Does premature birth affect Brazilian parents' practices related to infant positioning? / A prematuridade afeta as práticas maternas brasileiras relacionadas ao posicionamento de lactentes?

Abstract Objective: To verify whether the time spent in prone, supine, or seated positions differed between term and preterm infants; and to determine whether a single verbal guidance session for parents changed the time spent in different positions, and, consequently, the motor development scores, after one month in preterm infants. Methods: Sixty-one infants from a full-term and preterm group from Brazil were included. Motor development was assessed by the Alberta Infant Motor Scale (AIMS) and the parents registered the time spent in each position on a 24-hour schedule. A month after verbal guidance, a second assessment was performed only on the preterm infants. Results: The positioning times awake determined for the full-term and preterm parents were similar. Preterm infants spent more time in the prone sleeping position (2.1 vs. 0.8 h; p=0.037) than full-term infants. The AIMS percentile scores did not differ significantly between the groups. For preterm infants, the time spent in all positions did not change during the second assessment (n=18). Conclusions: The fact that some parents position their infants in the prone posture during sleeping periods reinforce the importance of parental education approaches for sudden infant death syndrome (SIDS) prevention during the first months of life. The verbal guidance provided to parents of preterm infants did not influence the AIMS percentile and time spent in various positions but increased preterm parents' confidence in placing their infants in a prone position to play.

RESUMO Objetivo: Verificar se o tempo nas posições prono, supino ou sentado difere entre lactentes a termo e pré-termo; bem como determinar se uma única sessão de orientação verbal aos pais alterou o tempo despendido nas diferentes posições e, consequentemente, o escore de desenvolvimento motor, após um mês em lactentes pré-termo. Métodos: Foram incluídos 61 lactentes brasileiros nos grupos a termo e pré-termo. O desenvolvimento motor foi avaliado pela Alberta Infant Motor Scale (AIMS), e os pais registraram o tempo despendido em cada posição em uma linha do tempo de 24 horas. Um mês após a orientação verbal, uma segunda avaliação foi realizada apenas nos lactentes pré-termo. Resultados: O tempo de posicionamento acordado determinado pelos pais de lactentes a termo e pré-termo foi semelhante. Os lactentes pré-termo passaram mais tempo dormindo na posição prona (2,2 vs. 0,8 h; p=0,037) do que os lactentes a termo. Os escores de percentil AIMS não diferiram significativamente entre os grupos. Para lactentes pré-termo, o tempo despendido em todas as posições não se modificou durante a segunda avaliação (n=18). Conclusões: O fato de alguns pais posicionarem os lactentes em decúbito ventral durante os períodos de sono reforça a importância das abordagens educativas parentais para a prevenção da síndrome da morte súbita do lactente (SMSL) durante os primeiros meses de vida. A orientação verbal fornecida aos pais de prematuros não influenciou o percentil da AIMS e o tempo de permanência em várias posições, mas aumentou a confiança dos pais de lactentes prematuros em utilizar a posição prona para brincar.

Psychological distress and mother-child relationship: influence of life context on a population sample (BRISA) through the use of directed acyclic graphs (DAG)

This study aimed to investigate the association between maternal psychological distress and impairment in mother-child relationship in a sample from a Northeast capital city in Brazil with a low Human Development Index, using directed acyclic graphs (DAG). A total of 3,215 women were evaluated for the presence of psychological distress through the Self Reporting Questionnaire instrument and for the mother-child relationship by the first factor of Postpartum Bonding Questionnaire, considered the most appropriate in the literature. Demographic and socioeconomic variables were used to construct a theoretical model and, after this, multivariate logistic regression was performed using variables suggested by Directed Acyclic Graphs (DAG). Psychological distress was present in 22.7% of the women and 12.6% of them presented impaired mother-child relationships. After adjustment, the variable 'maternal mental distress' remained associated with impaired mother-child relationship (RR=3.03), and among the explanatory variables only 'primary school level' (RR=1.48) was associated as a risk factor to this outcome. The results indicated that, in this population, women with psychological distress and lower schooling are more likely to present impaired mother-child relationships.

Codification method and Categories of Content of the Baby-directed Maternal Speech / Método de Codificação e Categorias de Conteúdo do Discurso Materno Dirigido a Bebês

Abstract The maternal speech oriented to the baby has been widely studied due to its importance for the child's development. In this article we present a research method and a set of content categories of maternal speech directed to the child. This methodological proposal is based on a survey of 80 dyads of mothers and babies, with and without postpartum depression (PPD). The distribution of frequency of the categories was similar in both groups. There was no statistical difference in the means of categories for mothers with and without PPD, indicating that there is no change in speech style due to maternal depression. In our view, these categories could be applied to study the speech of both healthy mothers and those with postpartum depression.

Resumo O discurso materno direcionado ao bebê tem sido amplamente estudado devido a sua importância no desenvolvimento infantil. Neste artigo apresentamos um método de investigação e um conjunto de categorias de conteúdo do discurso materno direcionado à criança. Esta proposta metodológica baseia-se numa pesquisa realizada com 80 díades de mães e bebês, com e sem depressão pós-parto (DPP). A distribuição das frequências das categorias foi semelhante nos dois grupos. Não houve diferença estatística nas médias das categorias para as mães com e sem DPP, indicando que não há mudança no estilo de discurso em função da depressão materna. Consideramos que as categorias podem ser aplicadas no estudo do discurso de mães saudáveis ou com depressão pós-parto.

