Near-term fetal response to maternal spoken voice

Trajectories of brain and behaviour development in the womb, at birth and through infancy

Birth is often seen as the starting point for studying effects of the environment on human development, with much research focused on the capacities of young infants. However, recent imaging advances have revealed that the complex behaviours of the fetus and the uterine environment exert influence. Birth is now viewed as a punctuate event along a developmental pathway of increasing autonomy of the child from their mother. Here we highlight (1) increasing physiological autonomy and perceptual sensitivity in the fetus, (2) physiological and neurochemical processes associated with birth that influence future behaviour, (3) the recalibration of motor and sensory systems in the newborn to adapt to the world outside the womb and (4) the effect of the prenatal environment on later infant behaviours and brain function. Taken together, these lines of evidence move us beyond nature-nurture issues to a developmental human lifespan view beginning within the womb.

Developmental Trajectory of the Frequency-Following Response During the First 6 Months of Life

PURPOSE

The aim of the present study is to characterize the maturational changes during the first 6 months of life in the neural encoding of two speech sound features relevant for early language acquisition: the stimulus fundamental frequency (fo), related to stimulus pitch, and the vowel formant composition, particularly F1. The frequency-following response (FFR) was used as a snapshot into the neural encoding of these two stimulus attributes.

METHOD

FFRs to a consonant-vowel stimulus /da/ were retrieved from electroencephalographic recordings in a sample of 80 healthy infants (45 at birth and 35 at the age of 1 month). Thirty-two infants (16 recorded at birth and 16 recorded at 1 month) returned for a second recording at 6 months of age.

RESULTS

Stimulus fo and F1 encoding showed improvements from birth to 6 months of age. Most remarkably, a significant improvement in the F1 neural encoding was observed during the first month of life.

CONCLUSION

Our results highlight the rapid and sustained maturation of the basic neural machinery necessary for the phoneme discrimination ability during the first 6 months of age.

Ideal Mode of Auditory Stimulation in Preterm Neonates in Neonatal Intensive Care Unit: A Systematic Review

The objective of this review was to find out the best mode of auditory stimulation for preterm neonates admitted to the neonatal intensive care unit. We also aimed to find out the different effects of different types of auditory stimulation in these neonates. Advanced neonatal care and technological advances in neonatal intensive care units have led to increased survival of preterm-born neonates, but this in turn leads to increased incidences of disabilities like cerebral palsy, visual impairment, delayed social development, etc. Early intervention is provided to facilitate further development and prevent delays in all domains. Auditory stimulation is proven to benefit these neonates to stabilize their vitals and improve their auditory performance in later life. Different modes of auditory stimulation have been studied worldwide, but none of the studies has presented the ideal mode of auditory stimulation for these preterm neonates. In this review, we have discussed the effects produced by different types of auditory stimulation and compared their pros and cons. For conducting a systematic review, a search strategy adopted by MEDLINE is used. A total of 78 articles published between 2012 and 2017, on the effects of auditory stimulation on preterm infants' performance were reviewed. Out of that, eight studies that met the inclusion criteria and focused on short-term and long-term effects were included in this systematic review. Search terms included preterm neonates, auditory stimulation, and early intervention. Randomized controlled trials and cohort studies were included. Auditory stimulation by maternal sound provides physiological and autonomic stability, but the behavioral states of preterm neonates improved with auditory stimulation by music therapy with lullabies. Maternal singing during kangaroo care may be recommended for providing physiological stability.

Skin-to-skin SDF positioning: The key to intersubjective intimacy between mother and very preterm newborn-A pilot matched-pair case-control study

Background

Skin-to-skin contact (SSC) has been widely studied in NICU and several meta-analyses have looked at its benefits, for both the baby and the parent. However, very few studies have investigated SSC' benefits for communication, in particular in the very-preterm newborn immediately after birth.

Aims

To investigate the immediate benefits of Supported Diagonal Flexion (SDF) positioning during SSC on the quality of mother-very-preterm newborn communication and to examine the coordination of the timing of communicative behaviors, just a few days after birth.

Subjects and study design

Monocentric prospective matched-pair case-control study. Thirty-four mothers and their very preterm infants (27 to 31 + 6 weeks GA, mean age at birth: 30 weeks GA) were assigned to one of the two SSC positioning, either the Vertical Control positioning (n = 17) or the SDF Intervention positioning (n = 17). Mother and newborn were filmed during the first 5 min of their first SSC.

