8th World Congress
Amsterdam, The Netherlands
Short Abstracts - Day 5, Saturday#477
WHEN THE BEGINNING IS SHOCKING. A CLINICAL AND RESEARCH MULTIDISCIPLINARY APPROACH OF MOTHER AND INFANT ON A PSYCHIATRIC MOTHER AND BABY UNIT.
Vliegen, N., Geenen, G., & Docx, R. Centre of Child Psychotherapy. University of Leuven. Tiensestraat 102, 3000 Leuven. Belgium. nicole.vliegen@psy.kuleuven.ac.be
We present a multidisciplinary research-project on babies of mothers with a puerperal mental illness. We illustrate how we are developing an assessment approach for clinical and research purposes, concerning three aspects: the mothers, their children and the interaction between both. We consider mother’s history, her internal representations and her affective structure, using content analysis of the psychiatric consultations, the AAI and the IFEEL Pictures test (Emde, 1993). Secondly, we evaluate the child development by the KID-N. Finally, we observe the interaction between mother and child in two different situations. The objective of this threefold assessment is to find out how these areas are influencing one another. Similarities and differences between a reference group and the clinical group are shown in the child development, the maternal indices and the interaction between mother and child. Since assessment is done at three moments from 3 to 12 months, a developmental line becomes clear, indicating the somewhat different processes of normal and pathological development.
#478
MOTHERING THE MOTHER: THE FINE LINE BETWEEN DOULAS AND INFANT-PARENT PSYCHOTHERAPISTS.
Zumbahlen, M. & Thorpe, C. Southern Illinois University, Carbondale, IL 62901-4610. USA mzumbahl@siu.edu.
The purpose of this workshop is to discuss the intersecting roles of doulas and infant-parent psychotherapists as early interventionists. Participants will react to data presented on three topics: 1. The psychological concerns which parents raise before and during labor. 2. Intake strategies to prepare for these psychological concerns. 3. Professional opinions regarding the inclusion of infant-parent psychotherapeutic techniques in doula training. Participants will break into small groups to share their experiences with the kinds of psychological issues laboring moms present, practice strategies to manage such concerns, as well as share their opinions regarding the boundaries between these professional roles. One possible outcome of this workshop is that participants establish guidelines for training doulas in psychotherapeutic techniques.
#479
THE INFANT-PARENTS THERAPY: WEAKNESS AND STRENGHTS OF THE PSYCHOANALITIC APPROACH.
Sandra.Maestro, Filippo.Muratori, RaffaellaTancredi( University of Pisa-IRCCS Stella Maris, Italy) Dr. Françoise Moggio, Dr Bernard Touati, Marie Christine Laznik (Centre A.Binet, France) Anne.Alvarez (Tavistock Clinic, United Kingdom)
Objective: the aim of the symposium consists of discussing the links between infant research and psychoanalytic approach in the field of the infant-parents psychotherapy. The authors propose some reflections about the history of the development of infant-parents psychotherapy and their application in different disorders of infancy and early childhood. In particular: a) the question of the assessment before treatment inside the consultation and the indications to parent infant psychoanalytical psychotherapy; b) the change of the setting, or other technical adjustments necessary in this kind of treatments as expression, or not, of a continuum with the psychoanalytic orientation; c) the contributions of other approaches (cognitive, developmental) as informing the therapies will be discussed.
Materials Through clinical examples (videotaped cases) the authors will compare their own models and will discuss technical implications in conducting therapies. In particular the authors will focus on the "therapeutic factors" of a tranche of a session, discussing on what works in the therapy (verbal interpretations, extra verbal acts, empathy, etc)
Conclusions Limits and strengths of the common psychoanalytic background will be discussed.
#480
PARENT-INFANT PSYCHOTHERAPIES IN EARLY BEHAVIOR PROBLEMS.
Palacio, F. & Rusconi Serpa S., Service de Psychiatrie et de l’Adolescent, 41, Crêts-de-Champel, 1206 Geneva, Switzerland. Francisco.Palacio@hcuge.ch.
The objective of this presentation is to describe the difficulties observed in parent-infant psychotherapies conducted in the context of a longitudinal study about early behavior disorders. Thirty infants aged 18 to 36 months with behavior problems (agression, temper tantrums and negativity) followed a parent-infant psychotherapy. Two different types of brief treatments were used: psychodynamic psychotherapy and interaction guidance therapy. The high proportion of drop out (40%) as well as the difficulties in conducting these treatments lead us to describe a constellation of typical obstacles often observed and to think about the appropriate adjustments of the therapeutic techniques. The most frequent obstacles were problems of setting, infant's symptomatology, parental psychopathology, problems to involve the father in the therapeutic process, difficulties in working with parents’ problematic. We present the adaptations made in the two types of therapy in order to facilitate the therapeutic alliance and to enable the therapeutic process.
#481
FROM THEORY TO POLICY: INTEGRATING PROMOTION OF EARLY RELATIONSHIPS INTO PRIMARY HEALTH CARE SERVICES FOR CHILDREN IN THE CITY OF HELSINKI.
Merja-Maaria Turunen, Child psychiatrist, Child psychiatric Evaluation Unit, Department of Health, City of Helsinki
The aim of the workshop is to show an example of how to introduce into primary health care services mental health promotion and early intervention for parent and infants. The presentations will cover work aimed at families with increased psychosocial risk and families with ordinary developmental tasks. The change from work emphasising mainly the physical aspects of health to work with a broader concept of health with relationship and mental health promotion as the context of the helping process will be described from the point of training and health visitor’s work. Parent’s attitudes for this new kind of work model is described. Practical aspects of workload and supervision needed will be presented. Evaluation of the working model as well as results from its effects in a very specific wartime context in Yugoslavia will be shown.
#482
EARLY PROMOTION AND INTERVENTION CAN BECOME AN INTEGRAL PART OF HEALTH STRATEGY AND SERVICES – RECENT DEVELOPMENTS IN THE CITY OF HELSINKI, CAPITAL OF FINLAND.
Merja-Maaria Turunen, Child psychiatrist, Child psychiatric Evaluation Unit, Department of Health, City of Helsinki
Several factors have influenced the recognition in Finland of the importance of mental health promotion, especially in the early years.1. Mental Health in general has been high on the agenda due to expensive treatment services needed and the lack of sufficient treatment and high suicide rates. Finland highlighted during its European Union Presidency: “there is no health without mental health”. 2. The research of parent-child interaction and it’s meaning for the development is convincing. 3. The epidemiological research in many countries show alarming figures about mental health problems in children and young people that often will have a long lasting detrimental effect into adulthood and next generation. 4. Effective models of intervention have been developed. 5. Finland is a Nordic country with a population of 5 million people and a tradition of universal public services in health-, social- and education sector, that provides an effective and feasible structure for interventions.
#483
EDUCATION OF HEALTH CARE NURSES BY USING THE EUROPEAN EARLY PROMOTION PROJECT MODEL – TRAINER’S VIEW.
