Documenting the ontogenetic trajectories of infant behaviors and maternal responses helps to elucidate the nature and structure of early human development.     

A mixed-methods evaluation using effectiveness perception surveys,social network analysis,and county-level health statistics: A pilot study of eight rural Indiana community health coalitions

Community health coalitions (CHCs) are a promising approach for addressing disparities in rural health statistics. However, their effectiveness has been variable, and evaluation methods have been insufficient and inconsistent. Thus, we propose a mixed-methods evaluation framework and discuss pilot study findings. CHCs in our pilot study partnered with Purdue Extension. Extension links communities and land grant universities, providing programming and support for community-engaged research. We conducted social network analysis and effectiveness perception surveys in CHCs in 8 rural Indiana counties during summer 2017 and accessed county-level health statistics from 2015-16. We compared calculated variables (i.e., effectiveness survey k-means clusters, network measures, health status/outcomes) using Pearson’s correlations. CHC members’ positive perceptions of their leadership and functioning correlated with interconnectedness in their partnership networks, while more centralized partnership networks correlated with CHC members reporting problems in their coalitions. CHCs with highly rated leadership and functioning developed in counties with poor infant/maternal health and opioid outcomes. Likewise, CHCs reporting fewer problems for participation developed in counties with poor infant/maternal health, poor opioid outcomes, and more people without healthcare coverage. This pilot study provides a framework for iterative CHC evaluation. As the evidence grows, we will make recommendations for best practices that optimize CHC partnerships to improve local health in rural areas.     

Prenatal Reflective Functioning and Accumulated Risk as Predictors of Maternal Interactive Behavior During Free Play,the Still‐Face Paradigm,and Two Teaching Tasks

This study examined whether prenatal reflective functioning (RF) was related to mothers’ interactive style across contexts with their 6‐month‐old infants (M age = 6.02 months, SD = 0.41, 54% boys), and to what extent quality of prenatal RF could account for the influence of accumulated risk on maternal interactive behavior. Accumulated risk was defined as the sum‐score of a selection of risk factors that have been associated with suboptimal infant development. Mother–infant dyads (N = 133) were observed during free play, two teaching tasks, and the Still‐Face Paradigm (SFP). Better prenatal RF was associated with more positive maternal behavior in all settings and less negative behavior during teaching and SFP reengagement. Accumulated risk and prenatal RF predicted shared variance in maternal interactive behavior (with unique predictive effects observed only for RF on sensitivity during teaching and SFP play, and for accumulated risk on sensitivity and positive engagement during SFP play, and internalizing‐helplessness during SFP reengagement). Accumulated risk had an indirect effect on maternal sensitivity during teaching and SFP play through prenatal RF. These findings suggest not only that RF may be targeted prenatally to improve mother–infant interactions, but also that enhancing RF skills may ameliorate some of the negative consequences from more stable perinatal risk factors that influence parent–child interactions.     

Migration, social support and perinatal health: an origin-destination analysis of Puerto Rican women

Using pooled origin-destination data from the Puerto Rican Maternal and Infant Health Study, we investigate linkages between migration, social support, and perinatal health. We document differences in social support between three groups of Puerto Rican women: non-migrant women in Puerto Rico, first-generation migrants to the U.S. mainland, and mainland-born women. The role of social support in producing differences in perinatal health outcomes between the groups is assessed. The analysis shows striking differences in social support between island and mainland women, but little systematic variation among mainland women by generation of U.S. residence. The lower level of social support available to mainland women is not reflected in the health outcomes examined, which do not generally worsen with migration to the United States (with the exception of maternal smoking). Nonetheless, we show that social support has important implications for stress, which in turn increases the risk of poor health behavior and compromised infant health.     

Maternal Psychosocial Adversity and the Longitudinal Development of Infant Sleep

Research has identified associations between indicators of social disadvantage and the presence of child sleep problems. We examined the longitudinal development of infant sleep in families experiencing high (n = 58) or low (n = 64) levels of psychosocial adversity, and the contributions of neonatal self‐regulatory capacities and maternal settling strategies to this development. Assessments of infant sleep at 4‐, 7‐, and 12‐weeks postpartum indicated no differences in sleeping difficulties between high‐ and low‐adversity groups. However, more infant sleep difficulties were reported in the high‐ versus low‐adversity groups at 12‐ and 18‐month follow‐ups. Neonatal self‐regulatory capacities were not related to the presence or absence of adversity, or to subsequent infant sleep quality. However, there were group differences in maternal settling strategies that did predict subsequent infant sleep difficulties. The pattern of sleep disturbance observed in association with maternal psychosocial adversity at 18‐months was consistent with risk for broader impairments in child functioning.     