Outcome measures

Infants' states of consciousness according to the Assessment of Preterm Infants' Behavior scale (APIB). Onset and duration of newborns' and mothers' vocalizations and their temporal proximity within a 1-s time-window.

Results

In comparison with the Vertical group, very preterm newborns in the SDF Intervention Group spent less time in a drowsy state and more in deep sleep. At 3.5 days of life, newborns' vocal production in SSC did not differ significantly between the two groups. Mothers offered a denser vocal envelope in the SDF group than in the Vertical group and their vocalizations were on average significantly longer. Moreover, in a one-second time-frame, temporal proximity of mother-very preterm newborn behaviors was greater in the SDF Intervention Group.

Conclusion

Although conducted on a limited number of dyads, our study shows that SDF positioning fosters mother-very preterm newborn intimate encounter during the very first skin to skin contact after delivery. Our pioneer data sheds light on the way a mother and her very preterm vocally meet, and constitutes a pilot step in the exploration of innate intersubjectivity in the context of very preterm birth.

Perinatal attention, memory and learning during sleep

The perinatal brain is well equipped to react to the environment during sleep. Several lines of research in animals and humans prior to and immediately after birth have documented the capability to respond, to process and remember patterns of stimulation. In this article, we will summarize recent findings as well as previous work documenting the memory and learning capacities of the developing brain during sleep and wake states. The role of these sleep state dependent processes may play in the ability to adapt to the postnatal environment will be discussed.

The validity of the Language Environment Analysis system in two neonatal intensive care units

AIM

To evaluate the validity of the Language Environment Analysis (LENA) system's automatic measures in two neonatal intensive care units supporting parent-infant closeness, and in two Finno-Ugric languages: Finnish and Estonian.

METHODS

The sound environment of 70 very preterm infants was recorded for 16 h in the neonatal intensive care units with the LENA system roughly at the gestational age of 32 (+2) weeks. Of these, the recordings of 14 infants (20%, two 5-min samples with a high percentage of speech, totally 140 min) were analysed in detail and in two different ways. Parental closeness diaries were used to document the presence of the parents. Agreements between LENA system and human coder estimates were analysed.

RESULTS

Findings showed a high variation in agreements. The highest agreements were found in female and adult word counts (r = 0.91 and 0.95). The agreements for child vocalisation count, conversational turns and silence were modest or low (r = -0.03 to 0.64).

CONCLUSION

Our study provides novel information on the validity of the LENA system in the neonatal intensive care unit. Findings show that the LENA system provides valid information on adult words, but LENA estimates for child vocalisations were less valid at this early age.

Infants' Mapping of New Faces to New Voices

The ability to identify individuals by voice is fundamental for communication. However, little is known about the expectations that infants hold when learning unfamiliar voices. Here, the voice-learning skills of 4- and 8-month-olds (N = 53; 29 girls, 14 boys of various ethnicities) were tested using a preferential-looking task that involved audiovisual stimuli of their mothers and other unfamiliar women. Findings reveal that the expectation that novel voices map on to novel faces emerges between 4 and 8 months of age, and that infants can retain learning of face-voice pairings via nonostensive cues by 8 months of age. This study provides new insights about infants' use of disambiguation and fast mapping in early voice learning.

Development of Auditory Cortex Circuits

The ability to process and perceive sensory stimuli is an essential function for animals. Among the sensory modalities, audition is crucial for communication, pleasure, care for the young, and perceiving threats. The auditory cortex (ACtx) is a key sound processing region that combines ascending signals from the auditory periphery and inputs from other sensory and non-sensory regions. The development of ACtx is a protracted process starting prenatally and requires the complex interplay of molecular programs, spontaneous activity, and sensory experience. Here, we review the development of thalamic and cortical auditory circuits during pre- and early post-natal periods.

Early peripheral activity alters nascent subplate circuits in the auditory cortex

Cortical function can be shaped by sensory experience during a critical period. The onset of the critical period is thought to coincide with the onset of thalamocortical transmission to the thalamo-recipient layer 4 (L4). In early development, subplate neurons (SPNs), and not L4 neurons, are the first targets of thalamic afferents. SPNs are transiently involved in early development and are largely eliminated during development. Activation of L4 by thalamic afferents coincides with the opening of ear canal (~P11 in mice) and precedes the later critical period. Here, we show in mice that abolishing peripheral function or presenting sound stimuli even before P11 leads to bidirectionally altered functional connectivity of SPNs in auditory cortex. Thus, early sensory experience can sculpt subplate circuits before thalamocortical circuits to L4 are mature. Our results show that peripheral activity shapes cortical circuits in a sequential manner and from earlier ages than has been appreciated.

