One doll fits all: validation of the Leiden Infant Simulator Sensitivity Assessment (LISSA)

How does sensitivity influence early executive function? A critical review on hot and cool processes

There is compelling evidence that the quality of caregiver-child interactions during toddlerhood and the preschool years supports the development of executive function (EF) (Bernier et al., 2010; 2015; 2016; Fay-Stammbach et al., 2014; Geeraerts et al., 2021). Based on such findings, we make the case herein that sensitivity may be one of the most important dimensions of parenting contributing to early EF. In the present article, we will review empirical evidence, integrating findings from a wide range of scientific disciplines - cognitive psychology, neuroscience, and developmental psychopathology - and present theoretical ideas about how two contexts of sensitive caregiving - i.e. sensitivity to distress and non-distress cues - may be contributing differently to hot and cool EF development. Implications for future investigations on the environmental contributors of early EF, and its mechanisms, are discussed.

Fathers' sensitive parenting enhanced by prenatal video-feedback: a randomized controlled trial using ultrasound imaging

BACKGROUND

The aim of this study was to evaluate an interaction-based prenatal parenting intervention program aimed at promoting parental sensitivity and involvement in expectant fathers using ultrasound images: Prenatal Video-Feedback Intervention to Promote Positive Parenting (VIPP-PRE).

METHODS

In this randomized controlled trial, 73 first-time, healthy expectant fathers were enrolled. Participants were randomly assigned to the VIPP-PRE intervention (n = 39) or a dummy intervention (n = 34). Parental sensitivity was coded from video-recorded 10-min interactions with an infant simulator at a prenatal pretest and with fathers' own infant at a postnatal posttest. Prenatal and postnatal involvement was assessed via an application on participants' smartphones.

RESULTS

Fathers receiving VIPP-PRE demonstrated increased sensitivity across the perinatal period, relative to fathers receiving a dummy intervention. Fathers' involvement with the infant increased significantly from the prenatal to postnatal period, regardless of the intervention.

CONCLUSIONS

Prenatal video-feedback using ultrasound imaging of the unborn child has the potential to promote the quality of parenting in an important, but understudied, population and period: men in the transition to fatherhood. Future research should examine the long-term effectiveness of VIPP-PRE and its effectiveness in increasing parenting quality in at-risk families.

IMPACT

This study identifies a brief and focused prenatal intervention using assisted interactions between the father and his baby by means of ultrasound imaging as a promising strategy to improve sensitive fathering in the early postnatal phase. Our study shows that pregnancy provides a window of opportunity for promoting prenatal involvement and bonding in expectant fathers, with potential long-term benefits for the future father-child relationship. Ultrasound measures are currently used to monitor fetal growth and development, but our results suggest that they may also create an opportunity for stimulating father-infant interaction to promote postnatal caregiving quality.

Prolonged Infant Crying: Caregiving Quality and Child Physical Abuse Risk

Research suggests that prolonged infant crying may increase risk for child physical abuse (CPA). However, few studies have examined behavioral responses to infant crying among parents at risk for CPA. The present study sought to fill this gap by using a simulated infant to examine how mothers and fathers with varying degrees of CPA risk respond to prolonged infant crying. Specifically, a sample of 184 general population caregivers (107 mothers and 77 fathers) participated in a task that involved attempting to soothe a simulated infant that cried continuously for 30 min. The simulated infant sessions were video-recorded, and quality of caregiving behavior was coded in 5-min segments. Participants rated their negative affect (feelings of upset, distress, irritability) at the outset of the data collection session, before beginning the simulated infant task, and after the simulated infant task concluded. It was predicted that high-risk caregivers, compared to low-risk caregivers, would display lower quality caregiving, higher levels of negative affect, and that CPA risk group differences would increase over time. Gender differences were explored in relation to the aforementioned hypotheses. Over the course of the 30-min simulated infant task, the quality of caregiving behavior diminished among both high- and low-risk caregivers. As expected, high-risk caregivers, compared to low-risk caregivers, exhibited lower quality caregiving behaviors and were more likely to discontinue the simulated infant task early. In addition, high-risk, compared to low-risk, caregivers reported higher levels of negative affect throughout the data collection session, with the highest level of negative affect reported by high-risk caregivers after completing the simulated infant task. Overall, the quality of caregiving exhibited by men and women did not significantly differ. The present findings highlight the importance of early intervention designed to support caregivers' abilities to respond effectively to prolonged infant crying.