Päivi Koskela, Psychologist, Eastern Health Care Centre, City of Helsinki
The application of the European Early Promotion Project Model (EEPP; created by professor Hilton Davis et. al) has yielded a remarkable increase in the competence level of health care nurses working in Helsinki with families expecting a baby or having children under school age. This education includes eight whole days of group teaching and a subsequent two-year supervision. Psychologists and nurses specially educated for the purpose act as the trainers of each group and supervision is provided by psychologists or child psychiatrists. Until now the entering into the education programme has been based on people’s own interest, which assumable indicates a higher motivation and prior knowledge of the subject. Yet the education has led to a further improvement in their professional skills. The education has helped them to
- use their knowledge about parent-infant relationship, family and individual development etc. in a more structured and conscious way
- improve their skills in counseling and supporting parents
- change their working model and routines more flexible
- notice the risk factors in families more adequately
- assist parents in finding their own ways in problem solving and in identifying their own strengths as parents
The EEPP education also seems to have increased the professional self-esteem of health care nurses, which improves their work capacity with less “burn out symptoms” and increasing enjoyment of their work.
#484
SUPPORTING PARENTING IS THE KEY ROLE OF THE HEALTH VISITOR
Kirsi Juutilainen, Health Visitor, Southern Health Care Centre, City of Helsinki
In primary health care in Finland health visitors are central since 1944 making a team with the general practitioner and other professionals. I work in the southern health care center with a population of 96 000 served by 71 health visitors - 34 are working especially with small infants.
Health visitors work monitoring the child’s growth and development, doing health screening and vaccinations, parent counseling and maternity care, in chronic illnesses and health care of the elderly. Tools for mental health promotion have been lacking in training.
Training in early promotion model has changed my work in: 1. Motivation, 2. Improvement of my skills and results, 3. Care of my own competence and well-being. The families and children have benefited: 1. The relationship is more open and respectful - very intimate and painful thoughts and experiences can be shared that unspoken have a negative influence to the couple and parent - child relationship 2.The fathers are more involved. 3. The context and network of the child and parents is recognized. I can better explore and understand their problems and strengths. 4. Both parents and I trust their own competences and solutions. 5.The child’s needs and skills are better recognized.
Time used at the beginning –on a home visit during pregnancy - improves the content and commitment to the work both for the parents and me.
#485
DANCING TOGETHER – A DISCOURSE ANALYTIC STUDY OF HEALTH VISITORS MEETINGS WITH PREGNANT MOTHERS
U. Suominen, Psychologist, Eastern Health Care Centre, City of Helsinki
During the EEPP-training (Davis et al., 1997) the health visitors are trained to use semi structured promotional interviews to be used during pregnancy and the child’s first years of life. The aim of the interview is to observe and identify risk factors and strengths in the family that will affect the development of the children.
The goal of my own qualitatively based research is to examine these interviews between health visitors and pregnant mothers.
Methods and questions to be asked
The method will be to record the interviews between the trained health visitors and the mothers and to analyze them through a discourse analytic repertoire. The research is guided by the following questions:
- Which are the narratives of motherhood and parenthood created in the interviews between health visitors and mothers
- How do health visitors through their own activity participate in the mother’s production of their own narratives and in the forming of new viewpoints,
- Which kind of motherhood identity does the pregnant women create during the conversation and how does the conversation participate in producing meanings that either strengthens/weakens the identity of parenthood.
The research explores and explains in the context of early promotion in primary health care the process of helping where the client meets the professional and decisions are made that either strengthen or weaken the resources of individuals.
#486
ASSESSING EFFECTIVENESS OF A SERVICE MODEL FOR FAMILIES WITH PARENT-INFANT INTERACTION AT RISK : DID THEY GET HELP?
Kinnunen, I, Östring, H. Services for Families with Infants, City of Helsinki, Finland.
In Eastern Helsinki, Finland since 1996 a regional service has been provided to support families where the parent-infant early interaction is at risk. The work is carried out by a pair of psychologists/psychotherapists, one from the Health Care Centre within primary health services and the other from the Family Guidance Centre within social services. The families are referred to the programme mainly from primary services, especially by health visitors and local mental health agencies. The reasons for referral differ: mothers may be exhausted or depressed, families might live in severely difficult social circumstances or they might have a demanding infant. Because of variety of problems and symptoms different interventions are needed. By the end of May 2001, 110 families have participated, about one fourth of them in the intensive treatment module. In the intensive treatment model the group of four mothers and babies come together twice a week. Each mother and her infant have also a weekly therapy session together. The father participates in the family meeting once a month. In autumn 2000 after the treatment period parents were sent a questionnaire concerning the treatment. The similar questionnaire was sent also for referring agencies. In the presentation the service will be described in detail and results of effectiveness of this intervention will be presented.
#487
MENTAL HEALTH PROMOTION IN EARLY CHILDHOOD - CREATING MATERIAL FOR HEALTH VISITORS AND PARENTS IN THE CITY OF HELSINKI.
Many years of producing mental health promotion resources has helped mentality evolve a model of resource development. This model ensures that any resource targeted towards a specific audience is relevant, appealing, accurate, informative, and stimulating enough to encourage adaptation and utilization of the fundamental principals that the resource is trying to convey.
The City of Helsinki commissioned mentality to contribute to their ongoing mental health promotion work and complement their VAVU-Helsinki project (0-2years) by developing mental health promotion resources for health visitors, parents and their children (2-7years).
After consultation mentality determined that the best way forward was to produce a set of resources, one for each of the target audiences. These would:
§ educate health visitors about mental health promotion focusing on the mental health of children (2-7 years) to enable them to fully support parents and children
§ educate parents as to their role in the development, protection and promotion of their child’s mental health (and their own)
§ give children a way of expressing their mental health needs and being understood so that those needs are met.
This brief presentation will take you through the essential processes used by mentality to develop this set of mental health promotion resources for the City of Helsinki, and how they were received by health visitors, parents and children.
#488
THE EUROPEAN EARLY PROMOTION PROJECT: ASSESSMENT OF NEED FOR INTERVENTION THE YUGOSLAV SAMPLE.
Rudic N; Ispanovic V; Radosavljev J; Tenjovic L; Miladinovic T Institute of Mental Health, Department for Child and Adolescent Psychiatry, Palmoticeva 37, 11000 Belgrade Yugoslavia, Imz@imh.org.vu
Early detection of conditions that may lead to non optimal psychosocial development of children are one of the most important targets of primary health care services for children and families. As a part European Early Promotion Project, group of primary health care workers (PHCW) in FRY (Belgrade) underwent specific training aimed at improving early identification of risk factors and presence of need for intervention. The comparison group of PHCWs did not participate in training and their decision on presence of need was based on their usual practice. Independent evaluation of participating families is being done by two psychologists. Their assessment serves as a mean of evaluating the accuracy of the judgment done by primary health care workers. Initial results from the Yugoslav sample do not show significant difference between trained and comparison groups of PHCWs in their accuracy of detecting the presence of need. Additional analysis of factors that influence the decision of the primary health care workers beyond training is discussed.
#489
ROOMING-IN IN PSYCHIATRY: A CHILD PSYCHIATRIC THERAPY CONCEPT.