Estilos de cuidado materno em primatas: considerações a partir de uma espécie do Novo Mundo / Styles de soins maternels dans les primates: considerations d'une espèce du Nouveau Monde / Estilos de cuidado materno en primates: consideraciones a partir de una especie del Nuevo Mundo / Maternal care styles in primates: considering a New World species

Resumo Quando buscamos entender o comportamento humano, comparações com primatas não humanos são especialmente relevantes para identificar homoplasias (características semelhantes que evoluem independentemente em diferentes espécies). Neste artigo, apresentamos um estudo longitudinal de dois anos sobre o comportamento materno de macacos-prego (Sapajus spp.) em condições naturalísticas. Nossos resultados permitiram identificar estilos de cuidado distintos dentro de um contínuo de permissividade a proteção. O desenvolvimento observado do vínculo entre mães e filhotes sugere que o período de dependência de filhotes de macaco-prego envolve, além de processos de maturação física, o estabelecimento e desenvolvimento de processos psicológicos associados ao sistema de apego. É possível que a variabilidade de estilos maternos resultante da combinação de características de mães, filhotes e contextos socioecológicos, aliada ao prolongamento do vínculo de apego, pavimente caminhos para diferentes trajetórias de desenvolvimento. Como em humanos, esse pode ser um dos mecanismos pelos quais surgem e se consolidam as diferenças interindividuais nas populações adultas.

Résumé Lorsque nous cherchons à comprendre le comportement humain, les comparaisons avec les primates non humains sont particulièrement pertinentes pour identifier les homoplasies (caractéristiques similaires qui évoluent indépendamment dans différentes espèces). Dans cet article, nous présentons les résultats d'une étude longitudinale de deux ans sur le comportement maternel du Sapajou capucin (Sapajus spp.) dans des conditions naturelles. Nos résultats nous ont permis d'identifier différents styles de soins maternels dans un continuum de permissivité à la protection. Nous avons observé que le modèle de lien d'attachement entre la mère et la progéniture suggère que la période de dépendance des bébés singes implique, en plus des processus de maturation physique, l'établissement et le développement de processus psychologiques associés au système d'attachement. Il est possible que la variabilité des styles maternels résultant de la combinaison des caractéristiques de la mère, de la progéniture et du contexte socioécologique, ainsi que l'extension du lien d'attachement, ouvrent la voie à différentes trajectoires de développement. Comme les humains, il peut être un des mécanismes par lequel les différences interindividuelles apparaissent et se consolident au sein des populations adultes.

Resumen Cuando buscamos entender el comportamiento humano, comparaciones con primates no humanos son especialmente relevantes para identificar homoplasias (características similares que evolucionan independientemente en diferentes especies). En este artículo, presentamos los resultados de un estudio longitudinal de dos años sobre el comportamiento materno de monos capuchinos (Sapajus spp.) en condiciones naturales. Los resultados permitieron identificar estilos de cuidado materno distintos dentro de un continuo de permisividad a la protección. Se observó que el patrón de desarrollo del vínculo de apego entre madre y cría sugiere que el período de dependencia de la cría de monos capuchinos involucra, además de procesos de maduración física, el establecimiento y desarrollo de procesos psicológicos asociados al sistema de apego. Es posible que la variabilidad de estilos maternos resultante de la combinación de características de madres, crías y contextos socioecológicos, aliada a la prolongación del vínculo de apego, establezca caminos para diferentes trayectorias de desarrollo. Tal como en humanos, este puede ser uno de los mecanismos por los que surgen y se consolidan las diferencias interindividuales en las poblaciones adultas.

Abstract When aiming understand the human behavior, comparisons with nonhuman primates are especially relevant to identify homoplasies (similar characteristics that evolve independently in different species). In this paper, we present a two-year longitudinal study on the maternal behavior of capuchin monkeys (Sapajus spp.) under naturalistic conditions. Our results revel distinct maternal care styles within a continuum ranging from permissiveness (laissez-faire) to protectiveness. The observed development of mothers and infants bond suggests that the dependence period of capuchin monkeys infants involves, in addition to physical maturation processes, the establishment and development of psychological processes associated with the attachment system. It is possible that the variability of maternal styles - resulting from the combination of mothers' and infants' characteristics, as well as socioecological contexts, along with the extension of the attachment bond - are responsible for paving the way for different developmental trajectories. This may be one of the mechanisms underlying interindividual differences arise in adult populations, as seen in humans.

Conocimientos sobre los aspectos formales y referenciales del dibujo, la escritura y los numerales en la lectura compartida entre madres y niños pequeños / Knowledge about the formal and referential aspects of drawing, writing and numerals during mothers and young children shared book reading

Los niños construyen conocimientos sobre los sistemas de representación externa en interacción con adultos que obran como mediadores de sus procesos cognitivos. Distintas investigaciones muestran que los niños reconocen el dibujo a partir de los 2 años y medio y pueden diferenciar entre dibujo, escritura y numerales alrededor de los 4 años. En este estudio se examinan los conocimientos sobre las propiedades formales y la función referencial de estos tres sistemas que niños de 2 años y medio y 4 años despliegan junto con sus madres durante la lectura compartida de un libro. Para ello se utilizó un libro que presenta en cada página dibujos de un animal, su nombre escrito y el numeral correspondiente a la cantidad de animales (1 a 9). Los análisis se centran en el foco de atención de las díadas, los aspectos del conocimiento notacional y las bases comunicativo-educativas de las interacciones, en función de la edad de los niños. Los resultados indican que las díadas centraron su atención en la función referencial del dibujo, como representación de la identidad del referente a los 2 años y medio, y de la identidad y la cantidad a los 4 años. Aunque la atención en la escritura y los numerales fue menor, las madres de los niños más pequeños brindaron información sobre las propiedades formales de los numerales, y las madres y los niños de 4 años elaboraron este aspecto del conocimiento de ambos sistemas. Se discuten estos resultados en relación con el potencial de la lectura compartida para la apropiación temprana del conocimiento notacional.