Young Infants' Behavioral Reactivity to Mild Perturbation: Developmental Continuity,Stability, and Organization

This study investigated the developmental continuity, stability, and organization of infants' behavioral response to mild stress from 1 to 3 months of age. Changes in infant stress reactivity were expected to coincide with a suspected neurobiological shift around the 2nd month. A total of 53 infants and their mothers participated in this study. At 1 and 3 months, infants' stress reactivity to mild perturbation was assessed by withdrawing a pacifier during nonnutritive sucking. Infant baseline heart rate activity and maternal reports of infant temperament were also obtained. Focusing on facial and vocal negativity, behavioral measures of infant reactivity to pacifier withdrawal were coded from videos. Results showed that developmental continuity and individual instability characterized changes in infant stress reactivity over the 2nd‐month transition. Developmental reorganization was also evidenced by changes in the direction and magnitude of infant stress reactivity in relation to baseline heart period and maternal temperament ratings, respectively. These findings provide direct supporting evidence for the contention that changes in infant stress reactivity to mild perturbation may be a function of developmental shifts in underlying neurobiological mechanisms in early infancy.     

Families,Not Parents,Differ: Development of Communication in Finnish Infants

This longitudinal study on Finnish families was conducted to identify developmental differences in family‐level communication among mothers, fathers, and their infants during the second half of the infant's first year, and associations with infants' later language and communicative skills. We examined coregulated communication of parent‐infant dyads during 5‐min laboratory play sessions at 7 and 11 months. Few differences in mutually regulated communicative exchanges emerged between maternal and paternal dyads, and few developmental changes were found across the whole sample. Families with different communication profiles were identified, and changes rather than stability characterized communicative development at the family level. The family‐level differences at 7 months predicted variation in children's language and communicative skills at 14 months.     

Infant Behavior and Competence Following Prenatal Exposure to a Natural Disaster: The QF2011 Queensland Flood Study

This study utilized a natural disaster to investigate the effects of prenatal maternal stress (PNMS) arising from exposure to a severe flood on maternally reported infant social–emotional and behavioral outcomes at 16 months, along with potential moderation by infant sex and gestational timing of flood exposure. Women pregnant during the Queensland floods in January 2011 completed measures of flood‐related objective hardship and posttraumatic stress (PTS). At 16 months postpartum, mothers completed measures describing depressive symptoms and infant social–emotional and behavioral problems (n = 123) and competence (n = 125). Greater maternal PTS symptoms were associated with reduced infant competence. A sex difference in infant behavioral problems emerged at higher levels of maternal objective hardship and PTS; boys had significantly more behavioral problems than girls. Additionally, greater PTS was associated with more behavioral problems in boys; however, this effect was attenuated by adjustment for maternal depressive symptoms. No main effects or interactions with gestational timing were found. Findings highlight specificity in the relationships between PNMS components and infant outcomes and demonstrate that the effects of PNMS exposure on behavior may be evident as early as infancy. Implications for the support of families exposed to a natural disaster during pregnancy are discussed.     

Developmental Outcomes of Vulnerable Youth in the Child Welfare System

Abstract

Adolescent development of youth in foster care holds great interest for society. This article examines a random sample of 200 adolescents currently placed in foster care on developmental outcomes. Using face-to-face interviews, the present study found that a majority of foster youth have biological families experiencing multiple problems and experience many developmental difficulties. A large percentage of the sample youth experience mental illness, school failure, substance abuse, and other antisocial behaviors. This paper considers implications from the study findings for policy and interventions designed to foster better developmental outcomes among youth in the child welfare system.     

The Emotional and Educational Functioning of Children Living with Maternal HIV/AIDS and Substance Use

The rates of HIV infection among women in the U.S. have risen dramatically in the past decades, affecting not only women as individuals, but also women as mothers and caregivers. Waning maternal physical and psychological resources, coupled with poverty and possible familial substance use, place children of HIV-infected women at behavioral and developmental risk. This study compared the emotional and educational functioning of HIV-uninfected children, 6–15 years of age, living with an HIV-infected mother who used substances to a comparison group of children living with maternal substance use only. Results indicate that children whose mothers are HIV-infected and use substances have poorer emotional functioning when their mother experiences HIV-related symptoms compared to the comparison group. Paradoxically, results also indicated that target group children were significantly less likely to be rated as disruptive during the interview than the control group children. Implications for practice are discussed.Cynthia Devane Fair, Associate Professor is affiliated with Department of Human Services, Elon University, USA     