Beyond the Words: Comparing Interpersonal Engagement Between Maternal and Paternal Infant-Directed Speech Acts

The present study investigates the way infants express their emotions in relation to parental feelings between maternal and paternal questions and direct requests. We therefore compared interpersonal engagement accompanying parental questions and direct requests between infant–mother and infant–father interactions. We video-recorded spontaneous communication between 11 infant–mother and 11 infant–father dyads—from the 2nd to the 6th month—in their home. The main results of this study are summarized as follows: (a) there are similarities in the way preverbal infants use their affections in spontaneous interactions with their mothers and fathers to express signs of sensitivity in sharing knowledge through questions and direct requests; and (b) the developmental trajectories of face-to-face emotional coordination in the course of parental questions descend in a similar way for both parents across the age range of this study. Regarding the developmental trajectories of emotional non-coordination, there is evidence of a linear trend in terms of age difference between the parents’ gender with fathers showing the steeper slope. The results are discussed in relation to the theory of intersubjectivity.

Fetal Response to a Maternal Internal Auditory Stimulus

BACKGROUND

Functional MRI (fMRI) is a noninvasive method to investigate the neural correlates of brain development. Insight into the rapidly developing brain in utero is limited, and fetal fMRI can be used to gain a greater understanding of the developmental process. Fetal brain fMRI is typically limited to resting-state fMRI due to the difficulty to instruct or provide a stimulus to the fetus. Previous studies have employed auditory task fMRI with an external sound stimulus directly on the abdomen of the mother; however, this practice has since been deemed unsafe for the developing fetus.

PURPOSE

To investigate a reliable and safe paradigm to study the development of fetal brain networks, we postulated that an internal task, such as the mother's singing, as the auditory stimulus would result in activation in the fetal primary auditory cortex.

STUDY TYPE

Cohort.

POPULATION

Pregnant women with singleton pregnancies (n = 9; 33-38 weeks gestational age).

FIELD STRENGTH/SEQUENCE

All subjects underwent two task-based block design blood oxygen level-dependent (BOLD) at 1.5T or 3T.

ASSESSMENT

Each volume was assessed for fetal motion and manually reoriented and realigned to correct for fetal motion. Once the motion was corrected, a gestational age-matched parcellated atlas with regions of interest overlaid onto the activation map was used to determine which regions in the brain had activation during task phases.

STATISTICAL TESTS

First Level Analysis. MRI data were analyzed using SPM 12 as a task fMRI.

RESULTS

Eight subjects had activation on the right Heschl's gyrus; six fetuses demonstrated activation on the left when exposed to the internal acoustic stimulus. Additionally, activation was found on the right and left middle cingulate cortex (MCC) and the left putamen.

DATA CONCLUSION

Maternal singing can be used as an internal stimulus to activate the auditory network and Heschl's gyrus during fetal fMRI. Level of Evidence 2 Technical Efficacy Stage 2 J. Magn. Reson. Imaging 2020;52:139-145.

Measurement of Maternal Mindful Awareness of Fetal Movement

INTRODUCTION

Decreased fetal movement is a common concern late in pregnancy that may be associated with increased fetal morbidity and mortality. Limited research suggests a relationship between maternal psychological factors and perception of fetal movement. The goal of this study was to test the reliability and external validity of a novel self-report instrument for maternal mindful awareness of fetal movement.

METHODS

Pregnant women who were at 20 weeks' gestation or later and feeling regular fetal movement (N = 497) were recruited online through a commercial pregnancy website to complete an internet survey from April to May 2016. The online survey included demographic and pregnancy characteristics, psychological and mindfulness measures, and investigator-developed items on mindful awareness of fetal movement. Reliability and validity of the instrument were tested with exploratory factor analysis, correlations with psychological variables, and hierarchical linear regression.

RESULTS

Exploratory factor analysis of mindful awareness of fetal movement items using principal components analysis showed a 2-factor structure, noticing and distracted, with internal consistency of α equal to .69 and .57, respectively. Hierarchical multiple regression analysis showed that noticing was associated with increased gestational age, mindfulness (observing facet), and maternal-fetal attachment. Distracted was associated with increased education level and prenatal anxiety and with decreased mindfulness (nonjudging facet).