Hormonal and behavioral responses to an infant simulator in women with and without children

We investigated the impact of maternal status on hormonal reactivity and behavioral responses to an infant simulator in 117 women (54 primiparous, 63 nulliparous). The amount of affectionate touch and motherese were analyzed as behavioral measures of caregiving. Saliva was collected before and 10 min after interaction with the infant simulator to analyze oxytocin, testosterone, cortisol, and estradiol levels. Nulliparous women also provided information about their fertility motivation. Linear mixed models indicated that greater use of affectionate touch was associated with lower overall testosterone levels. Cortisol decreased in response to the interaction in both groups. In the primiparous group, the amount of affectionate touch associated inversely with cortisol levels, whereas in the nulliparous group such association was not found. Oxytocin or estradiol reactivity to the simulator did not differ between the groups, nor were these hormones associated with behavior. Higher fertility motivation in nulliparous women was related to more motherese, and lower testosterone levels. Our results indicate that the simulator elicits hormonal reactivity both in mothers and nonmothers, but the patterns of associations between caregiving behavior and hormonal levels may be partially different. These results encourage using the infant simulator to explore hormonal processes related to the transition to parenthood.

Do empathy and oxytocin predict responsiveness to a crying infant simulator in expecting and non-expecting couples? A multilevel study

Infant crying is a strong emotional stimulus that elicits caregiving responses in adults. Here we examine the role of empathy (measured with the Polish version of Interpersonal Reactivity Index) and salivary oxytocin in modulating sensitive responsiveness to a crying infant simulator in two groups of heterosexual couples: 111 expecting or 110 not expecting a baby. Sensitive responsiveness was observed during a standardized procedure using the Ainsworth Sensitivity Scale while participants took care of the infant simulator, both individually and as a couple. Other-oriented empathy predicted elevated levels of individual but not couple sensitive responsiveness. More OT reactivity to crying predicted less responsiveness in non-expecting couples, which might be explained by their stronger focus on task performance. This study uniquely combined hormonal, observational and self-report measures in couples, and showed that personality and hormonal correlates of sensitive responsiveness might be studied before the child's birth with the use of infant simulators.

(Re-)activity in the caregiving situation: Genetic diversity within Oxytocin-Vasopressin Pathway is associated with salivary oxytocin and vasopressin concentrations in response to contact with a crying infant-simulator

Oxytocin (OT) and vasopressin (AVP) hormones as well as their receptors (OXTR and AVPR1a) have been deemed crucial for caregiving and sensitive responsiveness to infant cues. However, previous research on genetic polymorphisms and OT and AVP levels in the context of caregiving were sparse and have brought contradictory findings. The aim of this reported observational study was to examine the impact of genetic variations within genes related to OT and AVP signaling pathway on hormones levels' changes in response to the caregiving situation. A total of 221 adult intimate couples (110 childless, non-pregnant and 111 expectant couples) participated in three 10 min sessions, during which they were taking care of a crying life-like simulator. 30 min prior to the first session salivary samples to analyze basal OT and AVP, and polymorphisms in OXTR, AVPR1a and CD38 genes were collected. Subsequent OT and AVP levels were measured 15 min after each session. The two most frequently studied OXTR SNPs (rs53576 and rs2254298) had no or a minor impact on higher OT levels, which were linked to rs1042778, rs13316193, rs2228485, rs2268490, rs4686302 genotypes. AVP levels were affected by rs1042778, rs13316193, rs4686302 and rs237887. OT levels varied depending on the OT (rs2770378, rs4813625), CD38 (rs379686), and 5-HTR2A (rs6314) genotype. OT and AVP levels were also associated with rs6314 (5-HTR2A). AVP levels were linked to ESR1 (rs1884051) and SIM1 (rs3734354) variations. Shorter variants of RS3 and RS1 were associated with lower levels of AVP. In conclusion, analyzed polymorphisms were associated with both the level and changes in OT and AVP hormone levels in the standardized situation of caregiving reactions to infant crying.