Children acquire knowledge about external representational systems in interaction with adults who operate as mediators of their cognitive processes. Several studies have shown that 2.5-year-old children are able to recognize drawings, and 4-year-old children can distinguish between drawing, writing and numerals. The present study focuses on a developmental analysis of the knowledge about the formal properties and the referential function of these three systems that 2.5- and 4-year-old children unfold with their mothers during shared reading sessions. The referential function is the representational relation between the system and the referent. Each system has a referential function that is the result of a social convention: figurative drawing depicts the identity and characteristics of the referent, writing is a graphic representation of oral language and numerals represent numerical information. The formal properties include the name of the representational systems and their graphic units, the form of the strokes, their spatial disposition and their compositional rules. Our specific goals were:(1) to establish which representational system isthe main focus of attention; (2) to describe and analyze whether and how mothers and children elaborate knowledge about the formal properties and referential function of the systems; (3) to understand how notational knowledge emerges describing the educative-communicative basis of the interactions; and (4) to compare the focus of attention, notational knowledge and the educative-communicative basis of interactions as a function of children's age. Twenty-six mothers and their 2.5- (n = 13) and 4-year-old children (n = 13) participated. They were given a book and told to look at it together. The book was specially designed for this study; it includes in each page drawings of an animal, its written name and the numeral for the number of animals depicted (1 to 9). We designed a system of categories with three levels of analysis, related to the specific goals of the study: focus of attention, notational knowledge and educative-communicative basis. We performed non-parametric statistical analysis: Wilcoxon test and Mann- Whitney's U test. Results show that dyads of both age groups focused their attention on drawings more than on writing and numerals. However, 4-year-old children and their mothers made significantly more utterances about writing and numerals than the other group. Attention to writing and numerals in the older group seemed to be guided by mothers' interest to teach those systems to their children. Dyads talked especially about the referential function of drawing, as a representation of the identity of the referent at 2.5 years of age and as a representation of the identity and quantity at 4 years. Although less attention was paid to writing and numerals, the youngest children's mothers provided information about the formal properties of numerals and the mothers and the 4-year-old children elaborated this aspect of knowledge of both representational systems. Furthermore, in the older group, dyads started to discuss the referential function of numerals. With regard to the educative-communicative basis of the interactions, the mothers of both age groups tended to request information about the referents of drawings more than to provide their children with this kind of information. The mothers in the 2.5-year-olds' group provided information about the formal properties of numerals, while in the 4-year-olds' group the mothers both requested and provided this kind of information. Finally, the formal properties of writing were elaborated only by mothers in the older group. We discuss these results in terms of the potential of shared reading for the early acquisition of notational knowledge.

A influência da idade gestacional nas habilidades do desenvolvimento infantil e a qualidade da interação na díade mãe-bebê ao longo do primeiro ano de vida / The influence of gestational age on abilities of infant development and the quality of interaction in the mother-infant dyad throughout the first year of life

A idade gestacional é uma medida importante, pois quando o bebê nasce antes da 37ª semana há riscos para alterações do desenvolvimento. A relação dos bebês com pais fornece base para o desenvolvimento dos padrões de autorregulação, para o aumento da sensibilidade materna, e para o desenvolvimento do apego. Permeando a hipótese de que, a idade gestacional pode influenciar no desenvolvimento infantil, o objetivo do estudo foi verificar a influência da idade gestacional nas habilidades do desenvolvimento infantil (motora grossa, motora fina-adaptativa, pessoal-social e de linguagem) e a qualidade da interação na díade mãe-bebê, ao longo do primeiro ano de vida (três, nove e 12 meses). Cumpriram-se os princípios éticos. Participaram do estudo 28 díades mãe-bebê, com crianças nascidas entre a 32ª a 40ª semana de gestação, recrutadas ao nascimento. Aos três meses os familiares foram contatados para a primeira avaliação, que constou da aplicação do protocolo de anamnese, aplicação do procedimento Face to Face Still-Face (FFSF) e do Teste de Screnning de Desenvolvimento Denver II (TSDD-II). Aos nove meses repetiu-se a aplicação do FFSF, TSDD-II e foi verificada a qualidade da interação por meio do Child-Adult Relationship Experimental Index (CARE-Index). Aos 12 meses repetiu-se a medida do desenvolvimento TSDD-II e foi aplicada o paradigma laboratorial da Situação Estranha (SE). O tratamento estatístico constou de análise descritiva e aplicação do Teste de Correlação de Spearman, Teste exato de Fischer, Teste de Mann-Whitney e Teste Anova de Medições Repetidas. Os resultados indicaram influência da idade gestacional nas habilidades do desenvolvimento infantil (motora grossa, motora finaadaptativa, pessoal-social e de linguagem), aos três, nove e doze meses, com valor maior nível de significância aos três meses. A qualidade da interação avaliada por meio do CARE-index, indicou predomínio de mães com alto nível de sensibilidade (81,82%). Os padrões de autorregulação avaliados por meio do procedimento FFSF indicaram que 57,14% da casuística apresentaram orientação social não positiva e 42,86% orientação social positiva aos três e aos nove meses 78,57% orientação social não positiva e 21,43% orientação social positiva. O padrão de Apego, avaliado pela SE, verificou apego inseguro para 60,71% e apego seguro em 39,29% da casuística.(AU)

Gestational age is an important baseline because when the infant is born before the 37th week there are risks for developmental changes. The relationship between infants and parents provides a basis for the development of self-regulation standards, for the increase of maternal sensitivity, and for the development of attachment. Permeating the hypothesis that gestational age may influence infant development, this study aimed to verify the influence of gestational age on infants developmental skills (gross motor, fine-adaptive motor, personal-social and language), and the quality of gestational age of the mother-infant dyad interaction during the first year of life (three, nine and 12 months). Ethical principles were fulfilled. The study included 28 mother-infant dyads, with children born between the 32nd and 40th weeks of gestation, recruited at birth. At three months old the family members were contacted for the first evaluation, which included the application of the protocol of anamnesis, application of the Face to Face Still-Face (FFSF) procedure and the Denver Development Screening Test II (DDST-II). At nine months the FFSF, DDST-II was repeated and the quality of the interaction was verified through the Child-Adult Relationship Experimental Index (CARE-Index). At 12 months the DDST-II development measurement was repeated and the laboratory paradigm of the Strange Situation (SE) was applied. The statistical treatment consisted of descriptive analysis and application of Spearman's Correlation Test, Fischer's Exact Test, Mann-Whitney Test and Repeated Measures Anova Tests. The results indicated the influence of gestational age on infant's developmental abilities (gross motor, fine-adaptive motor, personal-social and language) at three, nine and twelve months, with a higher level of significance at three months old. The quality of the interaction evaluated through CARE-index, indicated predominance of mothers with a high level of sensitivity (81.82%). Self-regulation standards assessed through the FFSF procedure indicated that 57.14% of the case analysis had non-positive social guidance and 42.86% had positive social guidance at three, and at nine months 78.57% non-positive social guidance and 21.43% positive social orientation. The Attachment pattern, evaluated by the SE, found unsafe attachment to 60.71% and Secure attachment in 39,29% of the cases analysis.(AU)