Lüders,B.& Deneke,C., Department of Child and Adolescent Psychiatry, Hamburg University Hospital, Martinistr.52, D 20246 Hamburg, Germany, e-mail: lueders@uke.uni-hamburg.de
We will present the tratment concept of a small mother-baby unit, which is part of a child and adolescent psychiatric day clinic. Indications for admission are: lacks in impulse control, latent suicidality and uncontrollable fears. Usually the mother-baby interaction is disturbed, and the babies show developmental problems. Therefore, diagnostics have to include three areas: psychiatric and psychodynamic diagnostic of the mother, evaluation of the mother-baby interaction and assessment of the baby´s developmental status. Deficits of the social support system must be taken into account. The central objective of our therapeutic concept is the mother-baby relationship. Parts of the therapy are: the socio-therapeutic relational system, guidance by the nurses, support in handling the baby, play therapy stimulating the development, psychiatric treatment and psychotherapy, including the mother´s individual psychotherapy, mother-baby-psychotherapy and interaction guidance. The father´s position is strengthened by continuous couple therapy and fathers´group.
#490
THE ‘VILLAGE APPROACH’ TO EARLY CHILD DEVELOPMENT.
Hughes, J., & Sommerfeld, D., School of Nursing, Dalhousie University, Halifax, N.S., Canada B3H 3J5. jean.hughes@dal.ca.
Healthy child development is not the result of child factors alone but rather a number of interacting complex factors related to the parent and the community. Yet, most service agencies in at-risk communities employ models of intervention comprised of an array of fragmented services that focus mainly on the child and are largely designed and controlled by professionals. An alternate model, the ACE (Access, Celebrate and Empower) intervention model understands that the community must inform and drive services and that families must drive individual relationships with service providers. It creates conditions that (a) Access - contact and connect families and build their sense of belonging; (b) Celebrate – honor and praise families; and (b) enable families to identify their needs and to access their chosen programs and services. The linchpin is the Community Visitor – a recognized peer parent living in the community who makes the initial contacts to families, builds a relationship and, at the family’s request, serves as a conduit to chosen services. However, this role is not easily accepted by service providers and policy-makers. This paper will discuss the design and operationalization of the ACE model and examine its challenges, strengths, and limitations in terms of health outcome indicators, service delivery mechanisms, and policy priorities using different stakeholder perspectives.
#491
WHEN ONE THEORY IS NOT ENOUGH: DRAWING ON MOTOR LEARNING AND PSYCHOANALYTIC THEORY TO DEVELOP A MODEL OF CLINICAL PRACTICE FOR THE EARLY INTERVENTION OF INFANTS PRESENTING WITH ATTACHMENT PROBLEMS AND AUTISTIC SYMPTOMS.
Birkin, R. & Shears, A. Infant Mental Health Program, Alfred Child and Adolescent Mental Health Service, 594 St Kilda Road, MELBOURNE, Victoria, Australia 3004 r.birkin@alfred.org.au
Video material from the assessment and treatment of a toddler presenting with autistic symptoms, will be used to present a model of clinical practice that draws upon both motor learning and psychoanalytic theories. While psychoanalytic therapy attempts to address underlying difficulties that have lead to the presenting symptoms in order to bring about change, therapy informed by motor learning research attempts to directly address the manifest motor difficulties and in doing so, impact on underlying difficulties, as highlighted in the video material.
#492
UNDERSTANDING DRUG-EXPOSED CHILDREN: WHAT ARE THEIR PROBLEMS AND HOW CAN WE ADDRESS THESE?
VanBeveren, T.T. University of Texas Southwestern Medical Center/New Connections, Dallas, Texas, 75235, USA toosje.vanbeveren@utsouthwestern.edu
This presentation will discuss the effects of prenatal drug-exposure on infant and child development. Attendants to the presentation will receive information on the dangers of alcohol and other drugs ingested by the pregnant woman and the consequences of the drug use for the unborn child. Use of these drugs may result in developmental delays in children. A number of different drugs, including tobacco, marijuana, amphetamines, heroin, inhalants, cocaine, and alcohol will be discussed and the effects of the drugs on the development of the fetus, infant, and child will be explained. In the second part of the presentation, suggestions will be made for handling and teaching drug-exposed infants and children. Activities and exercises will be described to help children overcome developmental delays.
#493
DEVELOPMENTALLY BASED PREVENTION IN A MULTI-ETHNIC, DISADVANTAGED NEIGHBOURHOOD OF BRUSSELS: LONGITUDINAL EFFECTS ON CHILDREN AND PARENTS.
Meurs, P., Centre for Child Psychotherapy, University of Leuven (Belgium). Regastraat 25, 3000 Leuven (Belgium) patrick.meurs@psy.kuleuven.ac.be
The preventive project in The Families House in Brussels, a multi-ethnic and disadvantaged neighborhood, is aimed at improving social adaptation of children. In The First Steps, a project on developmental guidance, mother-child groups and parental groups are organized on a weekly base. Participants are stimulated to play together, to create a discourse about and a dialogue with their children and to share questions and experiences about development, parenting and education. Information about the project of The First Steps reaches more than 95% of the population of young mothers in this neighborhood. Empirical research is set up on affective communication between parents and children, on the affective structure of the mother and on several parameters of child development. We investigate the same variables in a reference group. Some group differences fade away, while others persist or get even marked more strongly between zero and three.
#494
MANAGING ACUTE PSYCHO-SOCIAL SITUATIONS IN PERINATAL CARE.
Rosenblum, O., Bydlowski, M., Squires, C., Danon, G. Laboratoire de Psychopathologie de la reproduction Cochin-Port Royal (Pr. D. Cabrol), Hopital Tarnier, 89 rue d'Assas, 75006, Paris, France. monique. bydlowski@ mageos.com.
Acute psycho-social situations were reviewed such as neonaticide, prenatal conjugal abuse, sexual abuse in the family, maternal drug addiction, homeless mothers, etc. Some invariants of the psychotherapeutic setting that we decided for these mothers will be shown and discussed especially concerning the management of counter-attitudes of the clinic team (flexible and cross identifications between the health worker and the mother or the new-born, or the foetus.
#496
FIRST-TIME FATHERS’ PARENTING IDENTITY DURING PREGNANCY.
Habib, C. & Lancaster, S. Department of Psychological Medicine, Monash University, Clayton, Victoria 3168. AUSTRALIA. Cherine.Habib@med.monash.edu.au.
This study examined the relationship between first-time fathers’ parenting identity in early pregnancy and self-reports of the quality of their spousal relationship, perceptions of their own parenting, their attachment to the foetus and general emotional functioning. One hundred and twenty men in heterosexual relationships participated in the study, which was the first phase of a longitudinal investigation into men’s transition into fatherhood. ‘The Pie’ method was used to measure the relative importance of men’s sense of self as a father-to-be at the end of the first trimester. The men were asked to think of who they are as a person and the various identities ( e.g. husband, worker, father-to-be, son) that make-up who they are, and to visually depict how important such identities are to how they see themselves. The men also completed various self-report questionnaires including the Dyadic Adjustment Scale, the Paternal Prenatal Attachment Scale, the General Health Questionnaire, and the Parental Bonding Instrument. Results will be presented and discussed in the context of the wider longitudinal study.
#497
FACTORS INFLUENCING MATERNAL ATTACHMENT TO THE FOETUS.
