8th World Congress
Amsterdam, The Netherlands
Short Abstracts - Day 4, Friday#381
THE DEVELOPMENTAL VISIT: A NONLINEAR DYNAMIC SYSTEMS APPROACH TO RELATIONSHIP-BASED ASSESSMENT FOR INFANTS AND FAMILIES.
Dettwiler, A. Bancroft Neurohealth/M.I.T., Hopkins Lane, P.O. Box 20, Haddonfield, NJ 08033. USA a_dettwiler@hotmail.com. and Recchia, S. L. slr20@columbia.edu.
The Developmental Visit, an innovative assessment/enrollment process for infants and families, highlights parent-child interaction as a context for understanding infant growth and development. A nonlinear dynamic systems approach is used to observe and describe infants’ skills and behaviors, acting as a complement to traditional assessment techniques. The Visit’s parent interview allows families to contribute meaningfully to a plan for intervention. Parents are given direct feedback to support their parenting skills, and to illuminate their children’s developmental capacities. Presenters will highlight the Visit’s value as a foundation for both relationship based intervention and transdisciplinary professional practice. Videotaped segments of the Visit will be used to provide examples and stimulate discussion among participants.
#383
SUPPORTING FAMILIES WITH YOUNG CHILDREN: INTERNATIONAL PERSPECTIVES ON PARENTING PROGRAMS.
Easterbrooks, M.A., & Brady, A.E. (organizers). Eliot-Pearson Department of Child Development, Tufts University, Medford, MA 02155. USA. ann.easterbrooks@tufts.edu.
When designing and funding programs to support young families, program developers and policymakers often seem to assume that a good program design will ensure measurable and socially significant changes in the life trajectories of parents and children. In recent years, though, evidence has emerged that indicates that some programs work for some people some of the time. This poster workshop will focus on six parenting intervention programs from around the world. Each contribution examines factors within parents’ ecologies that may challenge or facilitate program engagement and positive outcomes. These factors include family relationships, history, and social context; cultural and societal pressures, and elements of program operations themselves. Programs from Canada, Israel, Japan, the Netherlands, and the United States are represented. Each of the programs presented aims to support the development of families through prevention and intervention efforts in the earliest years of life. Taken together, the posters in this workshop provide a multidimensional examination of factors that can help programs and policymakers to effectively help infants and their parents achieve better life outcomes.
#384
WORKING WITH TEENAGE MOTHERS: WHO PARTICIPATES IN A HOME VISITING PROGRAM AND HOW?
Brady, A., Boulos, S., Goldberg, J., & Jacobs, F. Tufts University, 177 College Avenue, Medford, MA 02155. USA anne.brady@tufts.edu.
If programs for mothers and infants are to be beneficial, they must successfully retain their clients. But evaluations in the family support and home visiting fields consistently show lower than expected service delivery and retention rates. Factors associated with levels of engagement in past research include: age, stress, race/ethnicity, psychopathology, socioeconomic status, and health risk behaviors. Some studies revealed that higher-risk families had lower levels of engagement, whereas others found that higher-risk families were more likely to engage. We examine engagement from a multidimensional perspective using data from an evaluation of a home visiting program for first-time mothers under the age of 21 and their families. Different clients demonstrate different patterns of program usage for a variety of reasons. These patterns may represent healthy use of their time and program resources or they may represent problems that prevent full program engagement. A cluster analysis of mothers’ involvement in the program revealed four clusters related to program engagement. We examine the intra- and extra-personal factors that relate to these patterns of service utilization and engagement.
#385
RESULTS OF A PROCESS EVALUATION OF A HOME VISITATION PROGRAM.
Culp, A. M. & Culp, R. E. Department of Human Development, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL 35487-0158. USA aculp@ches.ua.edu.
The poster’s purpose is to address the process issues involved in implementation of a home visitation program delivered by child development professionals to first-time mothers (N= 355; intervention group = 156) living in rural communities. The curriculum focused on maternal health, child health and safety, and family functioning and parenting. Mothers, recruited prior to the 28th week of their pregnancy, received home visits weekly/biweekly from enrollment until 12 months postpartum. Results are based on 6,687 home visits. During pregnancy the mean number of home visits exceeded the model (115%). From birth to 6 months, 73% and from 6 to 12 months 63%of expected visits were completed. Lasting about 60 minutes, the majority of the home visits occurred in the home (83%). Approximately 91% of the home visit time was spent on “what was planned” by the home visitors. Engagement during the home visits was high. Content of the home visits varied over the course of the intervention shifting from emphasis on maternal health to child development. Results can guide practitioners, community program administrators, and researchers in learning more about the process of home visitation programs.
#386
MOTHER-FATHER RELATIONSHIPS AS SUPPORTS FOR PARENTING.
Easterbrooks, M.A., & Docherty, H. Eliot-Pearson Department of Child Development, Tufts University, Medford, MA. 02155. ann.easterbrooks@tufts.edu.
While research shows that close relationships with romantic partners and others serve as important supports for parenting, little is known about how adolescent mothers’ relationships with their babies’ fathers impacts parenting quality. This poster presents data from the Massachusetts Healthy Families Evaluation of 364 young mothers and their infants seen longitudinally for 18 months. Data assessing mother-father relationships (including violence), father involvement (extent and nature), and aspects of parenting (attitudes, stress, behavior) were collected via interviews, questionnaires, and home observations. Across the 1.5 years of the study, most fathers remained involved with their infants, though they did not necessarily continue romantic relationships with the mothers. 30%-50% of mothers desired greater father involvement (caregiving, emotional, financial). Analyses suggest that father involvement is related to several aspects of mothers’ parenting, including parenting attitudes (empathy, expectations), parenting stress, and mother-child interaction. Further analyses will examine whether the stability and quality of mother-father relationships are related to fathers’ parenting attitudes and behavior.
#387
THE IMPORTANCE OF SOCIAL CONTEXT IN UNDERSTANDING AND SUPPORTING ADOLESCENT PARENTS.
Gestsdottir, S., Chaudhuri, J.H., Easterbrooks, M.A. Tufts University, 177 College Avenue, Medford, MA 02155. USA sgests01@tufts.edu.
This poster examines how adolescent parenting is affected by factors within the individual (i.e. depression) and within broader societal contexts (i.e., neighborhood quality). Studies have shown that stress, maternal depression, and poverty can negatively affect infant developmental outcomes. Participation in parenting intervention programs can influence relations between contextual variables and parenting and infant outcomes. 364 adolescent mothers enrolled in Healthy Families Massachusetts completed measures of depression, parenting stress, parenting attitudes, and parenting knowledge. Indicators of environmental context include assessments of neighborhood safety, resources for children, and quality of the caregiving environment. Interactions between mothers and children were videotaped in their own homes. These data show that maternal parenting behaviors are related only to macro- variables. Home environments, neighborhood quality, and receipt of public assistance all related to different aspects of parenting behavior (sensitivity, structuring, nonintrusiveness, and nonhostility). Further analyses will include measures of parenting attitudes and knowledge, and the role of mothers’ level of participation in the program.
#388
INTERVENTION FOR CHILD ABUSE IN INFANCY IN JAPAN.
Homma, H. Miyagi Children and Family Treatment Center, 1-4-39 Honcho, Aobaku, Sendai, 980-0014, JAPAN. h.homma@juno.ocn.ne.jp
The Child Guidance Center in Japan plays a leading role in understanding the problem of child abuse as well as providing interventions for families where cases of child abuse have been documented. One of the aims of our research project is to describe the underlying factors between the mother and child involved in the maltreatment. This poster will describe an epidemiological study of about 500 cases of mothers and infants, classified according to risk status. This poster also will describe the supportive intervention for the mother and child. During the last four decades, Japan has developed an effective health check system for mothers and young children, with developmental screening by a municipal health nurse. Children’s developmental problems are addressed through collaboration between the municipal health nurse and special institutions. In addition, this poster will describe the design of a collaborative treatment system for mothers with childrearing difficulties.
#389
PREVENTIVE INTERVENTION OF EXTERNALIZING BEHAVIOR PROBLEMS IN EARLY CHILDHOOD.
Juffer, F., Mesman, J., van Zeijl, J., van Beek, W., Stolk, M., Bakermans-Kranenburg, M.J., & van IJzendoorn, M.H. Center for Child and Family Studies, Leiden University, P.O. Box 9555, NL-2300 RB Leiden, The Netherlands juffer@fsw.Leidenuniv.nl.
In an experimental cross-sequential study with three age groups (1-, 2-, and 3-year old boys and girls with externalizing behavior problems, selected on the basis of the CBCL), we test the effectiveness of a parenting intervention on parental sensitivity and disciplining. We also examine whether the enhancement of parents’ sensitive interactions and discipline with these children leads to less problematic child behavior and more empathic concern. We report some first results concerning parent and child characteristics, e.g., nature and severity of the children’s problem behaviors. Also, the intervention format (e.g., themes and content of the 6 home-based sessions) and intervention method will be discussed.
#390
THE DEVELOPMENT OF A HOME-VISITING PROJECT FOR “NEW” MOTHERS IN JERUSALEM, ISRAEL.
Kaitz, M., & Chriki, M. Department of Psychology, Hebrew University, Jerusalem 91905, Israel. msmarsha@mscc.huji.ac.il.