Empathy and Hormonal Changes as Predictors of Sensitive Responsiveness towards Infant Crying: A Study Protocol

Sensitive responsiveness refers to parents' ability to recognize and respond to infants' cues and has been linked to parental empathy. Additionally, oxytocin (OT) and vasopressin (AVP) are hormones important for sensitivity and empathy. The aim of this study is to test the links between dispositional empathy along with changing OT and AVP levels and responsiveness to a life-like doll in couples and to verify whether these factors are predictors of responsiveness to a child's cues. Exploratory analyses include predictors of sensitive responsiveness: polymorphisms of OXTR, AVPR1a and CD38 genes, personal characteristics and relational factors. The project employs standardized experimental settings that can be used with non-parents and the assessment of parental sensitive responsiveness towards their child. The participants are couples expecting their first child (111) and childless couples (110). The procedure involves caretaking of a life-like doll. Salivary samples and questionnaire data are collected in a planned manner. In the second part, the expectant couples are invited for the assessment of their sensitivity to their own child (Free Play episodes). Parental sensitivity is assessed using the Ainsworth Sensitivity Scale. This paper presents an interdisciplinary research project that reaches beyond the questionnaire measurement, considering many factors influencing the dynamics of adult-infant interaction.

Exploring the hormonal and neural correlates of paternal protective behavior to their infants

Infant protection is an important but largely neglected aspect of parental care. Available theory and research suggest that endocrine levels and neural responses might be biological correlates of protective behavior. However, no research to date examined associations between these neurobiological and behavioral aspects. This study, preregistered on https://osf.io/2acxd, explored the psychobiology of paternal protection in 77 new fathers by combining neural responses to infant-threatening situations, self-reported protective behavior, behavioral observations in a newly developed experimental set-up (Auditory Startling Task), and measurements of testosterone and vasopressin. fMRI analyses validated the role of several brain networks in the processing of infant-threatening situations and indicated replicable findings with the infant-threat paradigm. We found little overlap between observed and reported protective behavior. Robust associations between endocrine levels, neural responses, and paternal protective behavior were absent.

Attractiveness and neural processing of infant faces: effects of a facial abnormality but not dopamine

Adults' caregiving responses toward infants may have important origins in the perception and processing of infant cues as well as the motivation to attend to these cues. Moreover, some biological processes, such as dopaminergic neurotransmission, may be crucially involved. Although infant stimuli are generally experienced as cute and rewarding, infants with a visible disability may be regarded much less favorably than others, perhaps dependent on differences in perception, motivation, and neural processing. The current study investigated effects of administered dopamine on the perceived attractiveness and neurophysiological indices of attention and processing (i.e., the P1, P2, and N170 components of the event-related potential) of infant faces with and without a cleft lip. No evidence for effects of dopamine was found, but we replicated the finding that the decreased attractiveness of infants with a cleft lip was mediated by decreased configural face processing (smaller N170 amplitudes), but not more general attentional and/or executive processing (P2). The current findings show once again the unfavorable consequences of a cleft lip, but also highlight the importance of combining and relating measures across various levels of analysis and underscore the importance of replication.