Lancaster, S. Department of Psychological Medicine, Monash University, Clayton, Victoria 3168 AUSTRALIA. sandra.lancaster@med.monash.edu.au
Previous research has demonstrated the importance of the early mother-infant relationship in terms of child adjustment and the effects of postnatal depression on parent-infant interaction. While it is widely accepted that the mother’s relationship to her infant begins in pregnancy there have been few studies that have examined variables associated with this process. This paper reports on the relationship between maternal factors such as mood, past abuse, and marital satisfaction, and attachment to the foetus in pregnancy. Participants were 180 primiparous women attending hospital antenatal clinics who had agreed to be involved in a longitudinal study of parenting and child adjustment. Results of this wave of data collection confirm the need to improve our understanding of the development of attachment during pregnancy. Implications of the findings are discussed in the context of risk factors for the postnatal parent-infant relationship.
#498
BEGINNINGS OF MOTHER SELF.
Niemelä,P. Department of Psychology, University of Turku. 20014, Finland. pirkko.niemela@utu.fi
How does the mother´s sense of Mother Self develop in the interaction with the baby? Stern´s (1985) constructions of the development of the baby´s sense of self in interaction with his/her mother serve here as a starting point for the hypotheses of the development of mother´s sense of Mother Self. The very beginning Mother Self can be conceptualized as an emerging feeling of self when the motherobserves and feels her newborn. The sense of core self develops when the mother starts to feel that this is my baby and I am the mother for this very baby, when experiencing her agency, self-coherence,self-affectivity and continuity in time with her baby. Mothers´ words from interviews are used to describe the Emergent Self as a mother as well as the different aspects of her sense of Core Self as a mother.
#499
THE TRANSITION TO PARENTHOOD IN COUPLES WHO REQUIRE MEDICALLY ASSISTED PROCREATION.
Darwish, J., Fivaz-Depeursinge, E., Germond, M., Guex, P. C/L Psychiatry, University Hospital, Lausanne, Switzerland, Joelle.Darwish@inst.hospvd.ch
This poster presents the design of a new research project in the field of medically assisted procreation (MAP). Data will be collected concerning: 1) the emotional integration of their infertility history by the couples, during pregnancy and 2) the development of the affective communication in the father-mother-infant triad. We hypothesize that there exists a link between the way the couples have resolved their diagnosis of infertility and the quality of the affective communication in the family. 25 couples who had donor insemination and 25 couples who had intracytoplasmic sperm injection will be recruited. The videotaped research sessions will take place at the 5th month of pregnancy and, after birth, at 3, 9 and 18th months. Assessment procedures will include: reaction to diagnosis interview; pre- and post-birth Trilogue Play; validated questionnaires. There is a need for systematic observations of the development of MAP families before and after birth. The adjustment of the health care system to the needs of MAP families should ease the transition to parenthood and prevent problematic outcomes.
#500
PRENATAL COPARENTING AND POSTNATAL FAMILY ALLIANCE.
Corboz-Warnery, A., Carneiro, C., Montfort, V., Frascarolo, F., Antoinette.Corboz@inst.hospvd.ch
The transition to parenthood has been mainly studied through self-reported and observed marital interaction and through parental triangular representations. Our aim is to study it at interactional level by examining the relation between the parents-to-be enacted cooperation in a parenting task (coparenting alliance) and actual father-mother-infant cooperation in a play situation (family alliance). Based on the Lausanne Trilogue Play (LTP) paradigm, a task related to the future family’s interaction has been elaborated: the Prenatal LTP. The parents to be are instructed to role-play their first encounter after birth with their baby, represented by a doll. This task implies an enactment of the parents’ representations of being a threesome. In this poster the procedures and coding to assess prenatal co-parenting alliance and family alliance are presented, as well as results on 40 volunteer families. Preliminary results show a significant correlation between the scores of pre- and postnatal alliances. This continuity provides a new early assessment of family resources and vulnerabilities, with important clinical implications.
#501
PARENTAL DEPRESSION AND DECREASE OF MARITAL QUALITY DURING THE TRANSITION TO PARENTHOOD: “BLAME THE BABY”?
Perren, S., von Wyl, A., von Klitzing, K., Simoni, H., & Bürgin, D. Department of Child and Adolescent Psychiatry, University of Basel, Schaffhauserrheinweg 55, CH-4058 Basel, Switzerland, sonja.perren@unibas.ch
The aim of this study is to investigate (1) changes over time from pregnancy to 18 months after birth in parental depression, feelings of distress, and marital quality and (2) whether these changes are related to children’s developmental level and individual behavioral difficulties. This study is part of an ongoing longitudinal project on 80 couples and their first-born children. During pregnancy and the first months after birth, parents often reported depressive symptoms, particularly women and participants with psychiatric symptoms. In participants without psychiatric disorders, depression decreased over time. Thus, parental depressive symptoms seem to be related to children’s developmental progress. However, one-year-old infants who become more autonomous might cause high distress in parents. Participants reported most feelings of distress during this age period. Marital quality decreased over time but was not related to child characteristics. The results suggest that the transition to parenthood has strong effects on intra- and interpersonal functioning of mothers and fathers, especially among parents with psychiatric disorders.
#503
REVIEWED EXPERIENCE OF TEN YEARS OF PARENT-INFANT PSYCHIATRIC CLINIC.
Le Nestour, A., Danon, G., Bydlowski, M., Rosenblum, 0., Squires, C., Heroux, C., Patouillot, I., Laboratoire de Psychopathologie Perinatale, 89 rue d’Assas, 75006 Paris, France. L ' Aubier, Centre du Tout Petit, Erasme Hospital. Gisdana12@aol.com
L' Aubier, a specialized community based parent-infant psychiatric clinic, has worked steadily over the past ten years with a variety of families and in concentration with numerous community based institutions (day-care, community based medical centers, foster family facilities, etc.) and surrounding hospitals (maternity and pediatric wards). Over the years, a population of an average of 200 families has been managed and treated by the clinic's team. Only criteria for receiving care by the clinic was the presence in the family of an infant than 24 months of age. We emphasize the steady increase of the decrease in age of the infants referred. Infants less than 6 months are now commonly referred and there has bee progressive number of pregnant women referred for future mother-infant care (20% increase each year for the past 5 years). Is this due to an earlier assessment of parental psychopathology by practitioners? Is there an increase in pathology? We describe specific therapeutic strategies (home visit, home based intervention, emergency visit in maternity ward by teams trained in parent-infant psychopathology.) Video presentation.
#504
THE DEVELOPMENTAL AND PSYCHOLOGICAL CLINIC – A PREVENTION-INTERVENTION MODEL.
Kaminer, H. The Developmental and Psychological Clinic. 7 Saint Lukas, Haifa Israel. k_moshe@zahav.net.il
The Developmental and Psychological Clinic for young children is multi-faceted in its aims and areas of practice. The aim of the clinic is to serve children, identified as having developmental impairments or emotional disturbances due to physiological or environmental causes. The work of the clinic encompasses diagnosis, therapy and the psychological rehabilitation of children between the ages of 0-6. The guided policy: 1.Early identification evaluation and intervention. 2. Service which will be accessible with in the community. 3.Using community resources. The clinic is community oriented, and the staff, clinical psychologists and social workers, work in close co-operation with other professional agencies in the community where the child lives. There is an emphasis on preventive work in Mother and Child Clinics (Well baby clinics). In addition to primary prevention there is also the domain of the clinician, meaning treatment of psychotherapy. The main center’s approach is a dyadic parent-child therapy, a relational dyadic approach, emphasized the centrality of the parent-child interaction. An additional area of expertise is the detection of high-risk children. Also the clinic is today professionally responsible for 16 therapeutic kindergartens. To summarize, the activities of the clinic include: prevention, detection, assessment, intervention on the individual, group, systemic or community level.
