Related visual impairment to mother-infant interaction and development in infants with bilateral retinoblastoma.

PURPOSE: This study was conducted with infants diagnosed with bilateral retinoblastoma (RB) and their mothers. It explored characteristics of the mother-infant interaction, the infants' developmental characteristics and related risk factors. METHOD: Cross-sectional statistical analysis was performed with 18 dyads of one-year-old infants with bilateral RB and their mothers. RESULTS: Using the Japanese Nursing Child Assessment Teaching Scale (JNCATS) results showed that infants with RB had significantly lower scores compared to normative Japanese scores on all of the infants' subscales and "Child's contingency" (p < 0.01). Five infants with visual impairment at high risk of developmental problems had a pass rate of 0% on six JNCATS items. There were positive correlations between Developmental quotients (DQ) and JNCATS score of "Responsiveness to caregiver" (ρ = 0.50, p < 0.05) and DQ and "Child's contingency" (ρ = 0.47, p < 0.05). CONCLUSIONS: Infants with visual impairment were characterized by high likelihood of developmental delays and problematic behaviors; they tended not to turn their face or eyes toward their mothers, smile in response to their mothers' talking to them or the latter's changing body language or facial expressions, or react in a contingent manner in their interactions. These infant behaviors noted by their mothers shared similarities with developmental characteristics of children with visual impairments. These findings indicated a need to provide support promoting mother-infant interactions consistent with the developmental characteristics of RB infants with visual impairment.

Identifying and Intervening in Child Maltreatment and Implementing Related National Guidelines by Public Health Nurses in Finland and Japan.

Aim. This study aimed to investigate how public health nurses identify, intervene in, and implement the guidelines on child maltreatment in Finland and Japan and to compare the data between the two countries. Method. This study employed a cross-sectional design. Public health nurses' knowledge and skills with respect to child maltreatment prevention were assessed using a questionnaire consisting of three categories: identification, intervention, and implementation of guidelines. Public health nurses working in the area of maternal and child health care in Finland (n = 193) and Japan (n = 440) were the participants. Results. A significantly higher percentage of Japanese public health nurses identified child maltreatment compared to Finnish public health nurses, while Finnish nurses intervened in child maltreatment better than their Japanese counterparts. In both countries, public health nurses who had read and used the guidelines dealt with child maltreatment better than those who did not. Conclusion. The results suggest that effective training on child maltreatment and the use of guidelines are important to increase public health nurses' knowledge and skills for identifying and intervening in child maltreatment.

Influence of older primiparity on childbirth, parenting stress, and mother-child interaction.

AIM: Delivery at 35 years and above has increased in Japan. While there is much research concerning obstetrical risk and delivery at advanced age, little research addresses child-rearing after birth. This study seeks to identify how older primiparas' characteristics of child-rearing, parenting stress, and mother-child interaction differ from those of younger mothers. METHODS: Participants were primipara women aged 35 years and above and primiparas aged 20-29 years; all delivered in the hospital. Questionnaires were distributed during hospitalization after birth and during home visits at 3 months, 1 year, and 2 years post-partum. Mother-child interactions during home visits were assessed using the Nursing Child Assessment Teaching Scale (NCATS). RESULTS: The older group included 13 primiparas, and the control group included seven primiparas at the study's end. Some older primiparas used fertility treatment and cesarean section, but primiparas in their 20s used neither. There were no significant differences in terms of depression, psychological health, size of networks, and number of daytime or night-time feedings. Statistically significant differences were as follows. Older primiparas experienced more social isolation and overall stress, and their children exhibited greater hypersensitivity/lack of adaptability at 3 months. Older mothers were more likely to report little effort by their children to please them at 1 and 2 years after birth. Under observation, older primiparas received higher NCATS caregiver scores, but children of primiparas in their 20s received higher child scores. CONCLUSION: Mothers and child-care specialists should recognize that older primiparas interact more favorably with their children, but have more parenting stress.

Effect of Early Intervention to Promote Mother - Infant Interaction and Maternal Sensitivity in Japan: A Parenting Support Program based on Infant Mental Health.

This study investigated the effects of the Japanese Early Promotion Program (JEPP), which is based on the Infant Mental Health (IMH) program. The JEPP aims to promote mother-infant interactions by enhancing the mother's ability to respond appropriately her child. Mothers in the JEPP group (n = 15) received support from IMH nurses in a pediatric clinic until their infants reached 12 months of age. The nurses provided positive feedback that emphasized strength of parenting, and assisted the mothers in understanding the construct of their infants. Mother-infant interactions and mother's mental health status were assessed at intake (1-3 months), and at 6, 9, and 12 months of infants' age. The JEPP group data were compared with cross-sectional data of the control group (n = 120). Although JEPP dyads were not found to be significantly different from the control group in general dyadic synchrony, both before and after intervention, JEPP mothers significantly improved their ability to understand their infant's cues and to respond promptly. In the JEPP group, unresponsiveness to infants was reduced in mothers, while infants showed reduced passiveness and enhanced responsiveness to the mother. Furthermore, the intervention reduced the mothers' parenting stress and negative emotions, thereby enhancing their self-esteem.