Fatores de risco e desenvolvimento sociocomunicativo em prematuros / Risk factors and social communicative development of preterms / Factores de riesgo y desarrollo sociocomunicativo en prematuros

INTRODUÇÃO:Neonatos prematuros com baixo peso ao nascer podem apresentar déficits neurológicos e alterações no desenvolvimento sociocomunicativo. Interações iniciais mãe-bebê são importantes para avaliar esse processo de risco, verificado a partir de alterações na comunicação não verbal. OBJETIVO: verificar a relação entre fatores de risco, sociodemográficos e desenvolvimento sociocomunicativo de prematuros para cada grupo de díades em quatro momentos do desenvolvimento. MéTODO: participaram 18 díades com idade gestacional < 36 6/7 semanas e peso ao nascer < 2.500 gramas. As sessões aconteceram aos três, seis, nove e doze meses de vida. RESULTADOS: verificou-se que somente as crianças do grupo MP iniciaram interações triádicas aos nove meses (M = 0,16; DP = 0,40). Habilidade envolvendo pessoa, aos três meses, estava positivamente associada ao peso ao nascer (0,812; p < 0,05) e ao apgar 5 (0,861; p < 0,05). CONCLUSÃO: fatores de riscos e sociodemográficos interferem no desenvolvimento sociocomunicativo de prematuros.

INTRODUCTION:Premature infants with low birth weight can have neurologicals deficits and changes in social and communicative development. early mother-infant interactions are important to evaluate the process of risk, checked from changes in non-verbal communication. OBJECTIVE: Check the relationship between risk factors, socioeconomic and social communicative development of preterms to each group in four stages of development. METHODS: eigtheen dyads participated with gestational age < 36 6/7 weeks and birth weight <2500 grams. The sessions took place at three, six, nine and twelve months. RESULTS: Was found that only children in the MP group initiated triadic interactions at nine months (M = 0,16; DP = 0,40). The ability involving person at three months was positively associated with weight at birth (0,812; p < 0,05), the apgar 5 (0,861; p < 0,05). CONCLUSION: Risk and socioeconomic factors influence the social communicative development of preterms.

INTRODUCCIÓN:los recién nacidos prematuros con bajo peso al nacer pueden tener déficits neurológicos y cambios en el desarrollo de la atención. Interacciones tempranas madre-hijo son importantes para evaluar el proceso de riesgo, comprobado por los cambios en la comunicación no verbal. META: Compruebe la relación entre los factores de riesgo, socioeconómico y atención el desarrollo de cada grupo en cuatro etapas de desarrollo. MÉTODOS: Incluyendo 18 díadas con edad gestacional < 36 semanas 06/07 y el peso al nacer <2.500 gramos. Las sesiones tuvieron lugar en tres, seis, nueve y doce meses. RESULTADOS: Se encontró que sólo los niños del grupo MP empezaron interacciones triádicas a los nueve meses (M = 0,16, SD = 0,40). Habilidad implica persona a los tres meses se asoció positivamente con el peso al nacer (0,812; p < 0,05) y apgar5 (0,861; p < 0,05). CONCLUSIÓN: factores de riesgo y socioeconómicos interfieren en el desarrollo atención de los bebés prematuros

Repercussões da depressão pós-parto no desenvolvimento infantil / Repercussions of postpartum depression on child development / Repercusiónes de la depresión posparto en el desarrollo infantil

O presente trabalho tem como objetivo apresentar uma revisão da literatura científica nacional sobre as repercussões para o desenvolvimento emocional, social, comportamental e cognitivo do bebê, em contexto de depressão puerperal materna. Nesta revisão, foram recuperados trabalhos segundo os seguintes critérios de inclusão: artigos científicos de periódicos indexados, com publicação entre 2006 e 2012, no idioma português e que correlacionassem depressão pós-parto e desenvolvimento infantil. Foram excluídos livros, capítulos, notícias, resenhas, dissertações, teses, monografias, artigos com publicação anterior a 2005, trabalhos em idiomas estrangeiros e artigos que tratassem da depressão pós-parto somente em seus aspectos etiológicos. Foi observado que a depressão pós-parto é um fator de risco para o desenvolvimento infantil, pois os bebês que viveram tal contexto apresentam apego inseguro, menos exploração do ambiente, sono irregular, baixa autoestima, ansiedade e maior probabilidade de desenvolverem depressão na idade adulta. É essencial que o transtorno seja identificado para que a mãe e o bebê recebam cuidado profissional adequado, minimizando os prejuízos da depressão pós-parto para ambos e para a família.

This work aims to present a review of the scientific literature on the domestic repercussions for the emotional, social, behavioral and cognitive development baby on the context of maternal postpartum depression. In this review, papers were recovered according to the following inclusion criteria: scientific articles in indexed journals, having published between 2006 and 2012 in Portuguese and correlating postpartum depression and child development. Were excluded books, chapters, news, reviews, dissertations, theses, monographs, articles with publication prior to 2005, works in foreign languages and articles that treat postpartum depression only in their etiological aspects. It was observed that postpartum depression is a risk factor for child development because babies who have lived this context exhibit insecure attachment, less environmental exploration, irregular sleep, low self-esteem, anxiety and more likely to develop depression in adulthood . It is essential that the disorder is identified for the mother and baby receive appropriate professional care, minimizing the losses of postpartum depression for both and for the family.