#505
INCENTIVE PROGRAM USAGE AS A FUNCTION OF DEMOGRAPHIC CHARACTERISTICS.
Barnes, J., Otto, P., Scherf, T., Determan, C., Fitzgerald, H. Applied Developmental Science, Michigan State University, East Lansing, MI. 48824. USA barnes33@msu.edu
The Passport Initiative is a community collaborative designed to build a broad system of support. It connects families with existing services and educates families on the importance of the first five years of their child’s life. In order to encourage parents to use the knowledge the Passport Program provides to them, an incentive program has been implemented. Parents are given incentives for accessing community services and participating in activities that promote the emotional and physical health of their child. Families can redeem the incentive “coupons” at local businesses for services and products. An odds ratio analysis examined how the population characteristics of ethnicity, level of education, identification of a physician and identification of an insurance provider predict usage of the incentives. These demographic variables were chosen due to their potential as risk factors. Results of the analyses showed multiple main effects and interactive effects. In summary, being a member of a majority versus a minority ethnic group changed the effect of the other three risk factors. These results provide important information about those families who are difficult to reach to programs providing incentives to parents.
#506
A GUIDE FOR PRIMARY CARE PRACTITIONERS FOR THE DEVELOPMENTAL MONITORING OF INFANTS.
Ertem I.O., Gumusok A, Gok G. C., Ulukol B., Baskan S. G. Department of Pediatrics, Ankara University School of Medicine, Cebeci, Ankara, 06100, Turkey, ertem@dialup.ankara.edu.tr
The Developmental Monitoring Guide (DMG) is a semi-structured interview with open-ended questions and scoring based on parental report of the child’s development. Our aim was to examine the concurrent validity of the DMG with the Denver II, a previously validated screening test which has been standardized for Turkish children. One pediatric resident administered the DMG to 146 infants aged 2-18 months and on the same day; a child development specialist blinded to the DMG results conducted the Denver II. The DMG and Denver II identified 37 (25.3%) and 39 (26.7%) infants with developmental delays, respectively. Concordance rate of the two instruments was 98.6 %, Kappa 0.94 (p<0.001). Regarding the Denver II in this analysis as a hypothetical gold standard measure for screening, the sensitivity of the DMG was 94.9% and the specificity was 100%. The DMG may be an instrument to aid in the monitoring of the development of infants with similar detection rates for delays in development as the Denver.
#507
LIFE EVENTS AND MATERNAL PERCEPTION OF CHILD´S BEHAVIOUR: EFFECTS OF PRIMARY HEALTH CARE INTERVENTION PROGRAMME.
Puura K*, Virta E, Mäntymaa M, Tamminen T, Layio-Lignos E, Rudic N, Vizacou S. Tampere University Hospital and Medical School, 33014 University of Tampere, Finland, klkapu@uta.fi.
In the EEP-project we studied the effect of recent negative life events on maternal distress and child´s fussiness, and whether an early intervention would alleviate negative effects. In Tampere 15 well-baby clinic nurses were trained in parent counseling skills and promoting early mother-infant interaction, while 12 nurses formed a control group. A sample of 165 mother infant -pairs were assessed 6-8 weeks after birth giving with the Parenting Stress Index (PSI) and the Infant Characteristics Questionnaire (ICQ), and mothers were asked about recent major life events. The well-baby clinic nurses worked with the mothers and infants according to their skills until the children were two years old, and the second assessment was made with same measures. In our study negative life events increased the possibility of a mother experiencing her child as fussy, and this possibility was magnified by maternal distress. However, results also show that the effects of negative life events and maternal distress on the mother’s perception of the child´s difficultness can be alleviated by early intervention in primary health care.
#508
THE EUROPEAN EARLY PROMOTION PROJECT: FIRST RESULTS.
Puura K*, Roberts R, Paradisiotou A, Rudic, N, Layiou-Lignos, E. * Tampere University Hospital and University of Tampere, Medical School, 33014 University of Tampere, Finland, klkapu@uta.fi.
The European Early Promotion Project Project was designed to promote children’s mental health and prevent psychosocial problems within primary health care systems of five countries (Cyprus, Finland, Greece, United Kingdom and Federal Republic of Yugoslavia). Primary health care nurses in participating countries were trained in parent counseling and skills for assessing and promotion early mother-infant interaction. The trained nurses worked with children and their families participating the Project from birth to two years. A comparison group was formed of families seen by primary health care nurses without the EEPP training. In the symposium first results of the EEP-Project will be presented. Effects of the EEPP training on the work of primary health care nurses will be described together with factors affecting their decision-making. Results concerning the effect of the EEP-Project on maternal anxiety, maternal perception of the child’s behavior at 2 months and two years, and mother-child interaction at two years will also be presented.
#509
SOME OBSERVATIONS AND RESULTS FROM THE UK INCLUDING THE INTERACTION BETWEEN MOTHERS AND THEIR TWO YEAR OLD CHILDREN.
Roberts R* and Hilton D. *Lewisham & Guy´s Mental Health NHS Trust Bloomfield Center, Guy´s Hospital, London, UK. roberts@rob96.freeserve.co.uk.
The EEP Project has developed a service for young families which aims to promote positive parent-child interactions and family relationships using specially trained and supervised Primary Health Care Professionals. The effect of this intervention is evaluated compared with matched groups not receiving the intervention. Families participating in this project are assessed by independent researchers at 4-8 weeks and then at 2 years after the birth of the child. In order to assess the quality of mother-child interaction at two years, each pair is videotaped in a feeding situation, which is then analyzed using a specially modified system of coding. The original method proved highly discriminating, for example, in distinguishing interaction of depressed and non-depressed mothers with their children and in showing associations between parent-child interaction and children´s emotional and behavioral development. Selected results at two years between the intervention and comparison groups and between those families assessed by the researchers as being in need or not, will be compared and discussed.
#510
DUTCH CHILD PROTECTION WORK: INTRODUCING NEW METHODS.
Dr. Anneke J.G. Vinke, Drs. Carolien Knibbe, Drs. Fieke M.Klein Wassink, Clinical Child Psychologists. Projects carried out at Centre of Youth Care Utrecht, Dept. Of Child Protection, PO Box 9076, 3506 GB Utrecht. Aabs@hetnet.nl.
Finding new ways to improve work in involuntary counseling provides a challenge to social workers, supervising psychologists and managers. This workshop introduces two methods in child protection work. The first project is called 'startteam' and started in 1998 in order to help social workers to meet the standards on involuntary work that are written down in Dutch law. Each child that is referred to involuntary care, should be provided with a care and counseling plan within six weeks after the formal ruling of the judge. This standard is seldom met: it can take up to 20 weeks before a plan is written. Social workers, staff and management designed a new protocol. This new way of working was compared to the regular way of starting new cases and proven better. Research findings, theoretical and practical information will be subject of the presentation. The research findings suggest that this new way of starting cases improve quality of involuntary care. As for now, 2001, the method is being implemented for all new cases in the Utrecht area. The second project, called 'flexteam' - started 2001. It was designed to guarantee continuity in care, strategies and counseling when a social worker falls ill. Illness of the responsible worker used to lead to great gaps in care. Now a special team was equipped to start on short notice in cases where a social worker drops out. Both methods, practical findings and issues in implementation will be discussed. First research findings will be available in 2002.