How Well Do Couples Care When They Are Expecting Their First Child? Family and Dyadic Predictors of Parental Sensitivity in Expectant Couples

Belsky's Process Model points to family-of-origin (especially experiences of mistreatment in childhood) as well as personality and marital relations as determinants of parenting quality, including parental sensitive responsiveness. Parental sensitivity might be intuitively developed during pregnancy and affects perinatal mental health. However, there is a lack of studies investigating effects of family-of-origin and relationship perceptions on expectant couples' parental sensitive responsiveness. The aim of the presented study was to test mediation and moderation effects of perceived partner's empathic concern and retrospectively assessed abuse experienced in childhood on sensitive parental responsiveness operationalized as caretaking behaviors and emotional reactions to a crying life-like doll. One hundred eleven expectant couples (N = 222; age: M _women = 28.4 years, SD = 3.03; age: M _men = 29.2 years, SD = 3.31; relationship duration: M _years = 6.8, SD = 3.43; gestational week: M = 31.3, SD = 4.58) assessed the extent to which they experienced physical and emotional abuse from their parents in childhood and rated their current partner's empathic concern. In the experimental procedure, couples reacted to a crying life-like doll and were assessed by trained psychologists using the modified Ainsworth Sensitivity Scale to measure couples' sensitive responsiveness. The results confirmed a significant mediational effect of perceived women's (and not men's) empathic concern for the relationship between the reported experience of abuse in family-of-origin by expectant fathers (and not mothers) and couples' sensitivity. Support and interventions regarding couples' empathy and parenting competence can be offered to both mothers and fathers to identify those who are at risk of low parental sensitivity.

Predicting infant-father attachment: the role of pre- and postnatal triadic family alliance and paternal testosterone levels

This longitudinal study examined whether prenatal family alliance and prenatal paternal testosterone levels predicted infant-mother and infant-father attachment security and whether this association was mediated by postnatal family alliance and postnatal paternal testosterone levels. In 105 couples expecting their first child, family alliance was assessed in the third trimester of pregnancy with the prenatal version of the Lausanne Trilogue Play (LTP). Family alliance was measured again 6 months postnatally, using the LTP. Fathers provided testosterone samples prenatally and at 6 months postnatally. Infant-parent attachment was assessed with the Attachment Q-Sort (AQS) at 24 months. Results indicated an increase in paternal testosterone levels from the pre- to the postnatal period. A more positive prenatal family alliance predicted higher infant-father attachment security at 24 months, but not infant-mother attachment security. The association between prenatal family alliance and attachment security was not mediated by postnatal family alliance or postnatal paternal testosterone levels. This study highlights the significance of prenatal family relations, and the need to consider in research and practice the divergent effects of prenatal family alliance patterns on the emerging infant-mother and infant-father attachment relationships. The underlying hormonal mechanisms during the transition to fatherhood are important targets for future research.

Prenatal and postnatal cortisol and testosterone are related to parental caregiving quality in fathers, but not in mothers

Testosterone and cortisol have both been implicated in human parenting behavior. We investigated the relations between observed quality of caregiving during parent-child interactions and pre- and postnatal testosterone and cortisol levels, in both mothers (N = 88) and fathers (N = 57). Testosterone and cortisol were measured before and after interaction with an infant simulator (prenatal) and with their own child (postnatal) to index basal levels as well as steroid reactivity to the interaction. Our findings are that in fathers, interactions between cortisol and testosterone are related to quality of caregiving both pre- and postnatally. Prenatally there was a stronger negative relation between T and quality of caregiving in fathers with lower cortisol levels, and postnatally there was a stronger negative relation between cortisol and quality of caregiving in fathers high in testosterone levels. Furthermore, prenatal cortisol levels were related to paternal quality of caregiving during interaction with their own child. In mothers, no associations between quality of caregiving and our endocrine measures were observed. We interpret our findings in the context of hyperreactive physiological responses observed in parents at risk for insensitive caregiving, and in light of the dual-hormone hypothesis. The current findings contribute to the growing literature on the endocrine antecedents of human caregiving behavior.

