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ACADEMIC OUTCOMES OF VERY LOW BIRTH WEIGHT INFANTS: THE INFLUENCE OF MOTHER–CHILD RELATIONSHIPS LISA K. BOYCE
Utah State University GINA A. COOK
California State University, Stanislaus VICKI SIMONSMEIER AND SHAWNEE M. HENDERSHOT
Utah State University It is commonly accepted that parent–child interactions are bidirectional and complex and are influenced by many different factors. The current study examined the academic and behavioral skills in the early elementary years of preterm infants and the influence of their early mother–child interactions on these skills. Using a sample of 21 premature infants and their mothers, this study found that positive early interactions during feeding were related to later mutual enjoyment during a teaching task at school age, but early maternal depression was not. Early risk factors of premature infants, specifically the number of days spent on a ventilator, were positively related to maternal perceptions of hassle associated with feeding and negatively related to maternal sensitivity during feeding. Finally, mutual enjoyment was strongly associated with language, cognitive, and behavioral skills at school age. These results suggest that it is not only the infant risk factors following a premature birth that influence later development but also the parent–child relationship and emphasize the importance of understanding and promoting these early positive parent–child interactions for premature infants. ABSTRACT:
RESUMEN: Com´unmente se acepta que las interacciones madre-ni˜no son bidireccionales y complejas e influidas por muchos factores diferentes. El presente estudio examin´o las habilidades acad´emicas y de conducta en los tempranos a˜nos de la escuela primaria de infantes nacidos prematuramente y la influencia de sus tempranas interacciones madre-ni˜no sobre dichas habilidades. Con un grupo muestra de 21 infantes nacidos prematuramente y sus madres, este estudio hall´o que tempranas positivas interacciones durante el momento de alimentaci´on estaban relacionadas con un posterior disfrute mutuo durante una tarea de ense˜nanza a edad escolar, no as´ı la temprana depresi´on maternal. Los tempranos factores de riesgo de infantes prematuros, espec´ıficamente el n´umero de d´ıas dentro de un aparato, se relacionaron positivamente con las percepciones maternas de molestias asociadas con la alimentaci´on y negativamente con la sensibilidad materna en el momento de la alimentaci´on. Finalmente, el mutuo disfrute fue fuertemente asociado con las habilidades de lenguaje, cognitivas y de conducta a edad escolar. Estos resultados sugieren que no es s´olo los factores de riesgo del infante despu´es de un nacimiento prematuro que influyen el posterior desarrollo, sino tambi´en la relaci´on entre madre y ni˜no, y enfatizan la importancia de comprender y promover estas tempranas interacciones entre madre y ni˜no para infantes prematuros. ´ ´ RESUM E:
Il est commun´ement accept´e que les interactions parent-enfant sont bidirectionelles, complexes, et influenc´ees par diff´erents facteurs. Cette e´ tude a examin´e les comp´etences acad´emiques et les comp´etences de comportement dans les ann´ees pr´ecoces e´ l´ementaires de b´eb´es pr´ematur´es et l’influence de leurs interactions m`ere-enfant sur ces comp´etences. En utilisant un e´ chantillon de 21 b´eb´es pr´ematur´es et leurs m`eres, cette e´ tude a trouv´e que des interactions pr´ecoces positives durant la prise d’alimentation e´ taient li´ees au plaisir mutuel plus tard durant un exercice d’enseignement a` l’ˆage scolaire, mais la d´epression maternelle ne l’´etait pas. Les facteurs de risque de b´eb´e pr´ematur´es, plus sp´ecifiquement le nombre de jours sur le ventilateur, e´ taient positivement associ´es aux perceptions maternelles de complications li´ees a` l’alimentation et n´egativement li´es a` la sensibilit´e durant l’alimentation. Finalement le plaisir mutuel e´ tait fortement li´e aux comp´etences de language et aux comp´etences cognitives et de comportement a` l’ˆage scolaire. Ces r´esultats sugg`erent que ce n’est pas seulement lea facteurs de risque du b´eb´e suivant la naissance pr´ematur´ee qui influence le
This work was supported in part by Grant H324C980138 from the U.S. Department of Education. Direct corresponence to: Lisa Boyce, Department of Family, Consumer, and Human Development, 2600 Old Main Hill, Utah State University, Logan, UT 84322; e-mail: [email protected]. INFANT MENTAL HEALTH JOURNAL, Vol. 36(2), 156–166 (2015) C 2015 Michigan Association for Infant Mental Health View this article online at wileyonlinelibrary.com. DOI: 10.1002/imhj.21495