#511
DUTCH CHILD PROTECTION WORK: GETTING STARTED.
Dr. Anneke J.G.Vinke, clinical child psychologist, Av@vanmontfoort.nl, Drs. Carolien Knibbe, clinical child psychologist, Drs. Fieke Klein Wassink, clinical child psychologist, Clinical Child Psychologists. Projects carried out at Centre of Youth Care Utrecht, Dept. Of Child Protection, PO Box 9076, 3506 GB Utrecht.
Dutch law proscribes that all new child protection cases have to have a care plan within a six-week period from the start of the measure. This target, however, is rarely met. Dutch research suggests that a quick start in child protection cases leads to better results therefore provides qualitative better work and more client satisfaction.
The actual situation in child protection work could not live up to this research outcome. Standards for care were not adequately met. In order to get a swift and thorough start in new cases, the start team project was initiated. A new team was made and social workers were given additional time in order to develop a new method as well as to start new cases. The poster outlines the development of the method: a process involving workers, psychologists and managers. All new ideas, founded in recent theoretical and empirical research, were tested by the social workers on practical feasibility. Thus the new method evolved and was written down in a 'handbook'. The poster will illustrate that even complex cases can be 'mastered' within the scope of six weeks. A comparison is made with the regular way of working in new cases. This comparison will be illustrated with facts from a small explorative research study that was conducted during the first year of the project. As for now: the method has been successfully implemented at our Centre and is being used in all new cases.
#511a
DUTCH CHILD PROTECTION WORK: KEEP THE WHEEL TURNING.
Drs.Carolien Knibbe, dr. Anneke J.G. Vinke, drs. Fieke Klein Wassink, Centre of Youth Care, PO Box, 9076 3506f GB Utrecht, the Netherlands, aabs@hetnet.nl
The second project is called 'flex-team' and refers to a special method of working in cases of sick social workers. In certain periods drop out rates could rise to 15%. This was considered a huge problem, since care and strategies for the counselling of children ought to continue. Such was very difficult and quality of care was not always guaranteed. A new team was formed. The four social workers involved were given half of all their time to fill up the gaps in cases of colleagues. Together with their supervising psychologist and the manager, they developed a handbook on short-time intervention in cases of fellow social workers. In order to keep up continuity in the counseling, the flex-worker starts representing the original social worker two weeks after he or she falls ill. In the regular system it would take at least six weeks to find a replacement: cases were represented by the team. Unfortunately the team has a full case-load and is at that moment responsible for even 25 cases more than usual. Therefore quality of care was not guaranteed in this system. Clients do not have to wait long for a new representative and the care continues. Both methods, practice and evaluation will be presented by using examples from Dutch child protection cases. Preliminary findings suggest that this new method works is useful and meets its aims (continuity, high quality and good care).
#513
STRATEGICALLY POSITIONING TRAINING SERVICES: PRIMARY CARE WORKFORCE DEVELOPMENT TO FOCUS SERVICE DELIVERY ON EARLY INTERVENTION IN THE FIRST THREE YEARS.
Kowalenko, N. Barnett, B., Fowler, C & Glossop, T. Royal North Shore Hospital, NSW, Aus 2065. nkowa@doh.health.nsw.gov.au.
To focus the health system on infant mental health issues, a training package for integrated perinatal care in one Australian state, NSW, has been developed. The target is the primary care workforce and its aim is to improve the knowledge base about parental psychopathology, infant mental health, parent-infant interaction & preventive interventions. The aim of training is to upskill workers to identify and better target at-risk infants and their families; better provide continuity of care; and enhance intersectoral collaboration to secure comprehensive care. The training package initiates the implementation of better practice guidelines (www.auseinet.flinders.edu.au/pubs). This presentation will focus on describing the linking of training to evidence-based practice and the strategic role of workforce training in implementing service reorientation to early intervention. Initial evaluation of the training, & the method of its broader dissemination will be presented.
#514
INFANT MENTAL HEALTH PRACTICE: PRACTITIONERS’ AND PARENTS’ VOICES.
Weatherston, D. J. Merrill-Palmer Institute, Wayne State University, Detroit, MI. 48202 USA aa2233@wayne.edu.
The presenter will review findings from her study in which she interviewed Infant Mental Health practitioners and parents who participated with their infants in Infant Mental Health services. Individual summaries and collective accounts define Infant Mental Health services as complex and robust, leading to important developmental and relational changes for children and their parents. She will discuss how practitioners described their work with infants and families and summarize parents’ recollections about the course of treatment. What strategies did practitioners use as they worked with infants, toddlers and families? What did parents say was most effective in helping them to meet the psychological and developmental needs of their infants and toddlers? Practical, observational, and educational strategies will be described, as well as relational, emotional and reflective techniques. Results indicate the powerful role of relationship in affecting positive change and the significance of the infant or toddler’s presence in providing a vital and distinguishing focus and profoundly influencing the course of treatment.
#515
A CONTINUUM OF EXPERTISE IN PSYCHOSOCIAL PRACTCE.
Hornstein, J. Children's Hospital, Boston, and University of New Hampshire, 105C Morrill Hall, Durham, NH 03824. HORNSTJO@compuserve.com.
Two sources will be used to discuss the progression of expertise in psychosocial practice among practitioners from various disciplines working with families of young children. First, results of pre- and post-testing of trainees in the use of the AIMS (Attachment, Interaction, Mastery, Social Support) will be reported. Trainees from multiple disciplines demonstrated an increased capacity to identify family strengths and to select specific areas of focus. Pediatric residents showed an increase in capacity to address psychosocial concerns. Interviews with both groups indicate concern with extending their domain of expertise. Second, the development of the Touchpoints principles of practice will be discussed. These principles of practice, also intended for multidisciplinary use, are based on the work of T.Berry Brazelton, and are seen as guiding the behavior of competent practitioners. Both sources will be used to establish a continuum of psychosocial practice from novice-to-expert.
#516
PRACTICE-BASED IDENTIFICATION OF INFANT MENTAL HEALTH EXPERTISE.
Rains, M. MaineGeneral Medical Center, 269-1/2 Water St., Augusta, ME 04330 USA mrains@mainegeneral.org
Benner’s novice-to-expert model of competence in health care (1984, 1999) provides a framework for infant mental health practitioners to reflect on approaches to common dilemmas in their practice of parent-infant assessment and psychotherapy and for researchers to distill the essence of expert practice. How do parent-infant psychotherapists utilize training, experience, and intuition to (1) develop working relationships with parent, infant, family and community services, (2) select the most useful and efficient assessment protocols and intervention procedures for each real-life situation, (3) identify, prioritize, and integrate multiple sources of verbal, behavioral, contextual, and ecological data, and (4) manage personal stress, ethics, and counter-transference associated with decisions and dilemmas involving infant-parent relationships? Responses of one group of experienced practitioners will be summarized. Implications for supervision, evaluation and research design will be described. Potential replication of the model within a variety of practice settings, distance-learning sites, and infant mental health association gatherings will be discussed.