The Jerusalem-based “Mom to Mom” home-visiting project matches trained volunteers who are experienced mothers with “new” mothers who have a need for a supportive connection. The 2 year development of the project followed a 4 stage model: 1.) Survey needs of target population- assessed by ratings of 200 mothers on the Information and Support Questionnaire and 89 mothers on the Maternal Concerns Questionnaire, 2.) Partnership and Networking- established connections with other family-directed services for modeling, information, and support, 3.) Preparation of training and evaluation material, and 4.) Limited operation- matching of up to 20 volunteer-“mom” pairs. We are now in stage 4. Twenty volunteers have been trained and 15 of them have been matched with a new mother for weekly home-visiting. Data collected from initial survey data and evaluations by volunteers and new mothers enrolled in the program suggest that Mom to Mom is a needed and useful resource for Israeli mothers of young infants. The project also provides a forum for connecting women from diverse social and religious backgrounds.
#391
PROGRAM-PARTICIPANT PERSPECTIVES ON PARENTING DURING INFANCY.
Mistry, J., Diez, V., Renot, I., Cobb, A., Craddock, K. Eliot-Pearson Department of Child Development, Tufts University, Medford, MA 02155. USA. jmistry@tufts.edu.
This poster is based on an ethnographic study investigating parenting beliefs of families from three communities served by a teen home visiting program. The study examines the consonance between teen participants’ parenting beliefs and those underlying the programs’ intervention approach. Data were collected using multiple methods and over a one to two year period. Preliminary results suggest that conflicting beliefs about nursing and feeding are common in all three communities, Consistency between home visitors and participants in what they identify as conflicting beliefs and how they respond to these differences in opinion varies between the three communities.
#392
THE CHALLENGES OF PROVIDING ATTACHMENT-BASED INTERVENTIONS FOR ADOLESCENT MOTHERS.
Pederson, D.R., Moran, G., Krupka, A., Pederson, D., & Bailey, H.N. Department of Psychology, The University of Western Ontario, London, Ontario, CANADA N6A 5C2 pederson@uwo.ca.
Adolescent parenthood is associated with a broad range of negative psychosocial outcomes for the mother and infant. We report on an intervention designed to prevent a decline of sensitivity in 99 adolescent mothers. Only 25% were classified as autonomous on the Adult Attachment Interview, 36% as Dismissing and 37% were Unresolved/disoriented with respect to trauma. Over half of the mothers reported physical and/or sexual abuse during childhood. An intervention involving brief videotaping of play and a discussion with the mother that affirmed her parenting skills was successful with many mothers but was much less effective for mothers with a history of trauma and did not decrease the frequency of Disorganized attachment. This presentation explores the trauma experiences of this intervention-resistant group and the psychological sequel that raise substantial practical challenges for developing programs for adolescent mothers.
#393
MEDICINE STUDENTS AND HOME VISITS.
Nudelman, C., & Celia, S. Universidade Luterana Do Brasil, Rua Miguel Tostes, 101, Bairro São Luis - 92.420-280 Canoas/RS-Brasil. sahcbr@amrigs.com.br.
Our aim is to assess the way Medicine students at ULBRA (Lutheran University of Brazil), a university situated in the south of Brazil, have been working with poor families during home visits. The students taking the discipline “The Baby and its World - Mother-Infant Relationship” in the second term of Medicine School are given theoretical training in issues such as: attachment development, resilience, empathy, crèche and caregivers, elements of protection and risk, doctor-patient relationship, dynamics of interactions, imaginary interactions, and the neuropsychological development of babies. The practical training is held in a slum where the students, in charge of home visits, watch and look after a pregnant teenager or a baby and his/her family. The students are supervised and supported by professors on a weekly basis, individually or in groups. This work will consist of clinical reports, which show the care and support provided by Medicine students to pregnant women, teenage mothers and families at risk. During the home visits, the students listen attentive and empathically to these families, who are often running affective and social risks, making them feel supported and strengthened to overcome their hardships and develop early bonds with their babies, which in turn will result in a more adequate mothering and a better development for the baby.
#395
POST-TRAUMATIC STRESS DISORDER AND DEPRESSION OF THE PARENTS OF PREMATURE CHILDREN.
S. Gamba Szijarto, M. Forcada Guex, C. Muller Nix, A. Nicole, B. Pierrehumbert, F. Ansermet.
Service de liaison PEL.,SUPEA Hopital Nestle, av. P. Decker 5.1011Lausanne. Within the framework of a research on the parental subjective experience and the outcome of prematurely, we wished to explore the incidence of depressive symptomatology and the symptoms of parental post-traumatic stress disorder at various moments in the life of the child. The population includes 65 premature infants hospitalized in the division of neonatology, born between 25 and 33 weeks of gestation, compared with a control group of 32 healthy full-term infants. The average age of gestation of the premature infants is 30 weeks + 2 and the average weight at birth is 1395 grams + 417. The incidence of depressive symptomatology was evaluated by the Edinburgh post-natal depression scale (EPDS; Cox 1987). The incidence of post-traumatic-stress was evaluated by two auto-administrated questionnaires, the Impact of Event Scale (IES, Horowitz 1979) and the Perinatal PTSD questionary (PPD, De Mier 1996). The questionnaire scores were correlated with the health status of the newborn infant using the perinatal risk inventory, (PERI, Scheiner and Sexton, 1993) and were compared between three groups of parents (parents of: full term infants, of healthy preterm infants and of sick preterm infants).
#396
POST-PARTUM DEPRESSION AND THE MOTHER-INFANT RELATIONSHIP IN A SOUTH AFRICAN, PERI-URBAN SETTLEMENT.
Mark Tomlinson, Chris Molteno, Peter Cooper & Leslie Swartz. The Child Guidance Clinic, University of Cape Town, Chapel Road, Rosebank, 7700, Cape Town, South Africa. mtomlins@protem.uct.ac.za
An epidemiological study was conducted in a disadvantaged peri-urban community in South Africa to determine the prevalence of post-partum depression. Associated difficulties in the mother-infant relationship and infant development were examined. A sample of 147 mother-infant dyads was collected in an area of Khayelitsha near Cape Town. Maternal mood was assessed at 2, 6 and 18 months. The mother-infant relationship was assessed in face-to-face interaction at 2 months. In addition, migration history and social circumstances were documented and infant growth and development over 18 months were recorded. At 2 months postpartum 34.7% of the sample was depressed, but by 6 months the rate had declined to 22% and at 18 months 12%. Postpartum depression was associated with an unplanned and unwanted pregnancy and with poor emotional and practical support for the mother. Mothers with strong rural ties were less depressed. Depressed mothers at 2 months displayed less sensitivity towards their infants who were also less actively engaged during the interaction. There was a tendency towards lower weights at 18 months in infants of depressed mothers and the Behaviour Screening Questionnaire (BSQ) revealed more problems in infants of mothers depressed at 2 months and those less sensitive on the interaction at 6 months. There was no association between maternal depression and infant development assessed on the Bayley Scales at 8 months.
#397
PRENATAL, POSTNATAL AND LATER SYMPTOMS OF DEPRESSION - DIFFERENT RISKS FOR A CHILD.
Luoma, I., Kaukonen, P. & Tamminen, T. Tampere University Hospital and University of Tampere, Medical School, FIN-33014 University of Tampere, Finland. ilona.luoma@uta.fi .
The objective of this study was to examine the associations of maternal prenatal, postnatal and later depressive symptoms with simultaneously and later perceived problems of the child. A population-based sample of 129 mother-child pairs was followed up from pregnancy until the firstborns were 8 to 9 years old. The Neonatal Perception Inventory was used to measure maternal perceptions concerning the child perinatally. At the later stages the Child Behavior Checklists were used to screen the problems of the 4- to 5-year-old and the 8- to 9-year-old children. At the same time points maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Maternal earlier psychiatric problems were also considered. Particularly prenatal depressive symptoms were associated with maternal previous psychiatric history. Prenatal depressive symptoms as a whole, prenatal sense of impaired coping in particular, and concurrent maternal anxiety predicted perceived problems of the school-aged child.
#398
RESPONDING TO THE DARKER SIDE OF MOTHERHOOD: A WEB OF SERVICES FOR DEPRESSED AND ISOLATED NEW MOTHERS.
Kaufman, P., Spielman, E. Center for Early Relationship Support, JF&CS, Boston, MA. 02114. USA PKaufman@jfcsboston.org
Although the problems of maternal depression and isolation are seen in the literature as risk factors for individual and relationship disorders, few programs exist that target these issues in a comprehensive and relationship-based way. This session will describe the development of the Center for Early Relationship Support at Jewish Family and Children’s Service in Boston, MA as it has evolved to meet the needs of depressed and isolated new mothers. These women are experiencing the darker side of motherhood: they may be feeling depressed or excessively fearful; they may be having difficulties feeling connected to their baby or unable to cope with the demands of motherhood. The Center includes a range of home visiting, group and consultative services: outreach and training to health and mental health care providers aims to facilitate early identification, assessment and referral of women in need; treatment is available either in the home or office for mothers alone, for mothers and babies together or for the parenting couple and baby; a unique group program located at several senior housing facilities brings together healthy senior women and new mothers for companionship and support.
