Using an observation tool (Parent-Infant Interaction Observation Scale) to assess parent-infant interaction in the first 2 weeks of life: A feasibility study.

BACKGROUND: Emotional maltreatment (EM) has profound effects on the developing brain but is hardest to identify in infancy. Early observations of parent-infant interactions may provide opportunities to identify babies at risk of neglect and EM. This prospective study tests, in the first fortnight of life, the feasibility of using an observation tool previously validated for use at 2 to 7 months of age. METHODS: Women awaiting induction of labour were recruited in South Wales in July 2016. Women consented to being contacted postnatally and video recordings of mother-infant interaction at two home visits between 7 and 10 days (T1) and 8-12 weeks old (T2). Demographic details, information on the pregnancy, delivery, and infant condition were obtained at T1. A questionnaire was completed at T2 to capture any significant events affecting the parent-infant relationship. The Parent-Infant Interaction Observation Scale (PIIOS) was used to score the videos. Exclusion criteria included admission to neonatal unit. RESULTS: Recruitment of suitable participants and full research data completion were feasible. Of 60 women who consented to be contacted post-delivery, 30 women (31 infants) participated at T1 and T2. Three babies were excluded. Women accepted being observed in their homes with their babies, with no attrition between T1 and T2. Using the PIIOS 10 of the 13 items could be scored with an awake infant under 2 weeks. CONCLUSION: These encouraging findings can inform exploration of an observation tool to identify high-risk dyads for targeted support. A trial and test of a modified scoring system (based on the PIIOS) should be developed for a future study using a larger sample size. Further research should assess if this approach reliably produces a consistent valid screening tool to assess parental sensitive responsiveness and resilience promoting behaviours at this early stage of life.

Headache meets neurology and psychiatry: a framework for diagnosis.

This is a case of a very rare progressive disorder which presented with unusual neurological symptoms. Significant diagnostic challenges were experienced. A structured approach to each stage of the case demonstrates a framework to use when considering children with unusual neurological presentations.