#517
IF WE CAN MAKE IT WORK – ANYBODY CAN: DISTANCE DELIVERY TRAINING FOR INFANT MENTAL HEALTH PARAPROFESSIONALS IN RURAL SETTINGS.
Cavalier, M. Center for Human Development: University of Alaska, 2210 Arca Drive, Anchorage, Alaska 99508. Looncabin@aol.com.
This workshop will discuss strategies used in the state of Alaska to develop distance delivery training and degree programs designed for working paraprofessionals in early childhood. The Center for Human Development:University of Alaska has developed in collaboration with other agencies two distance delivered associate degree programs (Associate’s in Early Childhood with an emphasis in special needs and an Associates in Disabilities) and a comprehensive training curriculum (Specialized Training for Associates/Paraprofessionals in Rural Settings). The programs combine traditional, indigenous methods of working with children and their families with western methodologies. Strategies of developing training materials include cost-effective methods that can be used in any rural settings. The session will include opportunities for participants to apply models to their own settings.
#518
FACILITATION OF INFANT MENTAL HEALTH SERVICES IN NURSERY SCHOOLS: TRAINING OF THE NURSERY SPECIALISTS IN JAPAN.
Aoki, K., & Baba, R. Ohanomizu University, Tokyo, Japan aokiku@pop06.odn.ne.jp.
Clinical psychologists have conducted continuous training for nursery specialists in order to improve the quality of individual support in nursery schools for the children who have some kind of risks in mental-physical development. 222 nursery schools took part in this research. Nursery specialists answered the questionnaire prepared to research the number of the children who require special support in daily nursery scenes and the specific clinical problems they have. Total number of the children with problems was 833.Clinical problems were divided mainly into the four factors of the cognitive behavioral development, control of impulses, problems in sociability and the family environment. With infants, in many cases, nursery specialists were aware of the problems, which were not pointed out at the physical examination conducted by the health centers once in a half a year, and even before the family noticed. Based on these results, groups consist of nursery specialists in charge of problematic infants and a clinical psychologist were formed to prepare support plans for each individual case, and the plans were implemented at each nursery school. Follow-up survey was conducted half a year later, and the effect of the training was examined.
#520
INTERGENERATIONAL TRANSMISSION OF ATTACHMENT IN A POPULATION OF EXTREME POVERTY.
Geenen, G., & Corveleyn, J., Centre for Research in Psychoanalysis and Psychodynamic Psychology, Catholic University Leuven, Belgium Greet.Geenen@psy.kuleuven.ac.be
This ongoing study examines intergenerational transmission of attachment styles in a Belgian sample that has been living in extreme poverty for generations. The multi-problems of the parents are transferred to the children in an almost unbreakable chain. Until now, little research has been done on psychological aspects of this transgenerational repetition. Attachment research suggests that internal working models are transferred by the parents’ behaviour, especially in moments of stress. We assume that precisely in this group transferability of attachment will be high, because their life is a series of stressful events. Mothers are visited at home from pregnancy until the child reaches 18 months. IFEEL Pictures and AAI are presented to (grand)mothers. The mother-child interaction is studied with the observational method of Bick, the maternal sensitivity rating scale and the AIDS scale. Child development is followed by the KID-N. At 18 months, AQS assesses infant attachment. Results can guide prevention programs to break through the ongoing chain of multi-problems.
#521
FACTORS OF RISK IN THE FIRST INFANCY: INTERACTIONAL STYLES AND ATTACHMENT MODELS BETWEEN MOTHERS AND CHILD.
Riva Crugnola, C., Albizzati, A., Giacon, B., Moioli, M., Walder, M. Department of Psychology, Milano-Bicocca State University, piazza Ateneo Nuovo 1, Milan, Italy cristina.riva-crugnola@unimib.it
The objective of this study is to find factors of risk in mother-child interactions, inquiring their relation with the attachment models of mothers and children, with psychopatological states of mothers and with children temperament. The longitudinal study examines the interactional styles of thirty mother-child pairs in the first year of life, drafts from a normal sample of population, through videotapes, codified with one observation instrument; it inquires the maternal attachment models through Adult Attachment Interview and their mental states through SCID-NP Scale. The patterns of children attachment are found with the Strange Situation, the sensomotory and cognitive development with the Bayley Scale, the temperament with Axia’s questionnaire. Most of all preliminary results shows meaningful relations between the attachment models of mothers and their interactional styles adopted with children. Results can supply useful indication in order to carry out early interventions.
#522
ATTACHMENT, TEMPERAMENT, AND SOMATIC DISORDERS IN CHILDREN ENTERING DAY CARE.
Grasso, F., Starakis, N., Cavallini, S ., Guedeney, A. Ist. Psic. Gen e Clin. Università di Siena, Via dei Tufi 1, 53100 Siena. ITALY franzgrasso@tin.it
The authors are investigating the correlation between:1) Type, duration and frequency of the medical diseases occurring after the child enters day care 2) Secure vs insecure attachment status of the child with the mother 3); Temperament of the child; 4) Maternal separation anxiety. A positive correlation is expected between insecure attachment status, and the increased occurrence and duration of infectious and functional disorders, within the six first months following the child’s entrance in nursery, and greater for children described by their mothers as difficult, and for those mothers experiencing greater maternal separation anxiety. Data from a pilot study carried out in a in Parisian day care center the will be presented, along with the research actually in progress with two nurseries in Livorno, Tuscany. Infants with insecure attachment could benefit from specific attention in day care to prevent frequent and chronic infections.
#523
THE INTERNAL WORKING MODELS IN AN AT RISK SAMPLE OF ITALIAN PREGNANT WOMEN: A PRELIMINAR INVESTIGATION.
Laura Vismara, Giuliana Carosi, Moira D’Isidori, Angela Mancone, Flaminia Odorisio, Facoltà di Psicologia, Università degli Studi di Roma "La Sapienza", Via dei Marsi, 78, 00185 Roma. ITALY lauravism@tiscalinet.it.
The aim of this work is to analyze the quality of mothers’ at risk Internal Working Models (IWM) during pregnancy through the administration of the Adult Attachment Interview (AAI, Main, Goldwyn, 1994) at the seventh month of pregnancy. Eighty women, between 26 and 39 years of age, have been selected within a program on "Maltreatment Prevention" conducted by Università "La Sapienza" di Roma in cooperation with four Public Social-Health Services. The women have been enrolled according to their belonging to either of the following categories: low income and social status/personal or family histories of maltreatment/ depression/traumas/ drug-alcohol addiction/ chronic illness/ other eventual specific critical events. This work is based on the assumption that representations, organized through the narrative structure, may give specific informations on the way the woman faces the experience of becoming parent and thus on her way of behaving with her own child. Preliminary analysis have shown that certain characteristics of the woman’s life may have an effect on the tipology of the woman’s IWM as assessed by the AAI, characterized by a tendency to be still involved in her own past experiences, which differentiates the two subgroups of women.
#524
SENSORIMOTOR EXAMINATION CONTRIBUTION IN THE EARLY ATTACHMENT TYPE EVALUATION (9-MONTH-OLD-BABIES).