Este trabajo tiene como objetivo presentar una revisión de la literatura científica sobre las repercusiones para el desarollo emocional, social, cognitivo y de comportamento del bebé en el contexto de la depresión posparto materna. En esta revisión, los documentos fueron recuperados de acuerdo con los siguientes criterios de inclusión: artículos científicos en revistas indexadas, después de haber publicado entre 2006 y 2012, en portugués y en la correlación de la depresión post-parto y el desarrollo del niño. Fueron excluidos los libros, capítulos, noticias, reseñas, tesinas, tesis, monografías, artículos con publicación antes de 2005, las obras en lenguas extranjeras y artículos que tratan la depresión posparto sólo en sus aspectos etiológicos. Se observó que la depresión posparto es un factor de riesgo para el desarrollo del niño, porque los bebés que han vivido este contexto exposición apego inseguro, exploración ambiental menor, sueño irregular, baja autoestima, ansiedad y más propensos a desarrollar depresión en la edad adulta. Es esencial que el trastorno se identifica para la madre y el bebé reciben atención profesional adecuada, minimizando las pérdidas de la depresión posparto para ambos e para la família.

Interacciones tempranas madre-niño y predicción de desarrollo motor mediante ecuaciones estructurales: Aplicación del modelo en niños con riesgo de daño neurológico perinatal / Mother-child interactions and early motor development prediction using structural equation: Application of the model in children with perinatal risk of neurological damage

Los impactos más importantes de las expresiones tempranas del daño neurológico en los niños, son las dificultades para establecer intercambios con su medio social, afectando en la etapa inicial las primeras interacciones con su madre. Niños con riesgo biológico muestran grandes dificultades para iniciar interacciones. Cuando las madres se ajustan en una relación bidireccional se logra un aumento en las iniciaciones del niño; si las madres responden menos, los niños disminuyen las iniciaciones y aumentan la irritabilidad. Los programas de intervención temprana que integran en sus estrategias el manejo de las interacciones madre-niño se han considerado exitosos por sus implicaciones directas en el desarrollo del niño. Se requiere mayor soporte empírico sobre la influencia de patrones específicos de interacciones tempranas madre-hijo y el desarrollo posterior de niños con daño neurológico perinatal, en términos de prevención de alteraciones o discapacidad. Se realizó un estudio longitudinal y se reporta el efecto de las interacciones de reciprocidad madre-hijo en el desarrollo motor observado en niños a los 4, 8 y 12 meses de edad, a través del empleo del Modelo de Ecuaciones Estructurales (Curva de Crecimiento Latente). Se concluye que el modelo permitió mostrar que en niños de riesgo perinatal, las interacciones madre-hijo representan un buen predictor del desarrollo motor en el primer año de vida. Estos hallazgos tienen importantes implicaciones en la práctica clínica como estrategia integral para el diseño de acciones de intervención temprana debido a que los logros motores en los primeros meses representan un indicador predictivo del desarrollo infantil posterior.

The most important impact of early expressions of neurological damage in children is the difficulty of mixing up in their social environment which at the beginning affects their interactions with their mother. Children with biological risks show great difficulties to begin interactions. When mothers get adjusted to bidirectional relations with neurologically damaged children, an increase in the commencement of interactions by a child is achieved, while fewer responses of the mother to child produce fewer interactions and increases irritability. Early intervention programs which contain in their strategies management of mother-infant interactions have been considered effective for child development. However, further empirical studies are required, concerning the influence of specific patterns of early mother-infant interaction and future development of children with perinatal neurological damage, in terms of prevention of alterations or disability. The present longitudinal study reports the effect of reciprocity of mother-infant interactions in the motor development observed in children of 4, 8, and 12 months old, latent growth curve in structural equation modeling. This model permits the identifications of causal factors that could affect the results in different age groups and provides predictions of the relations in a more complex form than lineal relations. Based on the model designed, it could be shown that mother-infant interactions of reciprocity best characterized children with higher development level while the absence is seen in children with retarded development. We classified mothers and children in two types, respectively: interactive and organized mothers vs. non-interactive and disorganized ones; interactive and responsive children vs. non-interactive and non-responsive ones. Subjecting these two types of mothers and children to four possible combinations, the model results showed different motor development predictions in the children. On one hand, we estimated regression coefficient of four dyadic systems, obtained by combinations of different types of mothers and children: interactive and organized mother with interactive and responsive child (Dyadic system 1); interactive and organized mother with non-interactive and non-responsive child (Dyadic system 2); non-interactive and disorganized mother with interactive and responsive child (Dyadic system 3); and non-interactive and disorganized mother with non-interactive and non-responsive child (Dyadic system 4). Dyadic system 1 was associated with a better motor development in children with a mayor regression coefficient (19.82), followed by System 2 and System 3 (regression coefficient of 17.54 and 11.46, respectively). System 4 had a negative estimate value of regression coefficient (-11.27) in our model. On the other hand, we estimated intercept values according to the interactive type of these mothers and children. Among the four interactive types, solely two of them had statistically significant intercepts (p < .05), or = 66.13 for interactive children and or = 42.76, for non-interactive children. To predict the motor development of 4, 8, and 12 months old children, the slope with attenuation permitted to give a mayor model fitting, with the regression coefficient of 0, 1 and 1.5, respectively. This model presented excellent values of model fitting indicators (X² = .96, p = .97, CFI = 1.00, RMSEA = .00). This line of study should be widened, because motor development is the principal domain consolidated in the first months of life. It is fundamental in domain organizations of higher complexity as cognition and language. We conclude that this model showed that in high risk perinatal children, early mother-child interactions represent a good predictor of motor development in the first year of life. Moreover, we found that motor achievements in the first months of life can be a strong predictive indicator of future development of a child. These findings suggest the importance in clinical practice of observation and registration of mother-child interactions as part of an integral strategy of child evaluation.