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d´eveloppement ult´erieur mais aussi la relation parent-enfant et mettent en e´ vidence l’importance qu’il y a a` comprendre et a` promouvoir ces interactions positives pr´ecoces parent-enfant pour le b´eb´es pr´ematur´es. ZUSAMMENFASSUNG: Es ist allgemein akzeptiert, dass Eltern-Kind-Interaktionen bidirektional und komplex sind und von vielen verschiedenen Faktoren beeinflusst sind. Die aktuelle Studie untersuchte die akademischen und behavioralen Kompetenzen von Fr¨uhgeborenen in den fr¨uhen Grundschuljahren und den Einfluss ihrer fr¨uhen Mutter-Kind-Interaktionen auf diese F¨ahigkeiten. Anhand einer Stichprobe von 21 Fr¨uhgeborenen und ihren M¨uttern, stellte diese Studie fest, dass positive fr¨uhe Interaktionen w¨ahrend der F¨utterung mit sp¨aterem beidseitigen Vergn¨ugen w¨ahrend einer Unterrichtsaufgabe im Schulalter verbunden sind, jedoch fr¨uhe m¨utterliche Depression nicht damit assoziiert ist. Fr¨uhe Risikofaktoren von Fr¨uhgeborenen, insbesondere ¨ die Anzahl der Tage an einem Beatmungsger¨at, waren positiv mit der m¨utterlichen Wahrnehmung von Arger und M¨uhe bei der F¨utterung assoziiert und standen negativ mit der m¨utterlichen Sensitivit¨at bei der F¨utterung im Zusammenhang. Schließlich war beidseitiges Vergn¨ugen stark mit sprachlichen, kognitiven und behavioralen Kompetenzen im Schulalter assoziiert. Diese Ergebnisse legen nahe, dass nicht nur die Risikofaktoren der S¨auglinge nach einer Fr¨uhgeburt die sp¨atere Entwicklung beeinflussen, sondern auch die Eltern-Kind-Beziehung. Dies unterstreicht die Bedeutung des Verst¨andnisses und der F¨orderung dieser fr¨uhen positiven Eltern-Kind-Interaktionen bei Fr¨uhgeborenen. ABSTRACT: dd:d−dddddddddddddddddddddddddddddddddddddddddddddddddd ddddddddddddddddddddddddddddddddddddddddddd−dddddddddddddddd ddddddddd21dddddddddddddddddddddddddddddddddddddddddddddddddd dddddddddddddddddddddddddddddddddddddddddddddddddddddddddddd dddddddddddddddddddddddddddddddddddddddddddddddddddddddddddd dddddddddddddddddddddddddddddddddddddddddddddddddddddddddddd dddddddddddddddddddddddddddddd−ddddddddddddddddddddddddddddd dddddddd−dddddddddddddddddddddddddddddd : ,, 21,, ,,,, ,,, ,,,
* * *
It is commonly accepted that parent–child interactions are bidirectional and complex and are influenced by different environmental, temperamental, developmental, and mental health factors (Del Vecchio & Rhoades, 2010; Sameroff, 1975; Scarr & McCartney, 1983). It also has been well-documented that positive parent–child interactions, especially during the early years, are critical for positive child cognitive, language, and social outcomes (Bornstein & Tamis-LeMonda, 1989; Landry, Smith, Swank, Assel, & Vellet, 2001). These interactions are particularly salient for preterm infants because prematurity can be associated with poor developmental and academic outcomes (Bayless, Pit-ten Cate, & Stevenson, 2008; Cox, Hopkins, & Hans, 2000; Moster, Lie, & Markstead, 2008). Parent–child interaction research with premature infants often has focused on the trauma associated with a premature birth and subsequent neonatal intensive care unit
(NICU) stay, parenting stress and mental health, and the barriers to responsive parenting due to the infants’ medical severity and disorganization (Muller-Nix et al., 2004; Zelkowitz, Papageorgiou, Bardin, & Wang, 2009). While there has been significant research documenting the importance of promoting positive parenting to enhance premature infant developmental outcomes, there is less known about the consistency and longitudinal influence of these interactions into the elementary years (Benzies, Magill-Evans, Hayden, & Ballantyne, 2013; Vanderveen, Bassler, Robertson, & Kirpalani, 2009). The purpose of this study was to examine the academic and behavioral skills of preterm infants in the early elementary years and the influence of their early mother–child interactions on these academic and behavioral skills. A greater understanding of the longitudinal influence and consistency of these mother–child interactions can be used to guide caregiver practices.
Infant Mental Health Journal DOI 10.1002/imhj. Published on behalf of the Michigan Association for Infant Mental Health.
158
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L.K. Boyce et al.