L. Barthelemy, B. Golse, A. Bullinger, Hôpital Necker-Enfants-Malades, Service de Pédopsychiatrie, 149 rue de Sèvres, 75015 Paris – FRANCE b.golse@svp.ap-hop-paris.fr
The hypothesis of this work is there should be a connection between the sensorimotor examination and the strange situation (protocol which estimates attachment) seeing as the diagram's quality of a children 's attachment seems to influence the maturation of sensorimotor's balance. Attachment could be considered to be like an early strategy for the baby to adapt and defend itself from his background and "premises an independence towards attachment figure" (Bowlby). The sensorimotor period (between birth and 18-24 months) " is characterized by principal material which feeds psychic activity, and are sensoriel and motor skills" ( Bullinger).
We've made the sensorimotor examination to 29 9-month-old-babies in pediatric consultations, and then the strange situation. Later, we've made again the strange situation with 12 12-month-old-babies of the 29 to test the stability of results (its validity is for babies from 12 month): same notes at 9 and 12 months. We've found 3 insecure babies with a normal motor development, but troubles in the tonic regulation and in the interactions.
In spite of a too small and not representative sample, we can yet notice that the baby's tonus quality depends on the relational quality with his parents. The idea is to propose an early psychiatric way for a common pediatric examination to improve the collaboration between the paediatrist-child-psychiatrist, and specially the parents-children interactions.
#525
ATTACHMENT AND DELAY IN MOTOR DEVELOPMENT AT AGE ONE YEAR: CONSIDERING PROXIMAL AND DISTAL FACTORS OF INFLUENCE.
Kissgen, R. University of Cologne - Department of Special Education, Frangenheimstr. 4, 50931 Cologne. Germany ruediger.kissgen@uni-koeln.de
The aim of the longitudinal study is to extract new knowledge on the basis of attachment research that can be redirected in working fields with motor development delayed children and their families. At age 12 months 61 of 74 examined children were assigned to the clinical group with motor-development delay (n=27) or the control group with normal, healthy children (n=34). A Psychomotor Development Index (PDI) of < 85 was the criterion for placing a child in the clinical group. Examined were: mother-infant attachment quality, the children’s motor and cognitive development, the children’s temperament, the parents perception of marital quality and parental stress. Between quality of attachment and quality of motor development a significant correlation (r=.28, p=.023) was found. T tests showed that both groups do not differ on statistically significant levels regarding the examined proximal (aspects of children’s temperament) and distal factors (perception of marital quality, perception of parental stress). It has to be underlined that the found correlation emphasizes the importance of early support and intervention regarding motor development and mother-infant attachment.
#526
ATTACHMENT STYLE AND SOCIAL SUPPORT IN ADOLESCENT AND ADULT MOTHERS.
Figueiredo, B., Departamento de Psicologia, Universidade do Minho, Campus de Gualtar, 4700 Braga. Portugal. bbfi@iep.uminho.ptPacheco, A., Departamento de Psicologia, Universidade do Minho, Campus de Gualtar, 4700 Braga. Portugal. Costa, R., Departamento de Psicologia, Universidade do Minho, Campus de Gualtar, 4700 Braga. Portugal.
Attachment and social support are both important dimensions related with the mother’s psychological adaptation to motherhood, namely to the quality of the care and the interaction provide to the infant. The study that we will present analyze a sample of 40 adolescent mothers and 40 adult mothers in terms of their attachment style and the social support that they obtain from the companion and from significant others during the pregnancy period. The result show significant differences between the two groups in terms of the quality of the mother’s attachment style and social support, as a great variability in each group regarding these same aspects. Despite of that, significant associations were found between different styles of attachment and different types and the quality of the mother’s relationship with significant others, as between the mother’s attachment style and social support and her psychological well being during pregnancy, specially in at risk condition, as in the case of adolescent mothers.
#527
ATTACHMENT REPRESENTATIONS AMONG PARENTS TO CHILDREN TAKEN INTO FOSTER CARE.
Kalland, M., Sinkkonen, J. Save the Children, PB 177 Lapinrinne 2 00181 Finland. mirjam.kalland@pela.fi.
Parents most likely to maltreat their children are those whose childhoods include major losses of or frequent separations from their attachment figures, rejection and physical or sexual abuse. The AAI-interview permits the classification of an adult’s state of mind with respect to attachment. The aim of the study was to assess attachment representations and detect traumas and losses among parents to children taken into foster care. We found that the family histories included substance abuse, family violence and mental health problems. The attachment representations were compulsive and/or obsessive and they had unresolved losses and traumas. They repeated their own childhood history with their own children, but failed to see the connection between their current situation and their childhood experiences.
#528
THE COOL WEB OF ATTACHMENT: MOTHERS’ REPRESENTATIONS OF THEIR INFANTS AND LINKS TO CURRENT CAREGIVING AND PAST EXPERIENCES.
Balbernie, R., Swiss Cottage, The Park, Painswick, Gloucestershire, GL6 6SN. United Kingdom. balbernie@connectfree.co.uk.
This study examined the way in which different caregivers described both their infants and the relationship between the pair of them. It was based on a clinical sample of five mothers who all had been seen for infant-parent psychotherapy. Each subject was asked a series of set questions, and their answers were recorded and transcribed. In addition, one other mother was interviewed to provide a non-clinical comparison.
The transcripts of all the interviews were examined to discover how often, and in what way, the internal and external worlds of infant and mother were acknowledged. Both the answers to the questions and the manner in which the descriptions were put together and presented have been set in their individual contexts to demonstrate a continuity between each mother’s replies and their own past relationship history. A coding system was created in order to compare certain features of the data and to display how each mother built up a representation of their child and herself. When put in the form of a table each caregiver’s use of language showed certain specific features that appeared to correlate with the amount of strain that marked the relationship with their child. The results also demonstrated a variation in the fluency of discourse similar to that found by other studies where it has been shown to indicate the probability of a child developing a secure or insecure attachment.
#529
A LONGITUDINAL STUDY OF ATTACHMENT IN A DYAD OF A DEPRESSED MOTHER AND HER YOUNG INFANT (DURING THE FIRST 40 WEEKS OF POSTNATAL PERIOD).
Widyawati, I., Shirataki, S., Indriastuti, L., Wiguna, T. Department of Psychiatry, Medical Faculty, University of Indonesia, 6 Salemba Street, Jakarta (10430) Indonesia. Ikgandha@dnet.net.id.
The objective of this study was to evaluate mother–infant interaction of a depressed mother and her young infant, every 3 weeks during the first 40 weeks of postnatal period by video-camera. Methodology: 1) The mother-infant interaction was analyzed by Conditional probability analyses with a log sequential concept. 2). Maternal depressive symptomatology was measured by Hamilton Rating Scale for Depression (HRS-D). Result: 1). There was clear difference between the mother-infant interaction of the depressed mother and the non-depressed mother; 2). The number of mother’s movements was also different between the depressed mother and the non-depressed mother; 3). The behavioral responsiveness of the non-depressed mother was very clear difference than the behavioral responsiveness of the non-depressed mother during the first 20 weeks, but not in the second 20 weeks. Conclusion : there is a qualitative and quantitative difference between the mother-infant interaction of a depressed and a non-depressed mother.