DISCUSSION

There was moderate internal consistency in the items measuring mindful awareness of fetal movement. Findings suggest relationships between mindful awareness of fetal movement and state mindfulness, maternal-fetal attachment, and prenatal anxiety. More research is needed to further develop items for a mindful awareness of fetal movement scale suitable for research and clinical practice.

Towards the Womb of Neonatal Intensive Care

Within the mother's womb, life finds its first stirrings. The womb shelters the fetus, the growing child within. We recognize the existential traces of a wombed existence when a newborn calms in response to being held; when a newborn stills in response to his or her mother's heartbeat; and, when a newborn startles in the presence of bright light. Yet, how does experiential human life begin within another human being? What are the conditions and paths of becoming for the fetus within the womb? And for the child born early, what "womb" welcomes the premature child in neonatal intensive care?

The role of prosody in infants' preference for speech: A comparison between speech and birdsong

Speech preferences emerge very early in infancy, pointing to a special status for speech in auditory processing and a crucial role of prosody in driving infant preferences. Recent theoretical models suggest that infant auditory perception may initially encompass a broad range of human and nonhuman vocalizations, then tune in to relevant sounds for the acquisition of species-specific communication sounds. However, little is known about sound properties eliciting infants' tuning-in to speech. To address this issue, we presented a group of 4-month-olds with segments of non-native speech (Mandarin Chinese) and birdsong, a nonhuman vocalization that shares some prosodic components with speech. A second group of infants was presented with the same segment of birdsong paired with Mandarin played in reverse. Infants showed an overall preference for birdsong over non-native speech. Moreover, infants in the Backward condition preferred birdsong over backward speech whereas infants in the Forward condition did not show clear preference. These results confirm the prominent role of prosody in early auditory processing and suggest that infants' preferences may privilege communicative vocalizations featured by certain prosodic dimensions regardless of the biological source of the sound, human or nonhuman.

Verbal abuse during pregnancy increases frequency of newborn hearing screening referral: The Japan Environment and Children's Study

BACKGROUND

Verbal abuse during pregnancy has a greater impact than physical and sexual violence on the incidence of postnatal depression and maternal abuse behavior towards their children. In addition, exposure of children (aged 12 months to adolescence) to verbal abuse from their parents exerts an adverse impact to the children's auditory function. However, the effect of verbal abuse during pregnancy on fetal auditory function has not yet been thoroughly investigated.

OBJECTIVE

The objective of the study was to examine the relationship between intimate partner verbal abuse during pregnancy and newborn hearing screening (NHS) referral, which indicates immature or impaired auditory function.

PARTICIPANTS AND SETTING

The Japan Environment and Children's Study is an ongoing nationwide population-based birth-cohort study designed to determine environmental factors during and after pregnancy that affect the development, health, or wellbeing of children. Pregnant women living in 15 areas of Japan were recruited between January 2011 and March 2014.

METHODS

Multiple imputation for missing data was performed, followed by multiple logistic regression using 16 confounding variables.

RESULTS

Of 104,102 records in the dataset, 79,985 mother-infant pairs submitted complete data for questions related to verbal and physical abuse and the results of NHS. Of 79,985 pregnant women, 10,786 (13.5%) experienced verbal abuse and 978 (1.2%) experienced physical abuse. Of 79,985 newborns, 787 (0.98%) received a NHS referral. Verbal abuse was significantly associated with NHS referral (adjusted odds ratio: 1.44; 95% confidence interval: 1.05-1.98).

CONCLUSIONS

Verbal abuse should be avoided during pregnancy to preserve the newborn's auditory function.

Young children's neural processing of their mother's voice: An fMRI study

In addition to semantic content, human speech carries paralinguistic information that conveys important social cues such as a speaker's identity. For young children, their own mothers' voice is one of the most salient vocal inputs in their daily environment. Indeed, qualities of mothers' voices are shown to contribute to children's social development. Our knowledge of how the mother's voice is processed at the neural level, however, is limited. This study investigated whether the voice of a mother modulates activation in the network of regions activated by the human voice in young children differently than the voice of an unfamiliar mother. We collected fMRI data from 32 typically developing 7- and 8-year-olds as they listened to natural speech produced by their mother and another child's mother. We used emotionally-varied natural speech stimuli to approximate the range of children's day-to-day experience. We individually-defined functional ROIs in children's voice-sensitive neural network and then independently investigated the extent to which activation in these regions is modulated by speaker identity. The bilateral posterior auditory cortex, superior temporal gyrus (STG), and inferior frontal gyrus (IFG) exhibit enhanced activation in response to the voice of one's own mother versus that of an unfamiliar mother. The findings indicate that children process the voice of their own mother uniquely, and pave the way for future studies of how social information processing contributes to the trajectory of child social development.