PREMATURITY AS A RISK FACTOR
Premature and very low birth weight (VLBW;
R
T
I
C
L
E
ACADEMIC OUTCOMES OF VERY LOW BIRTH WEIGHT INFANTS: THE INFLUENCE OF MOTHER–CHILD RELATIONSHIPS LISA K. BOYCE
Utah State University GINA A. COOK
California State University, Stanislaus VICKI SIMONSMEIER AND SHAWNEE M. HENDERSHOT
Utah State University It is commonly accepted that parent–child interactions are bidirectional and complex and are influenced by many different factors. The current study examined the academic and behavioral skills in the early elementary years of preterm infants and the influence of their early mother–child interactions on these skills. Using a sample of 21 premature infants and their mothers, this study found that positive early interactions during feeding were related to later mutual enjoyment during a teaching task at school age, but early maternal depression was not. Early risk factors of premature infants, specifically the number of days spent on a ventilator, were positively related to maternal perceptions of hassle associated with feeding and negatively related to maternal sensitivity during feeding. Finally, mutual enjoyment was strongly associated with language, cognitive, and behavioral skills at school age. These results suggest that it is not only the infant risk factors following a premature birth that influence later development but also the parent–child relationship and emphasize the importance of understanding and promoting these early positive parent–child interactions for premature infants. ABSTRACT:
RESUMEN: Com´unmente se acepta que las interacciones madre-ni˜no son bidireccionales y complejas e influidas por muchos factores diferentes. El presente estudio examin´o las habilidades acad´emicas y de conducta en los tempranos a˜nos de la escuela primaria de infantes nacidos prematuramente y la influencia de sus tempranas interacciones madre-ni˜no sobre dichas habilidades. Con un grupo muestra de 21 infantes nacidos prematuramente y sus madres, este estudio hall´o que tempranas positivas interacciones durante el momento de alimentaci´on estaban relacionadas con un posterior disfrute mutuo durante una tarea de ense˜nanza a edad escolar, no as´ı la temprana depresi´on maternal. Los tempranos factores de riesgo de infantes prematuros, espec´ıficamente el n´umero de d´ıas dentro de un aparato, se relacionaron positivamente con las percepciones maternas de molestias asociadas con la alimentaci´on y negativamente con la sensibilidad materna en el momento de la alimentaci´on. Finalmente, el mutuo disfrute fue fuertemente asociado con las habilidades de lenguaje, cognitivas y de conducta a edad escolar. Estos resultados sugieren que no es s´olo los factores de riesgo del infante despu´es de un nacimiento prematuro que influyen el posterior desarrollo, sino tambi´en la relaci´on entre madre y ni˜no, y enfatizan la importancia de comprender y promover estas tempranas interacciones entre madre y ni˜no para infantes prematuros. ´ ´ RESUM E:
Il est commun´ement accept´e que les interactions parent-enfant sont bidirectionelles, complexes, et influenc´ees par diff´erents facteurs. Cette e´ tude a examin´e les comp´etences acad´emiques et les comp´etences de comportement dans les ann´ees pr´ecoces e´ l´ementaires de b´eb´es pr´ematur´es et l’influence de leurs interactions m`ere-enfant sur ces comp´etences. En utilisant un e´ chantillon de 21 b´eb´es pr´ematur´es et leurs m`eres, cette e´ tude a trouv´e que des interactions pr´ecoces positives durant la prise d’alimentation e´ taient li´ees au plaisir mutuel plus tard durant un exercice d’enseignement a` l’ˆage scolaire, mais la d´epression maternelle ne l’´etait pas. Les facteurs de risque de b´eb´e pr´ematur´es, plus sp´ecifiquement le nombre de jours sur le ventilateur, e´ taient positivement associ´es aux perceptions maternelles de complications li´ees a` l’alimentation et n´egativement li´es a` la sensibilit´e durant l’alimentation. Finalement le plaisir mutuel e´ tait fortement li´e aux comp´etences de language et aux comp´etences cognitives et de comportement a` l’ˆage scolaire. Ces r´esultats sugg`erent que ce n’est pas seulement lea facteurs de risque du b´eb´e suivant la naissance pr´ematur´ee qui influence le
This work was supported in part by Grant H324C980138 from the U.S. Department of Education. Direct corresponence to: Lisa Boyce, Department of Family, Consumer, and Human Development, 2600 Old Main Hill, Utah State University, Logan, UT 84322; e-mail: [email protected]. INFANT MENTAL HEALTH JOURNAL, Vol. 36(2), 156–166 (2015) C 2015 Michigan Association for Infant Mental Health View this article online at wileyonlinelibrary.com. DOI: 10.1002/imhj.21495