Holding the Baby: Using the Leiden Infant Simulator Sensitivity Assessment to Examine Attachment Theory’s Sensitivity Hypothesis

Some students taking infant development classes have limited, direct experience of interacting with infants. This paper reports on a pilot of an innovative, research-informed workshop that provides hands-on experience through the use of infant simulators. The workshop adapted the Leiden Infant Sensitivity Simulator Assessment, which uses the RealCare Baby © infant simulator, to examine attachment theory’s sensitivity hypothesis. Students’ ratings indicated that an infant simulator activity was helpful in understanding the research and encouraged critical thinking about the research, hypothesis, and attachment theory in general. Moreover, the infant simulator activity was as helpful as a multiple-choice question activity for promoting understanding of the research. The workshop encouraged higher level thinking about the research, hypothesis, and theory in general, and there was no difference in the extent to which the infant simulator activity and a plan-a-study activity encouraged critical thinking. The findings of this pilot suggest that infant simulators can be successfully embedded into and serve as an effective tool for teaching about theoretical concepts surrounding infant–caregiver interaction.

Simulation-based research to improve infant health outcomes: Using the infant simulator to prevent infant shaking

Simulation is a technique that creates a situation or environment to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions. We will first provide an introduction to simulation in healthcare and describe the two types of simulation-based research (SBR) in the pediatric population. We will then provide an overview of the use of SBR to improve health outcomes for infants in health care settings and to improve parent-child interactions using the infant simulator. Finally, we will discuss previous and future research using simulation to reduce morbidity and mortality from abusive head trauma, the most common cause of traumatic death in infancy.

Young adult couples' behavioral and physiological responses to the infant simulator: A preliminary illustration of coparenting

This exploratory application of the infant simulator with two couples is designed to illustrate individual reactivity and coparenting behaviors in young couples in serious relationships who do not yet have children. A 35-min protocol with standardized onsets and offsets of inconsolable baby cries was used to capture partner's individual behavioral and physiological responses as well as the couple's joint efforts to soothe the crying baby. Task feasibility was demonstrated by couples' persistent and wide-ranging efforts to calm the baby including rocking, feeding, changing, talking to the baby, and singing. Within-person fluctuations in ongoing heart rate (HR) and electrodermal activity (EDA) through the protocol suggested evidence of heightened physiological reactivity during baby crying compared to silence. During bouts of crying, higher HR also was evidenced when participants took the lead in caregiving as contrasted with assisting or busying themselves in another task. Behavioral observations indicated that this task elicited examples of coparenting behaviors including cooperation, support, undermining, and negotiating the division of labor. These preliminary pilot data demonstrate the potential of infant simulator paradigms with couples who are not yet pregnant but envision being future parents, and set the stage for future research to identify how individual and couple characteristics might impact reactions to shared baby caregiving.

The Gendered Family Process Model: An Integrative Framework of Gender in the Family

This article reviews and integrates research on gender-related biological, cognitive, and social processes that take place in or between family members, resulting in a newly developed gendered family process (GFP) model. The GFP model serves as a guiding framework for research on gender in the family context, calling for the integration of biological, social, and cognitive factors. Biological factors in the model are prenatal, postnatal, and pubertal androgen levels of children and parents, and genetic effects on parent and child gendered behavior. Social factors are family sex composition (i.e., parent sex, sexual orientation, marriage status, sibling sex composition) and parental gender socialization, such as modeling, gender-differentiated parenting, and gender talk. Cognitive factors are implicit and explicit gender-role cognitions of parents and children. Our review and the GFP model confirm that gender is an important organizer of family processes, but also highlight that much is still unclear about the mechanisms underlying gender-related processes within the family context. Therefore, we stress the need for (1) longitudinal studies that take into account the complex bidirectional relationship between parent and child gendered behavior and cognitions, in which within-family comparisons (comparing behavior of parents toward a boy and a girl in the same family) are made instead of between-family comparisons (comparing parenting between all-boy families and all-girl families, or between mixed-gender families and same-gender families), (2) experimental studies on the influence of testosterone on human gender development, (3) studies examining the interplay between biology with gender socialization and gender-role cognitions in humans.