Brain Connectivity and Neuroimaging of Social Networks in Autism

Impairments in social communication (SC) predominate among the core diagnostic features of autism spectrum disorders (ASDs). Neuroimaging has revealed numerous findings of atypical activity and connectivity of 'social brain' networks, yet no consensus view on crucial developmental causes of SC deficits has emerged. Aside from methodological challenges, the deeper problem concerns the clinical label of ASD. While genetic studies have not comprehensively explained the causes of nonsyndromic ASDs, they highlight that the clinical label encompasses many etiologically different disorders. The question of how potential causes and etiologies converge onto a comparatively narrow set of SC deficits remains. Only neuroimaging designs searching for subtypes within ASD cohorts (rather than conventional group level designs) can provide translationally informative answers.

Exposure to human voices has beneficial effects on preterm infants in the neonatal intensive care unit

We reviewed the literature up to March 2016 on the effects of nonmaternal voices on preterm infants' clinical outcomes. Of the 11 studies that met the inclusion criteria, 10 focused on short-term outcomes and one looked at long-term effects. The studies mainly showed that vocal stimuli increased preterm infants' stability in terms of heart rate, respiratory rate, oxygen saturation and behavioural measures. Improvements in feeding skills were also reported. The methods and the measures used in the studies were heterogeneous, making it difficult to draw reliable conclusions.

CONCLUSION

Vocal stimuli increased preterm infants' stability, but further studies are needed.

Antenatal ultrasound value in risk calculation for Autism Spectrum Disorder: A systematic review to support future research

There is a growing research interest on the antenatal features of children with neurodevelopmental disorders. Indeed, it has been proved that the neurodevelopment is, at least partly, affected by processes occurring in fetal life and that the early neurodevelopmental disorders identification is essential to optimize long-term outcomes. This systematic review aims to summarize findings on antenatal ultrasound data, which are or might be considered early risk indexes of postnatal social impairments. We conducted systematic searches in Pubmed and PsychINFO databases to identify studies including fetal ultrasound measurements and postnatal neurodevelopmental outcome assessment. The bibliographic search included 3203 articles but after the assessment of the eligibility conducted by two independent researchers, only 26 studies were selected. Some alterations in ultrasound antenatal measurements (such as biophysical data, nuchal thickness and enlargement of cerebral ventricles) have been associated to autism spectrum disorder. However, data are still limited, controversial and not specific. Reported data are here discussed to strongly support studies on fetuses at high risk for autism spectrum disorder.

Subplate neurons are the first cortical neurons to respond to sensory stimuli

In utero experience, such as maternal speech in humans, can shape later perception, although the underlying cortical substrate is unknown. In adult mammals, ascending thalamocortical projections target layer 4, and the onset of sensory responses in the cortex is thought to be dependent on the onset of thalamocortical transmission to layer 4 as well as the ear and eye opening. In developing animals, thalamic fibers do not target layer 4 but instead target subplate neurons deep in the developing white matter. We investigated if subplate neurons respond to sensory stimuli. Using electrophysiological recordings in young ferrets, we show that auditory cortex neurons respond to sound at very young ages, even before the opening of the ears. Single unit recordings showed that auditory responses emerged first in cortical subplate neurons. Subsequently, responses appeared in the future thalamocortical input layer 4, and sound-evoked spike latencies were longer in layer 4 than in subplate, consistent with the known relay of thalamic information to layer 4 by subplate neurons. Electrode array recordings show that early auditory responses demonstrate a nascent topographic organization, suggesting that topographic maps emerge before the onset of spiking responses in layer 4. Together our results show that sound-evoked activity and topographic organization of the cortex emerge earlier and in a different layer than previously thought. Thus, early sound experience can activate and potentially sculpt subplate circuits before permanent thalamocortical circuits to layer 4 are present, and disruption of this early sensory activity could be utilized for early diagnosis of developmental disorders.