Gender, age, and cultural differences in the Japanese version of the Infant-Toddler Social and Emotional Assessment.

This study aimed to clarify the characteristics of the Japanese version of the Infant-Toddler Social and Emotional Assessment (J-ITSEA), a parentreport questionnaire concerning social-emotional/behavioral problems and delays in competence in 1- to 3-year-old children. The differences in score between genders, ages, and between the J-ITSEA and the original Infant-Toddler Social and Emotional Assessment were examined. The data of 617 participants recruited from Saitama prefecture through stratified two-stage sampling were analyzed. The Cronbach's alpha ranged from 0.76 to 0.93. Gender differences emerged for some problems and all competence scales, with boys rated higher in the Externalizing problem domain and Activity/Impulsivity subscale and girls rated higher in the Internalizing problem domain, Inhibition to Novelty subscale, and all Competence scales. The Competence domain score increased across age groups. Compared with a normative sample in the US, participants in this study rated higher in Aggression/Defiance and Separation Distress, and rated lower in Peer Aggression and most of the Competence scales. The results indicate that the J-ITSEA scores should be interpreted in comparison with standard scores assigned for gender and 6-month age groups, and that specific criteria for the cut-off points for the J-ITSEA are required instead of those in the original questionnaire.

A Prospective Study of Factors Related to Mother-Infant Interaction in One-year-old Infants with Retinoblastoma.

This study aimed to clarify the relationships among developmental characteristics of retinoblastoma (RB) infants, mother-infant interaction, and mental health of mothers. Prospective studies were conducted twice with 13 dyads of mothers and infants who were between one (Time 1) and two years old (Time 2). Cross-sectional and longitudinal analyses were performed. The mean Developmental Quotients (DQ) significantly decreased between Time 1 and Time 2 (p < .05). Four (30.8%) infants showed DQ p < 85 at Time 1. They showed a DQ below the borderline at Time 2 and their developmental changes were different from RB infants in the normal DQ range. Infant Behavior Checklist-R (IBC-R) scores negatively correlated with DQ (p < .05). The mothers' Japanese Nursing Child Assessment Teaching Scale (JNCATS) scores were significantly higher than the normative mean. The IBC-R scores negatively correlated with mothers' JNCATS scores at Time 1 (ρ = -.66, p < .05) and positively correlated with the child domain scores on the Parenting Stress Index at Time 2 (ρ = .62, p < .05). Some RB infants showed a developmental delay. Mother-child interactions were negatively affected and mothers recognized their infants' problem. The support needs to be provided in early infancy.

Differences and similarities between father-infant interaction and mother-infant interaction.

The aim of this study was to compare father-infant interaction with mother-infant interaction, and explore differences and similarities between parents. Related factors for quality of father-infant interaction were also examined. Sixteen pairs of parents with infants aged 0 to 36 months were observed for play interaction between parents and their children. Results suggested no significant differences between parents, but children's interactions were significantly more contingent with fathers than mothers (p =.045). Significant correlations between parents were found in socialemotional growth fostering encouragement for children during interaction (ρ =.73, p =.001). Paternal depressive symptoms were significantly correlated to paternal sensitivity to child's cues (ρ =-.59, p =.017).

Effect of early intervention using state modulation and cue reading on mother-infant interactions in preterm infants and their mothers in Japan.

This study examined the effects of early intervention on mothers and their preterm infants. Intervention aimed to facilitate mother-infant interaction by enhancing the mother's ability to modulate her infant's state and to read infant cues. Specifically, the intervention consisted of a nurse researcher visiting the Neonatal Intensive Care Unit (NICU) before each infant was discharged, and conducting post-discharge home visits until the infant reached a corrected age of 60 weeks. For research design purposes, mother-infant dyads were placed into either (1) an Intensive Intervention Group (ⅡG) or (2) a Mild Intervention Group (MIG). The outcomes of the groups were then compared. The effects of early intervention were rated by examining mother-infant interaction and the durations of infant sleep and crying. Despite individual differences, there were more improved interaction scores at Time 1 in ⅡG members that had recorded lower interaction scores earlier than those of MIG. A lower frequency of night crying was also recorded from the ⅡG. The results implied that interventions teaching state-modulation methods and cue reading to the mothers should be started while their infants are in the NICU.

A study of the validity of the Japanese Nursing Child Assessment Teaching Scale (JNCATS) utilizing sequential analysis: a second analysis of mother-child teaching interaction.