#399
SCREENING AND TREATMENT OF PERINATAL DEPRESSION.
McComish, J.F., Weatherston, D., Liesman, C..L., Rowland, C., McCollough, M., Roumell, N. 258 Cohn, 5557 Cass Ave, Detroit, MI 48202 mccomishpj1@home.com
This project will promote integrated care for the estimated 580 Detroit Healthy Start Project (DHSP) area women who will experience perinatal depression each year by increasing screening and treatment, ensuring screening by primary care, and providing home-based intervention. Project aims will be met through a coalition of primary care, health department (DHD), community mental health and university staff. Women will be screened in clinics with the Edinburgh Depression Scale (EDPS). Those with low-level depression will be referred to DHD for short-term, cognitive behavioral intervention based on Seeley, Murray, and Cooper’s model. Those with moderate to high depression will be referred to IMH for longer-term intervention. Pre and posttest design will be used to assess maternal depression and infant withdrawal using EPDS and Alarm Distress Baby Scale (ADBB) at intake and 3 months after treatment. In IMH, infant development (Ages and Stages) and maternal well-being (Ryff Psychological Well-Being Scale) will also be assessed. Comparisons of outcomes achieved with the two types of intervention will be made. Preliminary data will be presented.
#400
DEPRESSION TENDENCY DURING PREGNANCY AND THE POSTPARTUM.
Kaneko, H., Sechiyama, H., Sasaki, Y., Arai, S., Ishiahara, M., Hatagaki, C., Nishiwaki, K., Takeuchi, Y., Inagaki, E., Usui, M., Miwa, K., Honjo, S., Ujiie, T., Murase, S., Inoko, K., Itakura, A. Graduate School of Education, Nagoya University, Japan kaneko97@psy.educa.nagoya-u.ac.jp
This study was conducted to assess depressive tendencies in the mother during pregnancy and after their childbirth. The subjects answered questionnaires two times during pregnancy and after their childbirth. The number of the subjects were 228 at the first time, including 135 and 106 subjects who answered questionnaires at the second and the third time. The questionnaires were composed of a self-rating depression scale (Zung-SDS), and a scale of anxieties towards future child rearing, menstrual conditions before pregnancy. and Postpartum Maternal Attachment Scale. Anxieties towards future child rearing and menstrual condition were correlated to depression score both during pregnancy and after childbirth. Postpartum Maternal Attachment was correlated to depressive score only after childbirth. Results suggest that psychological variables correlated to depression during pregnancy was different form the postpartum.
#401
SOCIAL SUPPORT AND MOTHERHOOD EXPERIENCE: SOME RESULTS FROM QUANTITATIVE DATA, (CAME) AND QUALITATIVE DATAS (FOCUS GROUP).
Guedeney, N., Dallay-Glatigny, E., Glangeaud-Freudenthal, N., Jacquemain, F., Garcia, S.& Duthil, P. CMP-IMM. 45 Rue de la Harpe. 75005 Paris. France. nicole.guedeney@imm.fr
Part of the transcultural study of postnatal depression within European health Systems, study, (RC Kumar (London), each center designed a pilot study for the harmonization of research methods to contribute in a better understanding of a bio psycho social model of postnatal depression. We present here the preliminary results of the longitudinal study ( 3rd trimester of pregnancy, 1 month postnatal and 6 months postnatal) conducted on the French sample (45 women recruited in Paris and Bordeaux) about the description of pre and postnatal support (qualitative and quantitative, female support, partner support, concrete support) and some dimensions of motherhood experience (pre and postnatal feeling of maternal competency and mother’s role conflict, parental alliance with partner,). These dimensions were assessed by a semi structured interview, the Contextual Assessement of Motherhood Experience, (CAME, Bernazzani et al, 1995). They will be compared with qualitative datas from focus groups.
#402
A STUDY ON MATERNAL DEPRESSION AND EMOTIONAL AVAILABILITY.
Morioka, Y., Sato, A., Oiji, A., Inoe, K., Murata, A., Watanabe, K. Faculty of Nursing, Yamagata University, Iida-nishi 2-2-2, Yamagata City, 990-9585, Japan, momo@med.id.yamagata-u.ac.jp
The objective of this study was to examine the effect of maternal depression on maternal emotional availability and mother-infant interaction. The subjects were 63 mothers and their infants. They gave written informed consent to participation in this study. The mothers were requested to respond to questionnaires including SDS in the third trimester of pregnancy, one to five days, one month, and four months after the birth of their children. Mother-infant interaction was observed and videotaped four months after the birth. Observers evaluated mother-infant interaction without any information about the subjects. The findings on the questionnaires suggested that depressive mothers felt they had not been cared sufficiently from their own mothers and they could not get support from their husband in their child rearing. The result of observation of mother-infant interaction suggested that depressive mothers showed less emotional availability than non-depressive mothers and that infants of them showed less positive mood and less smooth communication with them than infants of non-depressive mothers.
#403
POSTNATAL DEPRESSION AND ADOLESCENT MOTHERHOOD.
Ménard, I., Cossette, L., Neault, I., Saucier, J.-F., Chamberland, J., Dardachti, V., Paquette, D., & Goulet, C. Department of Psychology, Université du Québec à Montréal, Montréal. H3C 3P8, Canada cossette.louise@uqam.ca.
The aim of the present study was to evaluate postnatal depression in adolescent mothers and its potential impact on infant socioemotional development. Fifty adolescent mothers and their infant, and a control group of 50 adult mothers and their infant participated in the study. The validated French version of the Edinburgh Postnatal Depression Scale, a 10 items standardized questionnaire, was used to measure postpartum depression at 4 months and 10 months. Mothers were also observed while interacting with their infant. Infant behavior was observed in various situations. Preliminary analysis showed that adolescent mothers presented a low level of depressive symptoms at 4 months postpartum. No differences were found between the two groups of mothers in the amount of smiling addressed to their infant during face-to-face interaction. However, infants of adolescent mothers smiled significantly more while interacting with their mother than infants of adult mothers. Differences were also found during face-to-face interaction with a female stranger.
#404
WITHDRAWAL BEHAVIOUR IN INFANTS OF ADOLESCENT AND ADULT MOTHERS, AND IN POSTNATAL DEPRESSED AND NON DEPRESSED MOTHERS.
Figueiredo, B., Departamento de Psicologia, Universidade do Minho, Campus de Gualtar, 4700 Braga. Portugal. bbfi@iep.uminho.ptGuedeney, A, Hôpital Bichat-Claude Bernard, policlinique Ney, 124 blvd Ney, 75018 Paris. France.
Withdrawal behavior is an important alarm signal to draw attention to both organic and relationship disorders in infancy. The Alarm Distress BaBy scale (ADBB, Guedeney, 2001) was used in a sample of 200 Portuguese infants, aged between 3 and 12 months old. The poster present a large range of factors related with the withdrawal behavior observed in the infants of the sample, principally mother’s low age and postnatal depression, and the protective effect of others factors, as the presence of an extended family and the participation in a preventive program for mothers and babies. The results show us that the scale permit to quickly identify babies, who have developmental problems and need the attention of the clinician, and can also be used in the assessment of the benefits, obtains by the participation in an intervention program.
#406
FATHER INVOLVEMENT IN EARLY HEAD START PROGRAMS: METHODOLOGICAL CHALLENGES AND LESSONS FROM MATURE PROGRAMS.
Raikes, H. Gallup Organization, 3000 South 68th Street Pl., Lincoln, NE 68510, vanKammen, W., Boller, K. and Love, J.,Mathematica Policy Research, Princeton, NJ, 08543.
Programmatic challenges and successes in involving fathers were identified in a survey of 261Early Head Start programs, and programs were classified as early stage; mid stage and mature in their father involvement efforts. Mature father involvement programs provide strategies for drawing the father in and for sustaining and building upon his interest. Mature programs have unique approaches to recruiting fathers using a wider array of involvement approaches including recruiting from the community as well as through program mothers, and mature programs sustain involvement by offering a wider array of program options for fathers than is true for programs in general. These lessons learned by mature programs in the involvement and sustaining areas will be presented. Findings pertaining to differences in the father populations across programs as a function of race and culture and implications for engaging fathers will also be discussed. Mature programs teach us that they go through self-examination, providing training for all levels of staff until the program sees itself as serving both fathers and mothers. Implications for methodological approaches to conducting research on father involvement within early childhood programs will be discussed.
#407
OBSERVATIONAL DATA ON FATHER PLAY WITH INFANTS: CHALLENGING TO GET BUT VALUABLE TO HAVE.
Roggman, L. A., Boyce, L. K., Cook, G. A., & Hart, A. G. Department of Family and Human Development, EHS-R, 2905, Old Main Hill, Utah State University, Logan, UT 84322-2905 USA.
Although fathers may not provide as much caregiving for infants as mothers do, they spend more time playing than caregiving and play with infants in different ways than mothers do. Variations in fathers' play with infants may have implications for infant development that are as important as the implications of variations in mothers' care giving. Nevertheless, if certain types of play foster certain types of development, it may not matter whether that type of play occurs with fathers or with mothers. For these reasons, in our Early Head Start (EHS) research study, we wanted to observe children playing with fathers in a comparable situation (location and toys) to our observations of them playing with mothers. In our observations of fathers' interactions with infants, fathers were more likely than mothers to do the unexpected, to be more physical, to do less talking and less teaching, to repeat what the child likes, and also to vary more widely in their responsiveness to the child and use of toys in play. An examination of play scores in relation to standardized cognitive test scores from the Bayley MDI, indicated that only peak level of play with fathers was correlated with 24 month cognitive scores, at .32 (p. 01), suggesting a unique role of father child play in supporting long-term pathways to future cognitive competence.