The function of language in parent-infant psychotherapy

Parent-infant psychotherapy, a rather new field in psychoanalysis, raises questions of how to conceptualize the clinical process. Previous publications have used semiotic concepts to account for the therapist's non-verbal communication and investigated the countertransference, including what the baby might grasp of its variations. The present paper focuses on another argument for using verbal interventions to a baby in therapy; they present him with a symbolic order that differs from that of the parent. The qualitative difference between the parent's and the analyst's address is conceptualized by Dolto's term parler vrai. The therapeutic leverage is not the analytic interventions' lexical content but their message that words can be used to expose conflicts. Thereby, one can transform warded-off desires into demands that can be negotiated with one's objects. The reasons why this address catches the baby's attention are discussed. A prerequisite for such attention is that the infant brain is prewired for perceiving words as a special communicative mode. Relevant neuroscientific research is reviewed in regard to this question. The presentation relies on concepts by Dolto, Lacan and Winnicott and findings from neuroscience and developmental psychology. It also briefly discusses Chomsky's linguistic concepts in relation to these therapies.

Brain death during pregnancy and prolonged corporeal support of the body: A critical discussion

AIM

To discuss corporeal support of the brain-dead pregnant woman and to critically examine important aspects of this complex situation that remain as yet unexplored.

BACKGROUND

When brain death of the woman occurs during pregnancy, the fetus may be kept inside the corporeally supported body for prolonged periods to enable continued fetal growth and development. This has been increasingly reported in medical literature since 1982 and has received considerable media attention in the past few years.

IMPLICATIONS FOR MIDWIVES AND NURSES

Sophisticated advances in medical technologies have altered the boundaries of conception and birth, life and death, Western biomedical and cultural conceptions of women and their bodies, fetal personhood, fetal rights and fetal patienthood, profoundly influencing maternal behaviors, medical decisions and the treatment of pregnant women. This is especially so in the rare, but fraught instance of brain death of the pregnant woman, where nurses and midwives working in High Dependency Care units undertake the daily care of the corporeally supported body that holds a living fetus within it. This discussion enables critical and ethical conversation around the complexities of developing appropriate discourse concerning the woman who suffers brain death during pregnancy and considers the complexities for nurses and midwives caring for the Woman/body/fetus in this context. The potential impact on the fetus of growing and developing inside a 'dead' body is examined, and the absence in the literature of long-term follow up of infants gestated thus is questioned.

Postnatal auditory preferences in piglets differ according to maternal emotional experience with the same sounds during gestation

Prenatal sensory experience, notably auditory experience, is a source of fetal memories in many species. The contiguity between sensory stimuli and maternal emotional reactions provides opportunity for associative learning in utero but no clear evidence for this associative learning has been presented to date. Understanding this phenomenon would advance our knowledge of fetal sensory learning capacities. In the present study we tested the hypothesis that sounds (human voice) broadcast to pregnant sows while they experienced positive or negative emotional situations influences postnatal reactions of their offspring to these same sounds. The results show that: 1) from the first testing at the age of 2 days, the experimental piglets were less distressed by a social separation than controls if they heard the "familiar" voice, 2) piglets generalized to any human voice although the influence of novel voices was less pronounced, 3) in a challenging situation, piglets were more distressed if they heard the voice that was associated with maternal negative emotional state in utero. These findings open a whole line of new research on the long term effect of in utero associative learning that goes well beyond pigs, providing a framework for reconsidering the importance of sensory and emotional experiences during gestation.

Sprachentwicklungsstörungen

Zusammenfassung.Spracherwerb stellt eine zentrale Entwicklungsaufgabe in den ersten Lebensjahren eines Kindes dar. Misslingt die Bewältigung, dann treten in der sozial-emotionalen und kognitiven (schulischen) Entwicklung eines Kindes massive Probleme auf. Treten Sprachprobleme auf, kann man zwischen primären und sekundären Sprachstörungen unterscheiden. Störungen der Sprachentwicklung stellen die häufigste umschriebene Entwicklungsstörung dar. Die Prävalenz beträgt in Deutschland zwischen 5 bis 8 %, wobei Jungen ungefähr doppelt so häufig betroffen sind wie Mädchen. Die Symptomatik ist jedoch durch eine hohe Variabilität in den Erscheinungsformen geprägt, zudem besteht eine sehr große Altersabhängigkeit. Die Diagnostik und Behandlung ist interdisziplinär ausgerichtet.