The effects of domestic violence during pregnancy on maternal and infant health

The present study examined the impact of domestic violence on maternal and infant health by assessing maternal health during pregnancy and infant health at two months postpartum. Two hundred and two women (68 battered and 134 non-battered) were recruited from the community and completed both pregnancy and 2-month postpartum interviews. Results revealed that domestic violence during pregnancy was associated with numerous health problems for mothers and infants including more health problems during pregnancy, more likelihood of premature labor, later entrance into prenatal care, lower infant birth weight, greater utilization of health care resources, and more prenatal substance use. After income was controlled, the relationship between violence and timing of prenatal care and infant birth weight became nonsignificant. Maternal social support was found to protect against the effects of violence for several health outcomes. The current findings suggest the need for domestic violence screening during pregnancy, as well as clinical interventions for battered, pregnant women in order to prevent serious physical and emotional problems for both mothers and their infants.     

A Family Perspective for Substance Abuse: Implications from the Literature

SUMMARY

This paper calls for researchers and treatment providers to increase their recognition of the role that family and family functioning has for understanding the incidence and impact of substance abuse. Substance abuse is identified as a family problem by exploring its occurrence within families as well as its impact on marital relationship, family violence, and child abuse and neglect. The impact of substance abuse on the roles of spouses and parents are examined, as is the impact of substance abuse on children at various developmental stages. The role of the family as participant in active substance abuse as well as a valuable treatment resource is also explored. Finally, the authors present recommendations for increasing the focus on family in substance abuse research.     

Paid maternal leave is associated with better language and socioemotional outcomes during toddlerhood

The United States is the only high-income country that does not have a national policy mandating paid leave to working women who give birth. Increased rates of maternal employment post-birth call for greater understanding of the effects of family leave on infant development. This study examined the links between paid leave and toddler language, cognitive, and socioemotional outcomes (24–36 months; N = 328). Results indicate that paid leave was associated with better language outcomes, regardless of socioeconomic status. Additionally, paid leave was correlated with fewer infant behavior problems for mothers with lower levels of educational attainment. Expanding access to policies that support families in need, like paid family leave, may aid in reducing socioeconomic disparities in infant development.     

Creation and evaluation of a maternal mental health course

Perinatal Mood and Anxiety Disorders (PMADs) engender significant and increasing personal, social, developmental, and economic burdens to women, children, families, and global public health. In the US, a Master of Social Work (MSW) elective course, Introduction to Maternal Mental Health, was created to prepare future social workers to better understand, detect, intervene, and advocate with women struggling with perinatal mental health concerns. A pilot study used pre–post-surveys (N = 10) and a focus group to examine students’ knowledge acquisition, course satisfaction, and perceived self-efficacy. A Wilcoxon signed-rank test showed a statistically significant difference between pre- and post-survey course content knowledge scores. Positive focus group feedback and survey outcomes suggest that students benefitted from the course in terms of increased learning and professional efficacy in maternal mental health; however, the study should be replicated using a larger sample and comparison group. The course outline provided may be used to develop a similar course or to infuse maternal mental health content into existing courses. The paper concludes with implications and recommendations for social work educators.     

Maternal Welfare and Employment Experiences and Adolescent Well-Being: Do Mothers' Human Capital Characteristics Matter?

Using a representative sample of over 900 low-income urban families from the Three-City Study, analyses assessed whether maternal human capital characteristics moderate relationships between mothers' welfare and employment experiences and young adolescents' well-being. Results indicate synergistic effects whereby greater maternal education and literacy skills enhanced positive links between mothers' new or sustained employment and improvements in adolescent cognitive and psychosocial functioning. Greater human capital also enhanced the negative links between loss of maternal employment and adolescent functioning. Mothers' entrances onto welfare appeared protective for adolescents of mothers with little education but predicted decreased psychosocial functioning among teens of more educated mothers. Results suggest that maternal human capital characteristics may alter the payback of welfare and work experiences for low-income families.     

Successful Adoption of Children with Down Syndrome and Other Developmental Disabilities

Abstract

Children with many types of developmental disabilities have been successfully adopted. Nonetheless, there appears to be a belief among both adopters and some adoption workers that children with Down syndrome are especially easy to rear. The current paper uses different methodological strategies, including case-by-case matching and regression techniques, to test hypotheses relating to better outcomes for parents and families who have adopted children with Down syndrome in comparison to children with other developmental disabilities. The results demonstrated successful functioning for parents and families on a variety of measures, regardless of whether the adopted children had Down syndrome or other developmental disabilities. The positive stereotype for Down syndrome was not supported.