Representações acerca da maternidade no contexto da depressão pós-parto / Representations concerning motherhood in postpartum depression context

O presente estudo investigou as representações acerca da maternidade no contexto da depressão pós-parto. Participaram do estudo duas mães encaminhadas para a realização de uma psicoterapia breve pais-bebê devido à presença de depressão no primeiro ano de vida de suas filhas. Entrevistas de avaliação realizadas antes da psicoterapia foram analisadas a partir dos quatro eixos interpretativos que constituem a constelação da maternidade, proposta por Stern (1997): vida-crescimento; relacionar-se primário; matriz de apoio; e reorganização da identidade. Nos relatos de ambas as mães apareceram representações acerca do sentimento de não ser capaz de cuidar do bebê logo após o nascimento, de ser pouco apoiada pelo companheiro, bem como uma reavaliação do relacionamento com suas próprias mães e com seus cônjuges. Verificou-se também que as representações de cada mãe apontaram para uma estreita associação entre seus conflitos pregressos e a interação atual com o marido e com o bebê.

The present study investigated the representations concerning motherhood in the context of postpartum depression. The study sample was composed by two mothers referred to a brief parent-infant psychotherapy due to depression during the first year of their daughters' life. Interviews of evaluation carried out before psycotherapy were analyzed according to four interpretative axes of the motherhood constellation proposed by Stern (1997): life-growth; primary relatedness; supporting matrix; and identity reorganization. In the stories of both mothers there were representations concerning the feeling of not being capable to take care of their baby after birth, of being little supported by their husbands, as well as a reevaluation of the relationship with their own mothers and spouses. It was verified that the representations revealed a close association between their past conflicts and the current interaction with the husband and with the baby.

Expressões faciais de emoção em bebês: importância e evidências / Babies’ facial expressions of emotion: importance and evidences

As expressões emocionais de bebês têm despertado crescente interesse, refletindo a grande importância atribuída a suas habilidades para lidar com emoções. Sua capacidade de produzir e reconhecer expressões faciais de emoção parece central para se compreender o desenvolvimento infantil, seja cognitivo, afetivo ou social. Com o objetivo de favorecer futuros trabalhos, discutem-se as lacunas encontradas na literatura voltada para expressões faciais de emoção em bebês, e a conveniência de se adotar uma perspectiva sociocultural e evolucionista na formulação de hipóteses e produção de novos estudos empíricos. Fica evidente a necessidade de mais investigações realizadas em ambiente natural e de estudos longitudinais. (AU)

The emotional expressions of babies have provoked increasing interest, reflecting the importance attributed to their abilities to deal with emotions. Babies’ capacity to produce and to recognize facial expressions of emotion seems central to understand infant cognitive, affective or social development. Aiming to presenting some orientations to new studies in this area, identified gaps in the literature are discussed, and the adoption of a socio-cultural and evolutionary perspective for new investigations is proposed. From those discussions it is evident the necessity of more studies focusing the first year of life, produced in natural context at home and with longitudinal designs. (AU)

Interações mãe-bebê de um e cinco meses: aspectos afetivos, complexidade e sistemas parentais predominantes / Mother-infant (one and five months) interactions: affective aspects, complexity and predominant parental systems

Interações iniciais parecem ser adaptativas, e conhecê-las é fundamental para compreender a ontogênese humana. Este estudo compara dados de observações de díades mãe-bebê, analisando os comportamentos dos parceiros, a complexidade das trocas e seu componente afetivo. Participaram 56 díades (28 com bebês de um mês e 28 com bebês de cinco meses), filmadas em suas casas em situações livres. Foram identificados e analisados episódios de interação. Os resultados indicaram efeito do fator tipo de díade (de bebês de um ou de cinco meses) em quatro variáveis dependentes que indicam complexidade das interações. Diferenças foram observadas nos dois grupos quanto à manifestação de afetividade recíproca dos parceiros. As interações mostram-se predominantemente de tipo face-a face quando os bebês têm um mês e de estimulação por objeto aos cinco meses, indicando assim uma tendência observada em grupos urbanos ocidentais. As manifestações afetivas e a presença de interações que envolvem o sistema de contato corporal levam a que se hipotetize um padrão de autonomia relacional. Os resultados confirmam a literatura quanto à possibilidade de trocas em etapas iniciais do desenvolvimento, e o estudo contribui para o conhecimento de suas características. É destacada a afetividade, e enfatizado seu papel constitutivo nas interações, de fundamental importância no desenvolvimento infantil.

Early interactions seem to be adaptive, it is fundamental to know them in order to understand human ontogenesis. This study compares data of observations of mother-baby dyads, analyzing the behavior of the partners, the complexity of the interchanges and their affective components. The participants were 56 dyads (28 with one-month old babies and 28 with five-month old babies), filmed in their homes in free situations. Interaction episodes were identified and analyzed. The results showed the effect of the factor type of dyad (one or five months-old babies) in four dependent variables that indicate complexity of the interactions. Differences in the manifestation of reciprocal affectivity of the partners were observed in the two groups. The interactions were predominantly face-to-face when the babies are one-month old, and the system of object stimulation is predominant when the babies are five-months old. This indicates a tendency observed in Western urban groups. The affective manifestations and the presence of interactions which are characterized by the system of body contact favor the formulation of a hypothesis of the presence of an autonomous relational pattern. The results confirm the literature about the possibility of interchanges in initial stages of the development, and the study contributes for the knowledge of its characteristics. The affective aspect is stressed, and its constitutive role in interactions is emphasized, assuming its importance in child development.