On the Self-Organizing Origins of Agency

The question of agency and directedness in living systems has puzzled philosophers and scientists for centuries. What principles and mechanisms underlie the emergence of agency? Analysis and dynamical modeling of experiments on human infants suggest that the birth of agency is due to a eureka-like, pattern-forming phase transition in which the infant suddenly realizes it can make things happen in the world. The main mechanism involves positive feedback: when the baby's initially spontaneous movements cause the world to change, their perceived consequences have a sudden and sustained amplifying effect on the baby's further actions. The baby discovers itself as a causal agent. Some implications of this theory are discussed.

Ultrasonographic Investigation of Human Fetus Responses to Maternal Communicative and Non-communicative Stimuli

During pregnancy fetuses are responsive to the external environment, specifically to maternal stimulation. During this period, brain circuits develop to prepare neonates to respond appropriately. The detailed behavioral analysis of fetus’ mouth movements in response to mothers’ speech may reveal important aspects of their sensorimotor and affective skills; however, to date, no studies have investigated this response. Given that newborns at birth are capable of responding with matched behaviors to the social signals emitted by the caregiver, we hypothesize that such precocious responses could emerge in the prenatal period by exploiting infants’ sensitivity to their mother’s voice. By means of a two-dimensional (2D) ultrasonography, we assessed whether fetuses at 25 weeks of gestation, showed a congruent mouthmotor response to maternal acoustic stimulation. Mothers were asked to provide different stimuli, each characterized by a different acoustic output (e.g., chewing, yawning, nursery rhymes, etc.) and we recorded the behavioral responses of 29 fetuses. We found that, when mothers sang the syllable LA in a nursery rhyme, fetuses significantly increased mouth openings. Other stimuli provided by the mother did not produce other significant changes in fetus’ behavior. This finding suggests that fetuses are sensitive only to specific maternal vocalizations (LA) and that fetal matched responses are rudimentary signs of early mirroring behaviors that become functional in the postnatal period. In conclusion, fetuses seem to be predisposed to respond selectively to specific maternal stimuli. We propose that such responses may play a role in the development of behavioral and emotional attunement with their mothers long before birth.

STUDIES IN FETAL BEHAVIOR: REVISITED, RENEWED, AND REIMAGINED

Among the earliest volumes of this monograph series was a report by Lester Sontag and colleagues, of the esteemed Fels Institute, on the heart rate of the human fetus as an expression of the developing nervous system. Here, some 75 years later, we commemorate this work and provide historical and contemporary context on knowledge regarding fetal development, as well as results from our own research. These are based on synchronized monitoring of maternal and fetal parameters assessed between 24 and 36 weeks gestation on 740 maternal-fetal pairs compiled from eight separate longitudinal studies, which commenced in the early 1990s. Data include maternal heart rate, respiratory sinus arrhythmia, and electrodrmal activity and fetal heartrate, motor activity, and their integration. Hierarchical linear modeling of developmental trajectories reveals that the fetus develops in predictable ways consistent with advancing parasympathetic regulation. Findings also include:within-fetus stability (i.e., preservation of rank ordering over time) for heart rate, motor, and coupling measures; a transitional period of decelerating development near 30 weeks gestation; sex differences in fetal heart rate measures but not in most fetal motor activity measures; modest correspondence in fetal neurodevelopment among siblings as compared to unrelated fetuses; and deviations from normative fetal development in fetuses affected by intrauterine growth restriction and other conditions. Maternal parameters also change during this period of gestation and there is evidence that fetal sex and individual variation in fetal neurobehavior influence maternal physio-logical processes and the local intrauterine context. Results are discussed within the framework of neuromaturation, the emergence of individual differences, and the bidirectional nature of the maternal-fetal relationship.We pose a number of open questions for future research. Although the human fetus remains just out of reach, new technologies portend an era of accelerated discovery of the earliest period of development

Fetal Behavioural Responses to Maternal Voice and Touch

Background

Although there is data on the spontaneous behavioural repertoire of the fetus, studies on their behavioural responses to external stimulation are scarce.

Aim, Methods

The aim of the current study was to measure fetal behavioural responses in reaction to maternal voice; to maternal touch of the abdomen compared to a control condition, utilizing 3D real-time (4D) sonography. Behavioural responses of 23 fetuses (21st to 33rd week of gestation; N = 10 in the 2nd and N = 13 in the 3rd trimester) were frame-by-frame coded and analyzed in the three conditions.

Results

Results showed that fetuses displayed more arm, head, and mouth movements when the mother touched her abdomen and decreased their arm and head movements to maternal voice. Fetuses in the 3rd trimester showed increased regulatory (yawning), resting (arms crossed) and self-touch (hands touching the body) responses to the stimuli when compared to fetuses in the 2nd trimester.