#408
RESIDENTIAL STATUS OF BIOLOGICAL AND SOCIAL FATHERS: IMPACT ON FATHER-TODDLER INTERACTION.
McKelvey, L. M., Schiffman, R. F., Fitzgerald, H. E., Cunningham DeLuca, M., and Hawver, M. Michigan State University.
Researchers studying the father’s impact on child development must determine who functionally serves the fatherhood role for a particular child. This determination often is dictated by the child’s mother who may control access to fathers, particularly access to the child’s putative biological father. The purpose of the current study was to address some of the methodological issues surrounding the collection of data from biological and social fathers and to determine whether there are differences in the ways in which fathers and toddlers interact. Using NCATS data collected from both biological and social fathers we found that biological fathers were more responsive to toddler distress at 24 months but not at 36 months at which point the social fathers were more responsive. Unlike biological fathers, social fathers changed their behavior over time. The results appear to indicate that toddlers get better at interacting with their biological fathers over time, and social fathers get better at interacting with toddlers over time. The fathers’ residency status appeared to affect his interactions with his toddler as well, with non-residential biological fathers behaviors remaining relatively stable over time, while residential fathers, whether social or biological were apt to demonstrate changes.
#409
METHODOLOGICAL ISSUES IN QUALITATIVE RESEARCH WITH LOW-INCOME FATHERS: SWITCHING TO THE PATERNAL LENS.
Summers, J. A., & McLaughlin, G. B. University of Kansas, Juniper Gardens Children’s Project. 650 Minnesota, 2nd floor, Kansas City, KS 66101.
The qualitative study of Early Head Start (EHS) fathers was intended to find out more about fathers' perceptions of their role, the impacts of fatherhood on them, their experiences with their own fathers, perceived barriers and supports for their father role, and their about views support needs in general and EHS involvement in particular. The presenter will give examples of questions, which on the basis of the responses we received, were interpreted as having very different meanings than the question intended. Some of the questions we used, which were phrased in ways long proven to elicit extensive conversations from women, were threatening to fathers. Second, even when we were successful in building sufficient trust to allow fathers to be open with us, we were faced with the question of how to understand and analyze the meaning of their answers. We will explore some of the puzzles represented by recurrent phrases and iconic images the fathers used in their answers, and the apparent way that certain roles and activities are viewed that appear to be very different from the way mothers view those activities.
#410
CHANGE IN PARENT-CHILD INTERACTION IN LOW-INCOME FAMILIES: LINKS TO FATHER STATUS.
Van Egeren, L. A., McKelvey, L., Fitzgerald, H. E., & Schiffman, R. F. Institute for Children, Youth, and Families, Michigan State University, East Lansing, MI. 48824. USA. vanegere@msu.edu.
Change in mothers’ and fathers’ individual contingent responsiveness (NCAST) with their children was observed in 71 couples enrolled in the national evaluation of Early Head Start. Parent-child dyads were rated at enrollment and when children were 24 and 36 months. Growth trajectories indicated that both parents became more sensitive to cues and nurturing of cognitive growth. Whereas mothers increased in social-emotional growth fostering, fathers decreased. Children increased in clarity of cues and responsiveness, particularly toward mothers. For the most part, parents differed in responsiveness at enrollment, but became more similar by 36 months. Paternal status (biological and/or residential) was associated with in complex ways with paternal sensitivity and cognitive growth fostering, maternal social-emotional growth fostering, and children’s responsiveness to the mother.
#411
INTERGENERATIONAL CHILDHOOD EXPERIENCES AMONG LOW-INCOME FATHERS: A QUALITATIVE STUDY.
Lower, R. J., Rodriguez, V. M., Fitzgerald, H. E., & Shiffman, R. F. Department of Family and Child Ecology, Michigan State University, East Lansing, MI 48824. USA. lowerric@msu.edu.
This qualitative study explored childhood experiences among Early Head Start Fathers (n=49; 25= EHS program group/24=comparison group), using a semi-structured open-ended format. The data were analyzed to identify common themes across interviews. Participants identified the following six experiences surrounding the nature of their father-son relationship: special outings, limited experiences, sports, play and recreation, teaching values, spending time in general, alcoholic/violent experiences. These results can guide community program leaders and researchers in learning about the influence of intergenerational relationships on low-income fathers.
#412
AN EXAMINATION OF THE IMPACTS OF FATHER ANTISOCIALITY ON FAMILY OUTCOMES.
Montanez, M., McKelvey, L.M., Lower, R.J., Fitzgerald, H.E., & Schiffman, R.F. Department of Psychology, Michigan State University, East Lansing, MI. 48824. USA. montane1@msu.edu.
The objective of this study was to examine the impact of paternal antisociality on family outcomes. Information from eighty-one low-income families who were enrolled in a national longitudinal study evaluating Early Head Start programs was examined. Results showed that there were significant differences between scores in families with high vs low paternal antisociality. For example mothers in high antisocial group reported more severe discipline, higher conflict, and lower emotional responsiveness. Fathers were less responsive to child distress and had lower NCAST scores. There was a demonstrated trend towards a difference in child sociability at 14 months of age, however there were no differences in aggression or externalizing behaviors of children. These results indicate that paternal antisocial behavior is disruptive to normal family functioning. Furthermore it confirms the idea that paternal antisociality affects children indirectly through mothers.
#413
FATHERS’ EXPERIENCE OF FATHERHOOD AND FATHER-CHILD RELATIONSHIP.
Tuunanen, M. 1), Kemppinen, K. 1,2), Kumpulainen, K. 1), Räsänen, E. 1) Dept. of Child Psychiatry, University of Kuopio, P.O. Box 1777, 70211 Kuopio, Finland. 2) Kuopio University Hospital, Finland. mtuunane@hytti.uku.fi
Mothers still take the main responsibility on the infant although parents together share both homework and childcare in Finnish families. Over 60 % of fathers in Finland take part in delivery and childcare in the very first weeks e.g. by taking a paternity leave. Research on father-infant relationship has been increasing since 1970’s and the importance of this relationship has been further emphasized. This report is part of a two-year follow-up study, which deals with the parent-infant relationship and preventive work for mental health in well-baby clinics. We will focus on fathers’ mood, how do they see their new role and define their relationship to the infant. The GHQ-12 questionnaire was filled by 95 fathers before the birth of the child and by 72 fathers when the child had reached 2 years’ age. They were also asked to describe their impression of the child and themselves as a father. In this report we will discuss how father’s age, length of education, participation in childcare and results in GHQ-12 questionnaire correlate father’s experience of fatherhood and interaction with the child.
#414
FATHERS' REPRESENTATIONS AND INTERACTIONS WITH CHILDREN.
Candelori C., Facoltà di Psicologia I, Università "La Sapienza", Roma, Italia. Carla.Candelori@uniroma1.it
The purpose of this study was to investigate the contents of father mental representations before and after the birth of the child and to analyze the quality of interactions with his two year old child. The -not clinical- sample consisted of a group of 20 middle class fathers, ranging in age from 27 to 39. The procedure involved: 1) during the periodofpregnancy: a semi structured interview (IRPAG), to study internal representations of father's role; 2) two years after the birth of the child: a) The Adult Attachment Interview (AAI), to study the "state of mind" with respect to Attachment; b) The Parenting Experience Interview (IEG), to explore the experience of fathering; c) three play- situations, videotaped at home, using a specific play-set. We found a significant correlation between the level of fathers' representations and the quality of father-child interactions, characterized, in many cases, by a good level of sensitivity and communication. Furthermore, the fact that, in the main project, mothers were involved as well, allowed to compare fathers' and mothers' data and stimulated interesting reflections about the differences between the quality of representations and the relational modalities with children.
#416
EARLY CHILDHOOD NEGLECT AND OVEREATING: WHAT CAN WE LEARN ABOUT CHILDHOOD OBESITY?
Riolo, SA; Albright, K; Motavalli, NM sriolo@umich.edu
AIM: Explore impact of early relationships on development of affect and appetite regulation, childhood obesity, mood disturbance. GOALS: 1.) Case example of young children who overeat or binge eat; 2.) Discuss prognosis childhood overeating/binge eating/obesity; 3.) Discuss relationships of obese/binging children; 4.) Discuss nosology of childhood obesity. Evidence points to the importance of environment in causation and treatment of obesity. Obesity is the number one public health problem of U.S. children, yet it is ignored in psychiatry, both in research and clinically. Children present for overeating, overweight, bizarre eating (nighttime eating, binge eating, and/or hoarding of food.) These children have chaotic, neglectful, or abusive homes. Childhood is the critical period for development of obesity. Childhood obesity is correlated with adult obesity. Primary prevention of obesity in childhood is necessary to 'treat' obesity. Prevention can occur only with complete understanding of nosology and etiology. Overeating /binge eating are not included as options in the DSM IV Feeding Disorder of Infancy or Early Childhood (FDIEC) diagnosis. Looking at FDIEC as a spectrum of under- to over-eating may increase understanding of the impact of attachment on development of appetite and affect regulation. Obesity is classified only as a physical (Axis III) disorder and rarely viewed as an eating disorder, despite characteristics similar to those seen in eating disorders.
