Behavioral characteristics of infants with nonorganic failure to thrive during a play interaction

[Mental health disorders in the first years of life: disorders mostly related with psychogenic factors]

In the literature review the authors present current data on the clinical features, prevalence and general approaches to treatment and prevention of mental disorders related with environmental factors in early childhood. A quite new class of the disorders, which are specific for early childhood: attachment disorders, clinical specifics of posttraumatic stress disorder, clinical manifestations of sleep disorders and feeding disorders is considered. It is emphasized that disturbed parent-child relations can be one of the predictors of early mental disorders in children. The modern models of psychotherapy for children of early age are presented.

Does esophageal atresia influence the mother-infant interaction?

PURPOSE

Chronic illness in infancy may influence parent-infant interaction. We assessed quality of mother-infant interaction in children with esophageal atresia (EA) and searched for predictors for impaired interaction.

METHODS

The study group comprised 37 one-year-old infants with EA born in 1999 to 2002 and their mothers. A comparison group comprised 10 infants with urologic problems without feeding difficulties and their mothers. Parent Child Early Relational Assessment was used to assess mother-child interaction in feeding and play situation. General Health Questionnaire and State Trait Anxiety Inventory were used to assess maternal psychological distress and anxiety.

RESULTS

Many aspects of mother-EA infant interaction showed strength. However, mothers of EA children were compared to control-mothers significantly influenced in their ability to interact and the EA-mothers' "positive affective involvement, sensitivity, and responsiveness" during feeding was in range of concern. Small but significant effect of the mother's feeling of incompetence on their interaction was found.

CONCLUSION

Mothers' attitude during feeding was negatively influenced in interaction between mother and infant with EA. The results suggest possibility for improvement in mother infant interaction by enhancing mothers' welfare when caring for infants with EA in medical services.

Assessment of early mother-child relation in infants with oesophageal atresia

Fifteen one-year old infants with oesophageal atresia and their parents were used to demonstrate how the Parent-Child Early Relational Assessment (PCERA) can be used to explore the mother-child interaction in a clinical sample of children. The infants and their mothers were videotaped for 5-min episodes during feeding and free play, and the quality of the mother-infant interactions was assessed by PCERA. The results showed areas of strength regarding most of the maternal, infant and dyadic components. There was concern about maternal positive physical contact, maternal quality of verbalizations to or about the child, maternal social initiative, infant's communicative competence and infant's visual contact with mother. This concern of social proximity between infants and their mothers was most prominent in the feeding situation. The present study indicates that oesophageal atresia in infants may constitute stressors impinging on the parent-infant relationship. PCERA was found to be an adequate assessment tool with acceptable reliability to evaluate the mother-infant interaction.