The measurement of early mother-child relationship and interaction is a critical issue for infant mental health. The Nursing Child Assessment Teaching Scale (NCATS) has been regarded as one of the most effective assessment tools. A Japanese version (JNCATS) has been developed and its reliability was reported. The purpose of the present study was to show evidence for the validity of the JNCATS by utilizing micro analysis and sequential analysis of 53 mother-child interactions. Micro analysis is a second-by-second analysis of mother and child behavioral streams. Sequential analysis is a technique to detect mutual and contingent aspects of interaction. Variables obtained from these two methods were: a) probabilities of coding categories, and b) log odds ratios of contingency codes, whose correlations with JNCATS scores were examined. Some weak and medium correlations were found (p < .05). It was suggested that these two methods and the JNCATS could capture similar features of mother-child interaction, which provides evidence for the validity of the JNCATS.

Preliminary early intervention study using Nursing Child Assessment Teaching Scale in Japan.

BACKGROUND: Mother-infant interactions have been acknowledged as one of the most important elements in measuring outcomes of parent support and infant mental health interventions. The present study was conducted to measure early intervention outcomes using the Nursing Child Assessment Teaching Scale (NCATS), and to identify factors that affected Japanese mother-infant interactions. METHODS: Healthy Japanese mother-infant dyads who had lower scores on the NCATS, indicating potential problems, were assigned to an intervention group, and compared with a control group who had higher scores on NCATS. Health-care professionals visited the intervention group dyads in their homes, and gave them positive feedback on their interactions, consultations on parenting, and health advice. The control group dyads had home visitation once every 6 months for assessment only. RESULTS: The home visitations started at 3 months of age and continued until 18 months. NCATS scores in both groups were significantly different at baseline but differences faded by the end, which suggests that the intervention promoted improved interactions in the intervention group. Two of five factors were identified as influencing mother-infant interactions: maternal age; and personal networks, and together they significantly explained 27-30% of NCATS variance. CONCLUSION: The results appear to support the validity of measuring Japanese mother-infant interactions with NCATS. This study is the first to measure the outcomes of early intervention on Japanese dyads' interactions using NCATS. Additional replication studies should be conducted elsewhere in Japan, and clinical practices for promoting mother-infant interactions should begin to assess their effectiveness with NCATS as an outcome measure.

Measuring Japanese mothers' perception of child abuse: development of a Japanese version of the child abuse blame scale--physical abuse (CABS-PA-J).

BACKGROUND: The Child Abuse Blame Scale - Physical Abuse (CABS-PA) was translated into Japanese and its subscale items modified by the authors according to the Japanese cultural context. The aim of the current study was to investigate the appropriateness, reliability, and clinical applicability of the CABS-PA Japanese version (CABS-PA-J). Modifications were made to enable the determination of child abuse recognition in a Japanese cultural setting and early clinical intervention in child abuse cases. METHODS: The CABS-PA text was translated into Japanese, then back translated. The appropriateness of scale item translations was verified based on e-mail discussions with the original CABS-PA author. Exploratory and confirmatory factor analyses were performed to examine the validity of CABS-PA-J responses and to confirm the validity of factor structure. Criterion-related validity was also confirmed. The Japanese scale was used to examine the characteristic differences between mothers of premature infants (< 1500 g) and those of other infants (>or= 1500 g). RESULTS: Exploratory and confirmatory factor analyses found the factor structure to be similar between the original scale and the translated CABS-PA-J, suggesting adequate factor validity. There was a statistically significant correlation between social support from a spouse or third party and the abuse score on a subscale, partially demonstrating criterion-referenced validity. Similarities and differences were found in the stress reactions of the mothers of premature infants (< 1500 g) and those of other infants (>or= 1500 g). CONCLUSION: CABS-PA-J was shown to be appropriate and reliable. It is an effective tool for determining the recognition of child abuse among Japanese mothers.

Neurobehaviors of Japanese newborns in relation to the characteristics of early mother-infant interaction.

The authors examined the relationship between newborn neurobehavioral profiles and the characteristics of early mother-infant interaction in Nagasaki, Japan. The authors administered the Brazelton Neonatal Behavioral Assessment Scale (NBAS; T. B. Brazelton & J. K. Nugent, 1995) in the newborn period and the Nursing Child Assessment Teaching Scale at 1 month (NCATS; G. Sumner & A. Spietz, 1994). They administered the Perceived Stress Scale (S. Cohen, T. Kamarck, & R. Mermelstein, 1983) as an index of maternal stress experienced over the past month. Lower irritability, higher stability in skin coloration, and lower tremulousness in the neonatal period were correlated with higher levels of maternal nurturing behaviors at 1 month. Birth weight and 2 NBAS range-of-state items (peak of excitement, irritability) predicted 31% of the variance in NCATS caregiver subscale score. The NBAS autonomic stability items (tremulousness, startles, lability of skin color) predicted 31% of the variance in the NCATS child subscale score. Perceived stress and maternal sociodemographic variables (education, income, age, parity) were not associated with child, caregiver, and total scores on the NCATS. The results suggested that lack of autonomic stability in Japanese neonates might serve as an early indicator of infant frailty, negative behavioral cues, and decreased maternal responsiveness.