#417
Abstract not available
#418
FAILURE TO THRIVE IS LINKED TO FEEDING DISORDERS: A SURVEY.
Ramsay, M. , Janveau-Brennan, G., Forbes, P., Auger L., Sigman, T. The Montreal Children’s Hospital, Montreal H3H 1P3, Canada maria.ramsay@mcgill.ca
The relationship between failure to thrive (FTT), as a symptom, and feeding disorders (FD), as a cause, is slowly being recognized. Early surveys did not include FD as a possible cause for FTT and DSM-IV defines FD as a relationship disorder. The objective of this survey was to establish the diagnostic yield of investigation for FTT with FD as a physiological disorder in a tertiary care hospital during a one-year period. Of the 88 infants evaluated for FTT, 40 % had FD, 4 % had FD and social problems, and 1% had behavioral problems. Several pediatricians diagnosed inadequate intake (14%) as a cause for FTT, which we suspect, reflected FD and /or behavioral issues. Further 24 % were diagnosed with medical causes, 7% with constitutional short stature and 10 % with no FTT. Our results indicate that (1) etiological classification for FTT needs to be redefined, (2) FD, as a physiological disorder, should be included in the differential diagnosis and (3) FD should be diagnosed independently from relationship disorder. These results suggest that in the absence of medical disorders, FTT should no longer be considered solely as a symptom of relationship disorder.
#419
FEEDING DISORDER IN THE EARLY CHILDHOOD: “THE PEAK OF THE ICEBERG.”
Ladopoulou, K. Psycho- Medico pedagogical Center of Northern Greece, Evzonon 17, 54640-Thessaloniki, GREECE
This paper presents the case of a 3,5 year old boy, who manifested severe feeding difficulties, dated from the weaning period. The mother-child relationship was severely disturbed, the father was not able to function as a “third” and there were repetitive disruptions in the boy’s relationships with alternating nurses, exclusively responsible for his feeding.
The parents or the pediatrician did not report other symptoms, but the difficulties relating to the communication and relatedness, the symbolic capacity and the imaginative activities were evident. The aggressive impulsions were prominent and overwhelmed his inner world.
The difficulties at the diagnostic procedure and the planning of an individualized therapeutic program are discussed. The therapeutic interventions implemented and the favorable evolution, are described.
#420
PREVENTIVE INTERVENTION FOR INFANTS OF MOTHERS WITH EATING DISORDERS.
Moskowicz, M. Munck, H. & Høyer, M. Infantpsychiatric Unit, Child & Adolescent Psychiatric Department, Bispebjerg Hospital, DK-2400 Copenhagen NV, Denmark, nbn01@bbh.hosp.dk
The objective of this presentation is partly to describe data concerning mothers with eating disorders and their children, partly to describe some principles for preventive intervention for this population. Children with mothers who suffer from eating disorders have an increased risk of developmental problems. Maternal eating disorders have an impact on mother-child relationship, the child’s eating and behavior during meals and mental and physical health. The number of mothers with eating disorders has increased steadily since the Infant psychiatric Unit was established in 1992. Data will be presented concerning mothers’ diagnosis and the child’s developmental problems as well as principles of early preventive intervention and mother-infant relationship treatment.
#421
ANTECEDENTS AND INCIDENCE OF FAILURE TO THRIVE IN 0-1 YEAR OLD CHILDREN - A POPULATION-BASED COHORT-STUDY.
Olsen, E.M., Jørgensen, T., Weile, B., Skovgaard, A.M. Department of Child Psychiatry, University Hospital of Copenhagen, Glostrup, Denmark. else.marie.olsen@dadlnet.dk
Failure to thrive, FTT, in infancy, defined as inadequate growth for age, is associated with developmental, behavioural and emotional problems in later childhood. Whether these problems precede the onset of FTT or are consequences of it is still unanswered. This study investigates the incidence and predictors of FTT in a general population of infants. The study-population constitutes children born in the year 2000 in the county of Copenhagen, 5560 children. Demographic data are drawn from the national CPR-register while hospital diagnoses are obtained from patient- and death-registers. Detailed and prospectively collected data are obtained from standardized records of the public health nurses. In Denmark families with infants are offered routine visits in their home by a public health nurse and 98% of all infants receive at least 3-4 visits during their first year of life; at the ages 0-1, 2-3, 4-6, 8-10 months. The public health nurses are specially educated in assessing the health of young children and systematically record information about perinatal conditions, physical and mental health and development of the child, nutrition, parent-child-relationship and varies psychosocial risk factors and demographic data.
Longitudinal growth-curves are generated and compared with Danish and international reference-curves. Three commonly used definitions of FTT are compared with regard to incidence of FTT and populations identified. Associations between FTT and preceding factors are analyzed, especially with regard to feeding problems, difficulties in parent-child-relationship, delayed motor development and signs of psychopathology in the infant. Here wee present the preliminary results.
#422
STANDARDIZED TUBE WAENING IN INFANCY.
This workshop addresses issues concerned with the frequent but neglected topic of tube weaning in infancy (Benoit & Coolbear, 1998, Meyer et al. 1995). The infants and their families affected with the problem of long-term tube feeding are mostly severely ill children, possibly with severe developmental delays, after various treatments during the neonatal period. The diagnostic classification of the presented feeding behavior disorders covers posttraumatic feeding disorder, neuro-sensory feeding disorder and various types of attachment disorders concerned with impaired feeding. Tube feeding had been administered during the intensive care period. After recovery, tube weaning did not succeed for a variety of reasons in regular pediatric hospitals and concurrently the infants display developmental delays occurring far beyond the causes of the underlying illnesses. Tube weaning therefore becomes a crucial task for further development, especially in feeding and language abilities. Our protocol enables tube weaning of severely ill children, thus preventing secondary developmental and interactive disturbances. Weaning off the tube must analyze and differentiate three phases within the feeding process: 1. food offer, which is the task of the feeding surrounding 2.feeding, which is a highly sensitive interactive task 3. autonomous swallowing, which is entirely controlled by the infant itself. We present the successful weaning from long term tube feeding in 62 infants. The diagnostic assessment includes pediatric, developmental, psychological and interaction issues. The therapeutic approach is introduced on an inpatient basis offering 5-6 interdisciplinary therapy sessions per day. We present a semi-standardized therapeutic approach and highlight the importance of psychodynamic team development in the specialized treatment of infantile feeding disorders.
#424
THE SOLIHULL APPROACH: A PSYCHOTHERAPEUTIC AND BEHAVIOURAL APPROACH FOR WORKING WITH CHILDREN WITH SLEEPING, FEEDING, TOILETING AND BEHAVIOURAL DIFFICULTIES.
Douglas, H. and Rheeston, M. Craig Croft Clinic, Craig Croft, Chelmsley Wood, Birmingham, B37 7TR, UK. hazel.douglas@solihull-pct.nhs.uk This workshop will use case examples to illustrate the theoretical model, which is based on three major theories; containment from psychoanalytic theory, reciprocity from child development research and behavior management from behaviorism. It will also demonstrate how the resource pack can be used, which contains explanatory notes and materials for professionals and accompanying photocopiable leaflets for parents. The Solihull Approach was designed to be used within a five-session timeframe, but preliminary results suggest that it produces change within two to three sessions. Results indicated that there was a significant decrease in symptom severity and a 62% decrease in parental anxiety. Another study showed that the practice of professionals changed after the initial training and their job satisfaction increased.
#433
INTERNET-BASED INTERACTIVE INFANT MENTAL TRAINING MODULE.
Rains, M. Vienna, ME 04360-0145, USA rains@ctel.net
This poster describes an interactive, internet-based infant mental health training resource. Brief video segments are followed by open-end questions about what the learner perceives or would do and then by closed-end, multiple choices for the learner to indicate which choice is closest to their open-end response. Their choice branches to feedback about expertise in their response and to options for further resources about the topic that are linked to the expertise level of their response. Active server page processing provides input to a database, including expertise from the open-end questions and learner progress through the multiple-choice responses. The module serves as an individualized introduction to infant competencies and psychosocial motivation, parent competencies and goals, infant-parent interaction, and family-helper interaction. Utilization of the module and integration within more formal training will be summarized.
#434
START EARLY: LEARNING BEGINS AT BIRTH.
Vitale, J., Voices for Illinois Children, 208 S. LaSalle St., Suite 1490, Chicago, IL 60604. USA jvitale@voices4kids.org
Start Early: Learning Begins at Birth is a public awareness and public education campaign with three audiences, policy makers, community leaders and young moms. The education component is specifically targeted to the young (14 to 24 year old), single mom with limited resources and limited education who is unaware of the crucial importance of their impact on baby’s brain development. All early learning takes place in the relationship between the parent and child and scientists now say that 90% of brain development occurs before the age of three. The message, moms need to read, play, touch, and talk to their babies to help brain development is delivered through a video and magazine, developed and marketed with their interests. Evaluation results show that not only is awareness achieved, but also about 85% of these moms signal a behavior change in response to their babies. 90,000 videos and magazines have been given to moms by professionals, home visitors, teachers, child- care providers and pediatricians, with whom they have a “trusted” relationship. Presented will be the strategies used in development, delivery and evaluation of the campaign.
