Maternal depression and perceived social support as predictors of cognitive function trajectories during the first 3 years of life for preterm infants in Wisconsin.

BACKGROUND: Among families of infants born preterm, the association between post-natal depression and children's cognitive function is not well understood, but thought to be compromised. The purpose of this study is to investigate maternal depressive symptoms and perceived social support as predictors of children's cognitive function trajectories. METHODS: This is a longitudinal study of a sample of infants born preterm (less than 37 weeks) in Wisconsin. This study includes 130 infants who were hospitalized in one of three Wisconsin neonatal intensive care units in 2002-2005 and followed until 36 months of age. Maternal depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Social support was measured using the Maternal Support Scale. Children's cognitive function was measured using the Bayley Scales of Infant Development, 2nd Edition, and the Stanford-Binet Intelligence Scale, 5th Edition. RESULTS: Children's cognitive function trajectories declined initially and then increased. Being female (coefficient = 5.14, SE = 1.89) and non-poor (coefficient = 11.26, SE = 5.78), and having a mother who has a graduate degree (coefficient = 7.67, SE = 3.37) was associated with higher levels of cognition initially. Being white was associated with a more optimal cognitive trajectory. Although depression did not predict children's cognitive trajectories, the presence of clinically elevated depressive symptoms at 9 months post term was associated with lower cognitive functioning at 16 months when mothers reported low social support. CONCLUSION: Post-natal depressive symptoms appear to have a meaningful, dynamic influence on the cognitive outcomes of children born preterm, above and beyond family socio-demographic risk when the presence and timing of perceived social support are considered. Interventions to ameliorate developmental risk associated with preterm birth should include repeated assessments of maternal social support and post-natal depression and be targeted towards socially disadvantaged families.

Applied behaviour analysis: does intervention intensity relate to family stressors and maternal well-being?

BACKGROUND: Interventions based on applied behaviour analysis (ABA) are commonly recommended for children with an autism spectrum disorder (ASD); however, few studies address how this intervention model impacts families. The intense requirements that ABA programmes place on children and families are often cited as a critique of the programme, although little evidence is available to support this claim. Using Pearlin's (1999) stress process model, this study assessed: (1) whether mothers of children participating in a home-based ABA programme reported elevated depressive symptoms; and (2) whether ABA intensity related to unmet family needs and maternal feelings of depression, personal strain and mastery. METHOD: Forty-one mothers of children diagnosed with an ASD participated in this study by completing questionnaires about their child's ASD behaviours, unmet family needs, and maternal feelings of depression, personal strain and mastery. Additionally, mothers provided information about their child's intervention programme and their own level of involvement in the programme. At the time of data collection, all families had been running a home-based ABA programme for at least 6 months. RESULTS: Single-sample t-tests and multiple regression analyses were used to test the proposed hypotheses. Mothers of children participating in a home-based ABA programme reported more depressive symptoms than mothers of children with other developmental disabilities. Comparisons revealed comparable depressive symptoms between the mothers of the present sample and those in other ASD samples. When considering weekly ABA intensity, mothers reported fewer depressive symptoms when their child was older and when their child participated in more ABA therapy hours. Conversely, mothers who were more involved in their child's ABA programme reported more personal strain. CONCLUSIONS: The findings of this study supported the hypothesis that families participating in ABA experienced elevated depressive symptoms, much like any family raising a child with an ASD, suggesting a potential area for family-level intervention. Additionally, ABA intensity related to maternal depression and personal strain, and therefore deserves continued attention. Future studies should attempt to replicate these findings with a larger and more representative sample and seek to identify mechanisms through which ABA intensity may influence maternal and family well-being.

The interaction of maternal and infant vulnerabilities on developing attachment relationships.

The present study sought to document an example of how maternal and infant vulnerabilities interact in contributing to the quality of early attachment relationships. Maternal depressive symptoms, neonatal health characteristics, and infant mother attachment were assessed for 42 preterm, low birth weight infants and 42 full-term infants at 12 months postterm. Results indicated that preterm birth moderated the relation between maternal depressive symptoms and quality of infant-mother attachment, even controlling for level of neonatal health complications. Preterm infants with more symptomatic mothers were most likely to be classified as insecurely attached to their mothers, whereas no direct relation between subclinical depressive symptoms and attachment was found for full-term infants.

Predictors of grandmother participation in a multigenerational study.

Results of a growing body of literature regarding multigenerational relationships indicate that grandparents directly and indirectly influence their grandchildren's development. However, multiple generations have been difficult to assemble for research purposes, with refusal rates ranging from 40 percent to over 80 percent. Despite difficulties in obtaining information from more than one generation of family members, data examining potential biases in the selection of participants have rarely been reported. The present study explored predictors of grandmother participation in a multigenerational study with 84 mothers, 84 infants, and 52 maternal grandmothers. Results indicated that grandmothers were less likely to participate in the study when grandchildren experienced preterm birth and when mothers reported less family of origin support. However, grandmothers who participated in the study reported high levels of intergenerational involvement and contact with daughters and grandchildren.