Responsividade materna em famílias de mães solteiras e famílias nucleares no terceiro mês de vida da criança / Maternal responsiveness in single-mothers and two-parent families at three months of child’s life

O presente estudo investigou a responsividade materna no terceiro mês de vida do bebê em famílias de mães solteiras e famílias nucleares. Participaram do estudo 21 díades mãe-bebê, das quais sete de mães solteiras e quatorze de mães casadas. Uma sessão de observação da interação livre entre mãe e bebê foi utilizada para a avaliação da responsividade materna. Foram examinadas 21 seqüências responsivas e três seqüências não-responsivas envolvendo o sorriso, as vocalizações e o choro do bebê. O Teste Mann-Whitney revelou diferenças significativas entre os dois grupos tanto nas seqüências responsivas, como nas não-responsivas, indicando que as mães solteiras foram menos responsivas do que as mães casadas, em especial, no que se refere à vocalização e ao choro do bebê. Esses resultados corroboram parte da literatura que indica que as mães solteiras podem sofrer maior estresse quando precisam suprir sozinhas as demandas do bebê, principalmente no seu primeiro ano de vida, o que pode ter implicações para a relação da díade.

The present study investigated the maternal responsiveness in the third month of infantïs life in single mothers' families and nuclear families. Twenty one mother-infant dyads participated in the study seven of which were single mothers and fourteen were married mothers. A free interaction session between mother and infant was observed for evaluation of maternal responsiveness. Twenty-one responsive sequences and three non-responsive sequences involving infantïs smile, vocalizations and cry were examined. Mann-Whitney test revealed significant differences between the two groups in the responsive and non-responsive sequences, indicating that single mothers were less responsive than the married mothers, especially regarding infantïs vocalization and cry. The results give support to part of the literature that indicates that single mothers can suffer larger stress when they need to supply alone the infantïs demands, mainly during his/her first year of life, which can have implications for the dyadic relationship.

O bebê imaginado na gestação: aspectos teóricos e empíricos / The imagined baby during pregnancy: theoretical an empirical aspects

Com base na literatura, discute-se neste artigo a construção do bebê imaginado feita pela mãe durante a gestação. São apresentados relatos de quatro gestantes que no início do estudo se encontravam no terceiro trimestre gestacional. Elas foram entrevistadas, no final da gestação e no terceiro e oitavo mês de vida do bebê. Nestas entrevistas abordavam-se os sentimentos e expectativas sobre a maternidade e sobre o bebê. A partir da teorização psicanalítica analisaram-se os relatos das gestantes sobre o bebê imaginado no qual a mãe investe a sua libido no intuito de constituir espaço subjetivo para receber o bebê da realidade. A partir deste estudo sugere-se que o bebê imaginado tem um importante impacto para a futura interação mãe-bebê.

Based on the literature, the mother's construction of the imagined baby during pregnancy is discussed. Reports of pregnant women who were in the third trimester of pregnancy at the beginning of the study are presented. They were interviewed at the end of pregnancy and in the baby's third and eighth month. In these interviews the feelings and expectations concerning motherhood and the baby were explored. Based on psychoanalytic theory we analyzed the pregnant women's reports concerning the imagined baby in whom the mother invests her libido in order to constitute a subjective space to receive the baby of reality. From this study it is suggested that the imagined baby has an important impact on the future mother-infant interaction.

Con base en la literatura, se discute en este artículo la construcción del bebé imaginado hecha por la madre durante el embarazo. Se presentan relatos de cuatro embarazadas que al inicio del estudio estaban en el tercer trimestre gestacional. Las entrevistas se hicieron al final del embarazo, en el tercer y octavo mes de vida del bebé. En estas entrevistas se abordaban los sentimientos y expectativas sobre la maternidad y sobre el bebé. A partir de la teoría psicoanalítica, se analizaron los relatos de las embarazadas sobre el bebé imaginado, en el que la madre invierte su libido con el objetivo de constituir un espacio subjetivo para recibir al bebé de la realidad. A partir de este estudio se sugiere que el bebé imaginado tiene un impacto importante para la futura interacción madre-bebé.

Responsividade materna: aspectos biológicos e variações culturais / Maternal responsiveness: biological aspects and cultural variations

Este artigo tem como objetivo discutir criticamente alguns aspectos biológicos e variações culturais relativos ao conceito de responsividade materna. Está subdividido em duas partes. A primeira delas trata da responsividade e seus aspectos biológicos e variações culturais. A segunda apresenta duas grandes tendências de pesquisa sobre responsividade materna e variações culturais. As considerações finais sistematizam os argumentos críticos apresentados e destacam que as iniciativas de investigar este tema devem estar pautadas pelo reconhecimento de que a responsividade materna é uma das características das interações adulto-criança que tem origens e influências múltiplas. Nesse sentido, a sua compreensão deve estar incluída em um sistema amplo de referência que envolva, por exemplo, variáveis biológicas, contextuais, da história da díade e culturais.

The purpose of this article was to critically discuss some biological aspects and cultural variations in maternal responsiveness. It consists of two parts. The first discusses responsiveness and its biological aspects and cultural variations. The second part presents two major research tendencies in the investigations of cultural variations in maternal responsiveness. Our conclusion presents a brief of the critical arguments and highlights the need to recognize that maternal responsiveness is one of the adult-child interaction characteristics that has multiple origins and influences, from which any investigation in this theme must be based on. As a consequence, those initiatives should be included in a wide reference system that involves, for example, biological, contextual, dyads previous history, and cultural variables.