#435
EARLY FORMS OF RELATEDNESS IN AUTISM: A LONGITUDINAL CLINICAL AND QUANTITATIVE SINGLE CASE STUDY.
Alvarez,A & Lee,Anthony, Child & Family Department, Tavistock Clinic, London NW3 5BA, U.K.
The aim of this single case study was twofold: to identify and measure early forms of relatedness in a young child with autism and to examine changes in these forms over a period of three years. The child was videotaped in a standard therapeutic setting with a clinician. Observations made by the clinician, in the form of thrice-weekly processed notes, were accompanied by quantitative data drawn from videotaped recordings, clips of which will be presented. Both the clinical and quantitative studies found an increase in dyadic forms of relating, i.e. in visual and emotional engagement with the clinician. The authors discuss the need to distinguish between deviant and delayed functioning in the healthy related part of the child, and the importance for the mutability of the condition.
#437
THE RISE AND FALL OF COLLECTIVE SLEEP IN ISRAELI KIBBUTZIM: AN EXPERIMENT IN NATURE AND IMPLICATIONS FOR INFANT MENTAL HEALTH.
Sagi, A. Aviezer, O., & Oppenheim, D., Center for the Study of Child Development, University of Haifa, Haifa, 31905, Israel. sagi@psy.haifa.ac.il.
The focus of this symposium is on a unique “experiment in nature” that had taken place for approximately 60-70 years in Israeli kibbutzim. The most distinctive characteristic of kibbutz childcare was the practice of children’s sleeping together in children’s houses away from their parents during the night. We will present findings, which emerged from our research program that goes back to the 1970s and which is still underway. We will focus on infant attachment data, adult attachment data and intergenerational transmission of attachment and also on the long-term effects of the most unique two characteristics of infant care in kibbutzim: Early relations with multiple caregivers and communal sleeping. We will argue that unusual child rearing practices such as communal sleeping for infants created an artificial environment that was predestined to fail because it let down both essential attachment needs of infants and basic parental care giving needs. Implications for more general developmental-cross cultural issues as well as various issues of infant mental health will be discussed.
#438
SLEEPING AWAY FROM THE PARENTS AT NIGHT RISKS ATTACHMENT SECURITY.
Sagi, A., Aviezer, O., & Oppenheim, D., Center for the Study of Child Development, University of Haifa, Haifa, 31905, Israel. sagi@psy.haifa.ac.il.
When communal sleeping was still in effect in Israeli kibbutzim, infants spent all day at the infants’ house under the care of professional caregivers, much like in other daycare arrangements, while family time was exercised in the late afternoon and early evening when both parents tried to be fully available. At bedtime, parents brought their infants back to the infants’ house and put them to bed. Parents were replaced for the night by two unfamiliar watchwomen who supervised the sleep of all kibbutz children and whose assignment was based on weekly rotations that included all kibbutz women. In a series of studies we examined a number of attachment related issues and we found among communally sleeping infants deviations from universal attachment security norms as well as absence of intergenerational transmission of attachment. Moreover, only in family sleeping, but not in communal sleeping, higher maternal sensitivity was associated with infant attachment security. These findings highlight the risks that are associated with major separations of infants from their attachment figures during the night.
#439
LONGITUDINAL CORRELATES OF MULTIPLE CAREGIVING AND COMMUNAL SLEEPING.
Aviezer, O., Oppenheim, D., & Sagi, A. Oranim Teachers College, Tivon, Israel aviezer@research.haifa.ac.il.
This presentation focuses on findings pertinent to the long-term effects of the most unique two characteristics of infant care in collective education, namely early relations with multiple caregivers (i.e., mother, father, and professional caregiver) and communal sleeping of infants and children away from their parents. The longitudinal assessments in our project evaluated a broad spectrum of socioemotional competencies in kindergarten (age 5), grade school (age 11) and high school (age 17) and examined their associations to early attachment relationships with parents and professional caregiver. The results revealed that various aspects of later development were associated to quality of early relationships. In addition, we examined the hypothesis that shorter exposure to communal sleep will be associated with improved adjustment in later years. The results at age 11 showed that teachers rated schoolwork management of communally sleeping young adolescents as lower compared to home sleeping young adolescents. These associations suggest that in the two sleeping arrangement ecologies children experienced their relations with parents differently.
#440
THE EVOLUTION OF COLLECTIVE EDUCATION ON THE ISRAELI KIBBUTZ: IMPLICATIONS FOR INFANT MENTAL HEALTH.
Oppenheim, D., Aviezer, O., & Sagi, A. Center for the Study of Child Development, University of Haifa, Haifa, Israel. oppenhei@psy.haifa.ac.il
The Israeli kibbutz and its unique child-rearing system called “collective education” will be described along with findings from attachment studies. The most distinctive characteristic of this system involved the practice of communal sleeping, in which infants slept away from their parents in separate living quarters, making sensitive response to their needs at night impossible. Communal sleeping has been found to lead to higher rates of insecure infant-mother attachment and disruption of the intergenerational transmission of attachment. In an interesting historical transition, communal sleeping, which has been a corner stone of kibbutz upbringing, has been replaced with familial sleeping under the pressure of kibbutz parents demanding to be close to their infants at night. Several infant mental health issues are raised by the story of kibbutz child rearing, including understanding the factors that protected some infants from insecurity, communal sleeping as a cultural “blind spot”, and what happens when experts and child-rearing ideologies attempt to override parental functions.
#442
Abstract not available
#443
THERE IS MORE THAN ONE FEEDING DISORDER: THEORETICAL ISSUES OF DIAGNOSIS AND CLASSIFICATION.
Chatoor I. Children's National Medical Center 111 Michigan Avenue, N.W. Washington, D.C. 20010 USA Ichatoor@cnmc.org.
Although the introduction of "Feeding Disorder of Infancy and Early Childhood" in the DSM-IV (APA, 1994) as a diagnostic category, was a first step towards a definition of feeding disorders, the definition is broad and does not differentiate the variety of feeding disorders which present during this young age group. In addition, the definition excludes feeding disorders that do not present with growth failure and feeding disorders that are associated with medical conditions. As a result of these limitations, many authors have continued to use different labels and classification schemes, and research has been hampered because of the lack of generally accepted diagnostic criteria. This presentation will review the literature on clinical and research reports of various feeding disorders, discuss a proposed classification and operational diagnostic criteria of six feeding disorders.
#444
EARLY FEEDING DIFFICULTIES IN INFANCY. EARLY IDENTIFICATION, SYMPTOM PATTERNS AND RELATIONAL FACTORS.
Maldonado-Durán M., Helmig L., Moody C., Millhuff C. Family Service and Guidance Center. 325 Frazier Avenue Topeka, Kansas 66604 mmaldonado@fsgctopeka.com.
Data are presented of a project of screening of “well-babies” for feeding difficulties and failure to thrive. Babies were screened in three settings, a pediatrician’s office, a public health setting and a breastfeeding clinic. Data of approximately 200 such babies are presented in terms of the prevalence of feeding symptoms, failure to thrive and the specific concerns of the parents. Of the babies whose parents endorse feeding disturbance, we evaluated clinically “in depth” approximately 30 infants. In these a feeding history was obtained, direct observation of feeding interactions was conducted and rated. The presence of other symptoms of behavioral/emotional dysfunction were explored, as well as the overall nature of the caregiver/infant relationship. The children were diagnosed according to the Zero to Three classification. Several patterns or “clusters of symptoms” emerge: a) very early feeding problems, related to difficulties in state regulation and hypotonicity. b) problems in maintaining focus, hypersensitivity to stimuli, high levels of activity and becoming disorganized during feedings. c) lack of progression in feeding ability and d) a mixed pattern of behavior problems during meals.
#445
EARLY DYSFUNCTIONAL MOTHER-INFANT FEEDING INTERACTIONS: CLINICAL ASSESSMENT AND RESEARCH IMPLICATIONS.
Ammaniti, M., Ambruzzi A. M., Cimino S., Lucarelli L. University of Rome, Via dei Marsi, 78 00185 Rome Italy ammaniti.massimo@uniroma1.it
The aim of this study was to examine the interactional patterns of mothers and their infants who showed food refusal and growth failure in the first three years of life and of a non-referred comparison population. Feeding Scale, a standardized observation instrument was used. Five subscale scores were derived based on the analysis of a 20-minute videotaped feeding session: Dyadic Reciprocity, Dyadic Conflict, Talk and Distraction, Struggle for Control, Maternal Non Contingency. Significant differences in patterns of mother-infant interaction among infants classified by clinical evaluation as “normal feeding infants” versus “feeding disordered infants” were noted. Results confirm that mismatches between infants’ behaviors and parents’ responses foster intense negative affect and conflict during feeding. A second step was to explore maternal characteristics and perceptions of their children’s temperament and behavior. Results detected associations between mothers’ perceptions of their children and feeding problems. Mothers reported that their children were more arrhythmic in feeding and sleeping patterns; in addition, the children were perceived to be more demanding of attention (dependent), upset by separation and more willful. Furthermore, dyadic conflict can arise when parents’ characteristics limit their capacities to respond sensitively and contingently. Depression, anxiety, disordered feeding attitudes, insecure attachment representations in mothers were factors associated with early feeding disorders. Our results point out, through a multidisciplinary clinical assessment, that to understand the determinants of conflictual mother/infant interaction during feeding, valuation of factors linked to caregiver’s responsiveness to their children is needed. Such explorations will be discussed with regard to clinical and research implications.