Conclusion

In summary, the results from this study suggest that fetuses selectively respond to external stimulation earlier than previously reported, fetuses actively regulated their behaviours as a response to the external stimulation, and that fetal maturation affected the emergence of these differential responses to the environment.

An acoustic gap between the NICU and womb: a potential risk for compromised neuroplasticity of the auditory system in preterm infants

The intrauterine environment allows the fetus to begin hearing low-frequency sounds in a protected fashion, ensuring initial optimal development of the peripheral and central auditory system. However, the auditory nursery provided by the womb vanishes once the preterm newborn enters the high-frequency (HF) noisy environment of the neonatal intensive care unit (NICU). The present article draws a concerning line between auditory system development and HF noise in the NICU, which we argue is not necessarily conducive to fostering this development. Overexposure to HF noise during critical periods disrupts the functional organization of auditory cortical circuits. As a result, we theorize that the ability to tune out noise and extract acoustic information in a noisy environment may be impaired, leading to increased risks for a variety of auditory, language, and attention disorders. Additionally, HF noise in the NICU often masks human speech sounds, further limiting quality exposure to linguistic stimuli. Understanding the impact of the sound environment on the developing auditory system is an important first step in meeting the developmental demands of preterm newborns undergoing intensive care.

Rhythm perception, production, and synchronization during the perinatal period

Sensori-motor synchronization (SMS) is the coordination of rhythmic movement with an external rhythm. It plays a central role in motor, cognitive, and social behavior. SMS is commonly studied in adults and in children from four years of age onward. Prior to this age, the ability has rarely been investigated due to a lack of available methods. The present paper reviews what is known about SMS in young children, infants, newborns, and fetuses. The review highlights fetal and infant perception of rhythm and cross modal perception of rhythm, fetal, and infant production of rhythm and cross modal production of rhythm, and the contexts in which production of rhythm can be observed in infants. A primary question is whether infants, even newborns, can modify their spontaneous rhythmical motor behavior in response to external rhythmical stimulation. Spontaneous sucking, crying, and leg movements have been studied in the presence or absence of rhythmical auditory stimulation. Findings suggest that the interaction between movement and sound is present at birth and that SMS can be observed in special conditions and within a narrow range of tempi, particularly near the infant's own spontaneous motor tempo. The discussion centers on the fundamental role of SMS in interaction and communication at the beginning of life.

Staring us in the face? An embodied theory of innate face preference

Human expertise in face perception grows over development, but even within minutes of birth, infants exhibit an extraordinary sensitivity to face-like stimuli. The dominant theory accounts for innate face detection by proposing that the neonate brain contains an innate face detection device, dubbed 'Conspec'. Newborn face preference has been promoted as some of the strongest evidence for innate knowledge, and forms a canonical stage for the modern form of the nature-nurture debate in psychology. Interpretation of newborn face preference results has concentrated on monocular stimulus properties, with little mention or focused investigation of potential binocular involvement. However, the question of whether and how newborns integrate the binocular visual streams bears directly on the generation of observable visual preferences. In this theoretical paper, we employ a synthetic approach utilizing robotic and computational models to draw together the threads of binocular integration and face preference in newborns, and demonstrate cases where the former may explain the latter. We suggest that a system-level view considering the binocular embodiment of newborn vision may offer a mutually satisfying resolution to some long-running arguments in the polarizing debate surrounding the existence and causal structure of newborns' 'innate knowledge' of faces.

Bilateral gain control; an "innate predisposition" for all sorts of things

Empirical studies have revealed remarkable perceptual organization in neonates. Newborn behavioral distinctions have often been interpreted as implying functionally specific modular adaptations, and are widely cited as evidence supporting the nativist agenda. In this theoretical paper, we approach newborn perception and attention from an embodied, developmental perspective. At the mechanistic level, we argue that a generative mechanism based on mutual gain control between bilaterally corresponding points may underly a number of functionally defined “innate predispositions” related to spatial-configural perception. At the computational level, bilateral gain control implements beamforming, which enables spatial-configural tuning at the front end sampling stage. At the psychophysical level, we predict that selective attention in newborns will favor contrast energy which projects to bilaterally corresponding points on the neonate subject's sensor array. The current work extends and generalizes previous work to formalize the bilateral correlation model of newborn attention at a high level, and demonstrate in minimal agent-based simulations how bilateral gain control can enable a simple, robust and “social” attentional bias.