156
Academic Outcomes of Premature Infants
•
157
d´eveloppement ult´erieur mais aussi la relation parent-enfant et mettent en e´ vidence l’importance qu’il y a a` comprendre et a` promouvoir ces interactions positives pr´ecoces parent-enfant pour le b´eb´es pr´ematur´es. ZUSAMMENFASSUNG: Es ist allgemein akzeptiert, dass Eltern-Kind-Interaktionen bidirektional und komplex sind und von vielen verschiedenen Faktoren beeinflusst sind. Die aktuelle Studie untersuchte die akademischen und behavioralen Kompetenzen von Fr¨uhgeborenen in den fr¨uhen Grundschuljahren und den Einfluss ihrer fr¨uhen Mutter-Kind-Interaktionen auf diese F¨ahigkeiten. Anhand einer Stichprobe von 21 Fr¨uhgeborenen und ihren M¨uttern, stellte diese Studie fest, dass positive fr¨uhe Interaktionen w¨ahrend der F¨utterung mit sp¨aterem beidseitigen Vergn¨ugen w¨ahrend einer Unterrichtsaufgabe im Schulalter verbunden sind, jedoch fr¨uhe m¨utterliche Depression nicht damit assoziiert ist. Fr¨uhe Risikofaktoren von Fr¨uhgeborenen, insbesondere ¨ die Anzahl der Tage an einem Beatmungsger¨at, waren positiv mit der m¨utterlichen Wahrnehmung von Arger und M¨uhe bei der F¨utterung assoziiert und standen negativ mit der m¨utterlichen Sensitivit¨at bei der F¨utterung im Zusammenhang. Schließlich war beidseitiges Vergn¨ugen stark mit sprachlichen, kognitiven und behavioralen Kompetenzen im Schulalter assoziiert. Diese Ergebnisse legen nahe, dass nicht nur die Risikofaktoren der S¨auglinge nach einer Fr¨uhgeburt die sp¨atere Entwicklung beeinflussen, sondern auch die Eltern-Kind-Beziehung. Dies unterstreicht die Bedeutung des Verst¨andnisses und der F¨orderung dieser fr¨uhen positiven Eltern-Kind-Interaktionen bei Fr¨uhgeborenen. ABSTRACT: dd:d−dddddddddddddddddddddddddddddddddddddddddddddddddd ddddddddddddddddddddddddddddddddddddddddddd−dddddddddddddddd ddddddddd21dddddddddddddddddddddddddddddddddddddddddddddddddd dddddddddddddddddddddddddddddddddddddddddddddddddddddddddddd dddddddddddddddddddddddddddddddddddddddddddddddddddddddddddd dddddddddddddddddddddddddddddddddddddddddddddddddddddddddddd dddddddddddddddddddddddddddddd−ddddddddddddddddddddddddddddd dddddddd−dddddddddddddddddddddddddddddd : ,, 21,, ,,,, ,,, ,,,
* * *
It is commonly accepted that parent–child interactions are bidirectional and complex and are influenced by different environmental, temperamental, developmental, and mental health factors (Del Vecchio & Rhoades, 2010; Sameroff, 1975; Scarr & McCartney, 1983). It also has been well-documented that positive parent–child interactions, especially during the early years, are critical for positive child cognitive, language, and social outcomes (Bornstein & Tamis-LeMonda, 1989; Landry, Smith, Swank, Assel, & Vellet, 2001). These interactions are particularly salient for preterm infants because prematurity can be associated with poor developmental and academic outcomes (Bayless, Pit-ten Cate, & Stevenson, 2008; Cox, Hopkins, & Hans, 2000; Moster, Lie, & Markstead, 2008). Parent–child interaction research with premature infants often has focused on the trauma associated with a premature birth and subsequent neonatal intensive care unit
(NICU) stay, parenting stress and mental health, and the barriers to responsive parenting due to the infants’ medical severity and disorganization (Muller-Nix et al., 2004; Zelkowitz, Papageorgiou, Bardin, & Wang, 2009). While there has been significant research documenting the importance of promoting positive parenting to enhance premature infant developmental outcomes, there is less known about the consistency and longitudinal influence of these interactions into the elementary years (Benzies, Magill-Evans, Hayden, & Ballantyne, 2013; Vanderveen, Bassler, Robertson, & Kirpalani, 2009). The purpose of this study was to examine the academic and behavioral skills of preterm infants in the early elementary years and the influence of their early mother–child interactions on these academic and behavioral skills. A greater understanding of the longitudinal influence and consistency of these mother–child interactions can be used to guide caregiver practices.
Infant Mental Health Journal DOI 10.1002/imhj. Published on behalf of the Michigan Association for Infant Mental Health.
158
•
L.K. Boyce et al.
PREMATURITY AS A RISK FACTOR
Premature and very low birth weight (VLBW;