#447
NEW EVIDENCE FOR COHERENCE IN FAMILY DYNAMICS FROM ZERO TO THREE.
Fivaz, E. & McHale, J., co-organizers, Stern, D., discussant, CEF, Site de Cery, CH-1008 Prilly, efivaz@iprolink.ch.
The study of developmental family dynamics has progressed beyond the point of examining relationships among dyadic subsystems, with researchers studying the family system level. Thanks to this new approach, we are now in a position to trace different developmental trajectories of the family unit, and confirm whether coparenting and family alliances are indeed unique social forces that shape a child’s adjustment in ways different from those of any family subsystem. Researchers are beginning to ask : how much coherence truly exists in family-level variables over time ? Authors in this symposium address this question by drawing on data from longitudinal studies initiated during pregnancy or soon after birth, and tracing the subsequent course of coparenting and family alliances through toddlerhood. McHale et al. show that parents’ prenatal expectations about their partners’ anticipated parenting and coparenting beliefs and conduct foreshadow subsequent family group dynamics. Von Wyl et al. document substantial differences among pregnant parents’ «triadic capacity» and subsequent trilogue play interactions. Favez et al. document two distinctive family trajectories, «upward» and «downward», extending from pregnancy through 9 months post-partum; they are discriminated by marital satisfaction and time together as a couple before baby’s birth. Finally, Schoppe et al. document differences in education and child’s temperament among families showing high-stable and low stable, supportive or undermining coparenting patterns. Collectively, the papers indicate that family group level trajectories show noteworthy coherence across time and may begin taking form even before the child arrives on the scene.
#448
THE NASCENT FAMILY ALLIANCE.
Favez, N., Frascarolo, F., Carneiro, C., Montfort, V., Corboz A., Fivaz, E. Psychology Dpt, Fribourg University, Faucigny 2, CH-1701 Fribourg, nicolas.favez@unifr.ch.
The family alliance - how families work as units to achieve various tasks - begins to operate fully at birth - but is prepared during pregnancy as spouses begin planning to function as coparental as well as marital parties. Whereas much is known about evolution of marital adjustment across transitions to parenthood, little is known about continuity and change of family-level alliances during this period. In this study, pre to postnatal patterns of evolution of 40 families are described. Alliances were measured in the Lausanne Trilogue Play situation at 3 and 9 months and in an analogue procedure during pregnancy. Two longitudinal patterns of alliances were detected by means of cluster analysis: «upward»trajectory started out prenatally slightly higher than average and improved; «downward»trajectory started out «average» and deteriorated across time. While within-group evolution was not significantly different, between-group differences were significant at 3 and 9 months. In general, there were no major between-group differences in the factors expected to potentially influence alliance trajectories, but for marital satisfaction and years of living together before pregnancy. These findings can be understood within the context of current family research, which both substantiates relations between marital and family functioning, but also show that coparenting patterns, their correlates and determinants are often distinct from marital ones.
#449
DO PRE-BIRTH EXPECTANCIES ABOUT COPARENTING FORESHADOW POST-BIRTH COPARENTING DYNAMICS?
McHale, J., Khazan, I., DeCourcey, W., Carleton, M. Psychology Department, Clark University jmchale@clarku.edu.
In this symposium paper, we ask whether first-time expectant parents’ perceptions of their partners in the emergent coparenting partnership can be prospectively linked to subsequent coparenting and family dynamics three months after the baby’s arrival. 50 couples expecting their first child described during the third trimester of the pregnancy (a) their own ideas about parenting; (b) what they believed their partners’ ideas to be; and (c) the degree of discrepancy between what they imagined the division of childcare labor would be, and how they actually wished it would be. From the «Ideas about Parenting» data, two sets of scores were formed: (a) «actual» difference scores, reflecting the objective, arithmetic difference between mothers’ and fathers’ reports of their own parenting ideologies; and (b) perceived difference scores, reflecting discrepancies between parents’ reports of their own ideas, and what they believed their partners’ ideas to be. At three months post-partum, partners characterized the actual division of labor pattern in their family, and engaged together with their infant in two triadic play sessions. The videotaped play sessions were rated along several dimensions including coparental cooperation and family warmth. Results indicated that maternal pre-birth coparenting expectations were more closely linked to the enacted family process at three months than were paternal perceptions, and that perceptions of difference were often as or more predictive of family process than were actual differences. We argue that anticipatory sets about the family developing before the baby’s arrival may come to shape the nature of the emerging family process.
#450
THE INFLUENCE OF PRENATAL TRIADIC CAPACITIES ON EARLY MOTHER-FATHER-INFANT INTERACTION PATTERNS.
von Wyl A., von Klitzing K., Perren S., Braune-Krickau K. Simoni H. & Bürgin D., University of Basel, Department of Child and Asolescent Psychiatry, Schaffhauserrheinweg 55, CH-4058 Basel. agnes.vonwyl@unibas.ch.
In this longitudinal study of 80 parents and their first-born children we replicate and extend previous findings on a smaller sample. We assess the parents’ triadic capacity during pregnancy (ability of parents from pregnancy onward to make room for the child, and integrate the child into fantasies involving the couple’s relationship) and examine its relation to the quality of interaction involving the two parents and the infant at four months post-partum. Results to date indicate that the triadic capacity evaluated prenatally correlates significantly with the quality of father-mother-infant interaction (Lausanne Trilogue Play at 4 months). Parents who already during pregnancy in their imaginary world exclude themselves or their partner from the relationship to the child, also show a lower quality of triadic play during observation of play sessions. This corroborates the relationship observed in an earlier study with a smaller sample. We anticipate further significant correlations between trilogue play at 4 and 18 month and between triadic capacity of the parents and children’s socioemotional development. Beyond the early mother-child relationship, our data suggest that the relationship of a third person – especially the father – to the child, and his role in the familial triad, should receive more attention.
#451
INFLUENCES ON STABILITY AND CHANGE IN COPARENTING BEHAVIOR FROM INFANCY TO THE PRESCHOOL YEARS.
Schoppe, S. J., Frosch, C. A., & Mangelsdorf, S. C. Department of Psychology, University of Illinois, 603 E. Daniel St Champaign, IL 61820, sschoppe@s.psych.uiuc.edu.
This study examines factors that may influence stability or change in coparenting behavior from infancy to the preschool years. 43 two-parent families were visited in their homes when the target child was 6 months and 3 years old. The quality of coparenting behavior was assessed at both time points, and data regarding possible influences on stability and change in coparenting were collected via parent reports at both time points. Preliminarily, we focus on two important influences: family demographic characteristics and child temperament. Analyses indicate that families experiencing high levels of supportive coparenting at both time points had more highly educated parents and more temperamentally easy children than families experiencing low levels of supportive coparenting at both time points. In contrast, families experiencing high levels of undermining coparenting at both time points were not as clearly distinguishable from those experiencing low levels of undermining coparenting at both time points. Thus, findings from this study indicate that factors such as family demographics and child temperament may influence the stability of coparenting from infancy to the preschool years, but that stability in supportive and undermining coparenting may be related to different variables. Further analyses will consider parental personality, marital satisfaction and behavior, and the quality of dyadic parent-child relationships as additional potential influences on stability as well as change in coparenting behavior across the first three years of life.
#453
CREATING AN INFANT MENTAL HEALTH CULTURE IN THE UK.
Organiser: Daws, D. Tavistock Clinic, 120 Belsize Lane, London, NW3 2RU. UK.
This double symposium will bring together some of the work that is currently underway in the UK, in order to show how an infant mental health culture is being created there. The presenters are from different regions in the UK. The symposium begins by describing research on services provided for vulnerable mothers and then moves to those provided for infants and young children, with both service and policy implications. The second part of the symposium outlines initiatives for developing professionals’ expertise and the services they offer. There will be two international discussants, Antoine Guedeney from France and Brigid Jordan from Australia.
#454
THE SOLIHULL APPROACH: CONTRIBUTING TO AN INFANT MENTAL HEALTH CULTURE WITH A THEORETICAL MODEL AND RESOURCE PACK FOR FRONTLINE WORKERS.
Douglas, H. Craig Croft Clinic, Craig Croft, Chelmsley Wood, Birmingham B37 7TR. UK. hazel.douglas@solihull-pct.nhs.uk.
In 1996 a group of practitioners in the UK reviewed the materials available to help those in the frontline who work with infants and their families. There were notable gaps. A theoretical model evolved, which combines psychotherapeutic theory, child development research and behaviorism. This eclecticism may be reflected internationally as infant mental health professionals work to develop effective theories and techniques for working with very young children. It is also a university accredited open learning course. Initially targeted at Health Visitors, the method is now being used by paediatricians, psychologists, nursery nurses, playgroup leaders, childminders and others. Two preliminary research studies will be described, one showing that practitioners’ practice changes after the initial training and the second showing a 62% decrease in parents’ anxiety on the Beck’s Inventory within two to four sessions, as well as a very significant decrease in symptom severity.