Expressão da capacidade de empatia em bebês de 8 e 18 semanas / The expression of empathy in infants of 8 and 18 weeks

Este estudo investigou o padrão temporal e expressivo da capacidade de empatia em bebês de 8 e 18 semanas no contexto de interações face-face entre 90 duplas de mãe-bebê. As interações foram analisadas em tempo real e através de micro-análise. Alguns comportamentos infantis apresentaram maior probabilidade de fazerem parte do padrão expressivo da empatia do que outros. Ainda, o padrão expressivo se manifestou diferente em instâncias de empatia com emoções negativas e instâncias de empatia com emoções positivas comunicadas pela mãe. Em relação ao padrão temporal, observou-se que a manifestação da capacidade de empatia ocorreu dentro de um intervalo de tempo igual de ½ segundo antes e 1 segundo depois da mudança emocional da mãe. Os resultados indicam a necessidade de reavaliação das proposições tradicionais sobre as capacidades comunicativas precoces de bebês, e sugerem uma coerência entre os achados e as proposições teóricas contemporâneas na área da Psicologia Infantil.

The present study examined the expressive and temporal pattern of empathy in 8- and 18-week-old babies. Infant empathy was observed in the context of face-to-face interactions of 90 mother-infant dyads, seen both at 8 and 18 weeks. These interactions were observed and analyzed both, in real time and micro-analytically. Certain infant behaviors were more likely to be involved in the expressive pattern of infant empathy than others. In addition, the expressive pattern of infant empathy was found to be quite different in the case of the infant empathizing with positive and negative maternal emotions. In relation to its temporal pattern, it was observed that infant empathy occurred in a time-interval of ½ second before and 1 second after the emotional change in the mother. The results suggest the re-evaluation of traditional beliefs concerning early infant communicative capacities, while contemporary theoretical contexts are discussed.

The Effects of Infant Massage on Weight, Height, and Mother-Infant Interaction / 간호학회지

PURPOSE: The purpose of this study was to test the effects of infant massage (auditory (mother's voice), tactile/kinesthetic (massage) and visual (eye to eye contact) stimulation) on weight and height of infant and mother-infant interaction with normal infants over a period of 4 weeks. METHOD: This study was designed as a nonequivalent control group pretest-posttest design. The experimental group infants (aged 2-6 months) participated in one of the infant massage programs at the health district center for 4 weeks. The control group (N=26) was paired with the experimental group (N=26) by matching the infant's age and sex. Infant weight, height, and mother-infant interaction were measured two times and recordings of the mother-infant interaction were done using the video equipment in a room at the health center for 10 minutes. RESULTS: After 4 weeks of massage, there were no significant differences weight gain and height increase between the two groups. Comparison of the total scores for the mother-infant interaction between the two groups showed a significant difference (t=5.21, p=.000). There were also significant differences on maternal response (t=3.78, p=000), infant response (t=5.71, p=000) and dyadic response (t=4.05, p=000) in the mother-infant interaction between the two groups. CONCLUSION: Overall, the results of this study reassure that infant massage facilitates the mother-infant interaction for infants and mothers who give massage to their baby.

Development and Test of Effectiveness of a Prenatal Parental Role Education Program / 아동간호학회지

PURPOSE: This study was conducted to develop and evaluate the effectiveness of a prenatal parental role education program. Methods: The participants were healthy primiparous women and their healthy newborn babies. 57 mother-infant diads(27 in the intervention group, 30 in the control group). For the intervention group, an additional 4 prenatal parental role education programs and 2 postnatal telephone calls(1st & 3rd week after birth) were provided. Data were analyzed by frequency, chi-square test, t-test and repeated measures ANOVA using SPSS PC+ 10.0 program. RESULTS: Significant differences were found in self-confidence in maternal role performance, mother-infant interaction and infant physical growth between the two groups. This result indicate that the intervention program was effective in improving self-confidence in maternal role performance, mother-infant interaction and in facilitating infant physical growth. Conclusions: The prenatal parental role education program developed by the author was a very effective program in promoting maternal self-confidence, mother-infant interaction, and fostering infant's physical growth at 4 weeks after infant's birth.

The Effects of Sensory Stimulation on Mother-Infant Interaction, Maternal Self-Esteem and Infant Temperament / 아동간호학회지

PURPOSE: The purpose of this study was to investigate the effects of sensory stimulation conducted by primiparas on mother-infant interaction, maternal self-esteem and infant temperament. METHOD: A non-equivalent control group post-test study design was used. The data were collected from December 1, 2001 to March 30, 2003. The participants were 39 primiparas with normal birth weight infants. They were divided into two groups, 20 mothers in the intervention group and 19 in the control group. The mothers in the intervention group were given instruction on sensory stimulation by the researcher, and the mothers, in turn, used this technique on their infants twice a day during the first 2 months of life. Both groups were measured for maternal self-esteem and infant temperament using the maternal self-report inventory (MSRI) and What My Baby Is Like (WBL) and a film was made of the feeding situation when each infant was between 8 and 10 weeks of age. RESULTS: Compared to the control group, the experimental group had significantly higher scores in mother-infant interaction, maternal self-concept and infant temperament. CONCLUSION: This suggests that sensory stimulation conducted by primiparas may improve the mother-infant interaction, maternal self-esteem and infant temperament.

Effects of Meridian Massage on Weight in Infants and on Mother-Infant Interaction / 아동간호학회지

PURPOSE: This study was done to develop a new nursing intervention, Meridian Massage, and to investigate its effect on weight in infants and mother-infant interaction. METHOD: This study was conducted using a quasi experimental non equivalent control group pretest-posttest design. Thirty-one newborn infants from a postpartum Management Center were selected and assigned to two groups, experimental and control. Data were collected from February 1 to September 30, 2004. Infants in the experimental group (16) were given Meridian massage for 15 minutes daily for 6 days and weighed every day at 10 am. Using the Nursing Child Assessment Feeding Scale(1978), mother-infant interaction was determined before the treatment, after 1 week and 1 month after the massage. RESULTS: Infants in the experimental group had a higher average weight than those in the control group and the difference was significant (Z=-2.29, p=.022). For mother-infant interaction, the experimental group had higher scores than the control group, and the difference was significant between both the two groups, and the 3 measurement times. CONCLUSION: The Meridian Massage in this study showed positive weight gain and positive mother-infant interaction. This study shows that meridian massage is an effective nursing intervention in improving infant development.