Affective reactivity to cry sounds predicts young women's reactivity and behavior in a simulated caregiving task

Different populations of adults (experienced vs. inexperienced caregivers, men vs. women, abusive vs. nonabusive parents, etc.) have been reported to differ in their affective reactions to the sounds of infant crying. These differences are thought to impact caregiving behavior and, in some instances, to affect long-term outcomes for infants. There can be great intra-group variation, however, even when group differences are significant; modeling developmental process will require a finer grained approach. We have undertaken a pair of studies intended to validate the Negative Affect Scale (NA) from the PANAS as a measure of individuals' affective reactivity to cry sounds. In Study 1, 306 young women who were not yet mothers listened either to infant crying or to birdsong. The results supported the NA as a measure of reactivity to crying. In Study 2, a new sample of 301 young women listened to crying in a screening task; a group of "high reactors" (n = 21) and a group of "low reactors" (n = 22) then participated in a simulated caregiving situation. Individuals' affective reactivity to the caregiving simulation mirrored their affective reactivity in the screening task, and rates and overall organization of caregiving behavior differed between the groups. Changes in negative affect, then, appear to be both a result of infant crying and a determinant of some aspects of caregiving behavior. Further studies will extend these laboratory results to real infants and their caregivers, and further validate the NA as a measure of individual differences in reactivity to cry sounds.

Emotional development in the context of mother-child relationships

Emotions are generated and regulated in the context of close relationships, such as mother-child relationships. Children's emotional development is primarily directed by mother-child emotional processes. In the current review, we examine the advances in understanding how mother-child relationships impact emotion development. In particular, we explore novel and advanced techniques in measurement and design, autonomic psychophysiology, the structure of emotion socialization, and modeling of parent-child dynamics. As these innovations continue to progress, we expect that theoretical models of emotional development will be further refined.

Changes in face-specific neural processing explain reduced cuteness and approachability of infants with cleft lip

The current study investigated whether changes in the neural processing of faces of infants with a facial abnormality - a cleft lip - mediate effects of the cleft lip on judgments of infant cuteness and approachability. Event-related potentials (ERPs) in response to pictures of faces of healthy infants and infants with a cleft lip, and ratings of cuteness and approachability of these infant faces, were obtained from 30 females. Infants with a cleft lip were rated as less attractive (less cute and approachable) than healthy infants, and both the N170 and P2 components of the ERP were of reduced amplitude in response to pictures of infants with a cleft lip. Importantly, decreased configural processing of infant faces with a cleft lip, as evidenced by reduced N170 amplitudes, mediated the reduced attractiveness ratings for infants with a cleft lip compared to healthy infants. Our findings help elucidate the mechanisms behind the less favorable responses to infants with a cleft lip, highlighting the role of face-specific rather than domain-general neural processes.

Proximal Foundations of Jealousy: Expectations of Exclusivity in the Infant's First Year of Life

In this synthesis, we summarize studies that yielded evidence of jealousy in young infants. To shed light on this phenomenon, we present evidence that jealousy's foundation rests on history of dyadic interactions with caregivers which engender infants' expectations of exclusivity, and on maturation of sociocognitive capacities that enable infants to evaluate whether an exchange between their caregiver and another child represents a violation of that expectation. We conclude with a call for greater study of the antecedents and sequelae of both normative and atypical presentations of jealousy. In addition, we recommend approaches that address jealousy across a range of relationships, both within and beyond those which include attachment figures.

Infant approach and withdrawal in response to a goal blockage: Its antecedent causes and its effect on toddler persistence

In 2 separate longitudinal studies, infants and their mothers were seen in 3 longitudinal visits. At 2 months, they were observed in free play where mothers' contingency toward their infants was obtained. At 5 months, a goal blockage response was produced when a previously learned contingent response became ineffective in producing an interesting event. Infants' emotional responses, in particular anger and sad facial expressions, were observed. At 2 years, toddlers' persistence at play was assessed by measuring children's responses to an interruption of their play. In both studies, the amount of toddlers' persistence was positively related to their anger response to the blocked goal at 5 months. Maternal contingency was not related either to infants' response to the blocked goal or to their persistence at play. These findings provide evidence for the contribution to and the consequences of infants' response to a goal blockage and the role of anger as an approach emotion.