#455
BRIDGING THE DIVIDE: ADULT PSYCHOTHERAPY AND CHILD AND FAMILY PSYCHIATRY.
Pollett, S. Psychotherapy Family Unit, Thorn Road Clinic, Thorn Road, Runcorn, Cheshire. UK.
There is a widespread problem of adults in a mental health service being thought of only as individuals, with professionals disregarding the fact that they may also be parents whose children are affected by their parents’ state of mind.
An alliance will be described between an adult psychotherapy service and a child and adolescent mental health service, which also links with other adult mental health services. It outlines: the development of the unit into a significant training resource, the underlying philosophy and the key inter-relationships between teams and health visitors to enable the rapid access of families to assessment and treatment of the parent-child relationship. The implications of this way of working will be outlined.
#457
AN ATTEMPT TO DEVELOP AN INFANT MENTAL HEALTH CULTURE: ONE PRACTITIONER’S EXPERIENCE.
Barrows, P. Knowle Clinic, Broadfield Road, Bristol BS4 2UH. UK. knowle.clinic@btinternet.com.
This presentation will describe various local initiatives to develop an infant mental health culture. It will describe in detail the Postgraduate Diploma/MA in Infant Mental Health that has been developed and how this originated – the first such postgraduate course in the field in the UK. It will also describe the development of an Under-Fives counselling service, the ways in which support and teaching has been provided, particularly to the local network of Health Visitors and a number of other initiatives. It will be argued that it is this kind of gradual, long-term, bottom-up approach that is required to effect a major shift in culture. It is also important to be active at other levels of the system concurrently. The factors that militate against the development of services targeted at the 0-3 age group will be discussed. This includes institutional, cultural and political issues, and other factors that impede the recognition of the mental health needs of this population. The role of child mental health professionals in relation to these services will be considered. Finally there will be an attempt to summarize the extent to which this project has so far achieved its goals.
#459
PSYCHOANALYSIS AND PEDIATRICS IN A POOR COMMUNITY-TREATMENT AND PREVENTION OF PSYCHIC DISORDERS.
Lima, SG, Diniz,IP, Diniz,MGD, Nascimento,MG, Lyra,RS, Leite Soares,MVC Rua Manoel Cavalcante de Souza, 138 Cabo Branco 58045-090 Joao Pessoa PB Brazil matheus_guimaraes@bol.com.br.
During our medical course and specialization in Pediatrics, we are taught basically to treat the organic disease. In this fight against disease already set, we did not take into account the importance of emotions in the development of the child and in the genesis of certain diseases. After our acquaintance with psychoanalysis the way we cared for the children changed radically. Listening to the mother and watching the mother-baby pair resulted in a more harmonious doctor-mother-child relationship that provided a better understanding of the symptom. We started the joint work in the Pediatric Outpatient Clinic of the University Hospital of Federal University of Paraiba forming a study group on pediatrics and psychoanalysis. Then the pediatrician began referring patients to the psychoanalyst. Two years later, the work was expanded to a poor outskirts community, where a pediatrician worked as a volunteer in an NGO (religious organization – Pastoral da Criança). In this community a team was formed to welcome mothers and babies (the Welcoming Team), constituted of people from the own community and coordinated by the pediatrician and the psychoanalyst. Later we made prevention available before birth by organizing meetings with a group of pregnant women. Listening is paramount in the meetings, and health education is also offered.
#461
CAN THE THEME OF THE DOUBLE OFFER CLARIFICATION OF AUTISM AND LANGUAGE?
Correia, J.R.A., Amorim, M.S., Castro, D.B., Figueira, C.B.M., Lima, A.M.B., Oliveira, E.F., Queiroz, T.C.N. CEMPI - Rua Desemb. Martins Pereira, 204, Recife, PE 52050-220, Brazil. jrcorreia@nlink.com.br
This article originated from an interest in the theme of the double in the treatment of children with severe psychic disorders. How do children and autistic children begin to speak? What is the role of the "identical double", "different double" and "duplication" in the acquisition of both subjectivity and language? What are the meanings of mirroring inversion? What succeeds and what fails in echolalia? Is it possible to link lateral issues with literal approaches and to compare repetition in psychosis and mourning? It was found that autistic children beginning to speak do not use double syllables as other children do. The different "mirror image recognition levels" are proposed: a) Non-recognition of any mirror image; b) Recognition of another person's mirror image (imaginary image) but not one's own (symbolic image, Bergès), as in vampire fiction; c) Functional recognition, in which one's own face is only recognized like any other object; d) Full mirror image recognition. This leads to the distinction between "symbolic and imaginary alienation": normally complementary, they appear in children with severe psychic disorders. Also a stronger link between the preponderance of word and gaze in the child's cathexis and its unfolding becomes necessary.
#462
OUR YOUNGEST PARENTS, OUR GREATEST OPPORTUNITY FOR INFANT MENTAL HEALTH.
White, B., & Graham, M. Florida State University Center for Prevention and Early Intervention Policy, 1339 East Lafayette Street, Tallahassee, FL. 32301. USA bawhite@mailer.fsu.edu.
When compared to their non-parenting age peers, adolescents who give birth are far more likely 1) to have been born to a teen age mother; 2) to have grown up in a fatherless home; 3) to have been raised in poverty; 4) to have had unwanted sexual experiences; and 5) to have poor school attendance and low achievement. These events can impact the mother and child’s mental health. Research has documented that adolescent mothers engage in less smiling, less eye contact, less physical interaction, and less verbal interaction than adult mothers. However, equally compelling research indicates that intervention can mediate these risk factors. A multi-disciplinary framework will be presented that defines levels of infant mental health services to include responsive caregiving practices, early intervention services, and therapeutic support. Recommended practices and strategies for training and technical support will reflect the integration of relationship-focused care for young parents and their children.
#463
EXPERIENCES IN PROVIDING INFANT MENTAL HEALTH SERVICES. WHAT DID WE LEARN?
Weatherston, D. & Adams, S. Wayne State University, Detroit, Michigan, USA aa2233@wayne.edu.
The intent of this workshop is to discuss the development and implementation of infant mental health services and systems for training in two distinctly different regions of the USA. - Michigan and Florida. The presenters will describe the infants and families served in their programs, treatment strategies, and effective approaches used to identify and strengthen early relationship development and reduce the risks of emotional dysfunction or developmental delay. Each state offers unique models for the identification and treatment of young children under 3 years and their caregiving families. Services in Michigan have been established for over 25 years. They have traditionally been provided in the home with parent(s) and infant together. Services in Florida are newly designed. Three pilots serve children under 3 who are at risk for abuse and neglect or already in protective services or foster care. Results will be presented from both states, illustrating approaches to assessment and treatment that have been used with the population served, challenges and lessons learned. Training is integral to skillful service. Michigan has developed a four-tiered framework for the training and endorsement of infant mental health practitioners. Practitioners in Florida have developed a multi-level system in response to the immediate training needs in the state. Both presenters will discuss training as related to developing infant mental health services.
#464
RELATIONSHIPS ARE KEY IN PARENTING EDUCATION.
Perkins, J. M. HOW TO READ YOUR BABY, 280 Columbine St., Suite 311 Denver, CO. 80206. USA jperkins@howtoreadyourbaby.com
The Partners In Parenting Education (PIPE) Curriculum was originally created for adolescent parents and is now used in a wide range of settings including home visitation models, church parenting programs, social service settings and Early Head Start programs. The PIPE program focuses on relationship building skills between the primary caregiver and the baby. Child development research indicates that early relationships build the foundation for development and learning in a baby. The PIPE Curriculum is grounded in emotional development research done by Brazelton, Emde, Morgan, Sroufe and Tronick as well as other researchers from a wide range of disciplines. The instructional model used in PIPE is a four step sequential process of instruction. Emotional development concepts are presented in the first step. The second step is a demonstration of what the concept would look like in a parent-child interaction. The third step is a supervised parent-child interaction where the parent can practice new skills. The fourth step is an assessment where both parent and parent educator evaluate the interaction.
#465
PREMATURE CHILD: PARENTS AND SIBLINGS.
J. Despars, C. Muller-Nix, F.Ansermet. Pédopsychiatrie de Liaison, Hôpital Nestlé, CHUV, 1011 Lausanne. Switzerland. Joseedespars@hotmail.com.
Working in a department of liaison-child psychiatry we were interested in the reaction of the siblings to the premature child. The literature proves largely the traumatic effect of the event of prematurity but the writings are less abundant about how the siblings live the situation. In order to give a place to the elder, we have organized a 'siblings' group', which welcomes brothers and sisters of the premature child and of their parents around the first visit to the baby. We know that the hospitalized child causes some significant fear and worries to the parents. The elder child, according to his age, might have some difficulties to understand and to represent to himself what is happening around him. Facing the lack of availability of his parents, he might feel guilty, excluded and live some fear of abandonment. The parents and the elder child, can benefit from this 'siblings' group': the parents by using the relation with the elder to think through indirectly and more easily their relation with their premature child. The infant by using a specific space offered to him. We will have a clinical reflection on the experience of the 'siblings' group'.