Comorbidities of deformational plagiocephaly in infancy: A scoping review

AIM

While deformational plagiocephaly (DP) is suspected to be associated with comorbidities, their nature and prevalence are unclear. This scoping review aims to report DP comorbidities occurring until the age of 2 years, their prevalence and whether they depend on the child's age and sex.

METHODS

Relevant studies were identified by searching the Cochrane, MEDLINE, EMBASE, PubMed and EBSCO databases from 1992 to 30 April 2021. Data on study characteristics, comorbidities and assessment instruments were extracted and qualitatively synthesised. Risk of bias was assessed and studies with high risk of bias were excluded.

RESULTS

Studies meeting selection criteria (n = 27) often evaluated groups from tertiary clinics, implying selection bias. Studies reported on developmental delay (n = 16), limited speech production (n = 1), auditory (n = 3), visual (n = 3), mandibular (n = 3) and neurological impairments (n = 1). The data did not allow prevalence calculation or modifying effect of sex. Due to biased data, the review provided no evidence on DP comorbidities. Weak evidence suggested that in the selective samples, DP was associated with motor and language delays in the first year.

CONCLUSION

Due to biased data, no evidence on comorbidity in infants with DP was available. Our study underlined the need of risk of bias assessment in scoping reviews.

The development of tone discrimination in infancy: Evidence from a cross-linguistic, multi-lab report

We report the findings of a multi-language and multi-lab investigation of young infants' ability to discriminate lexical tones as a function of their native language, age and language experience, as well as of tone properties. Given the high prevalence of lexical tones across human languages, understanding lexical tone acquisition is fundamental for comprehensive theories of language learning. While there are some similarities between the developmental course of lexical tone perception and that of vowels and consonants, findings for lexical tones tend to vary greatly across different laboratories. To reconcile these differences and to assess the developmental trajectory of native and non-native perception of tone contrasts, this study employed a single experimental paradigm with the same two pairs of Cantonese tone contrasts (perceptually similar vs. distinct) across 13 laboratories in Asia-Pacific, Europe and North-America testing 5-, 10- and 17-month-old monolingual (tone, pitch-accent, non-tone) and bilingual (tone/non-tone, non-tone/non-tone) infants. Across the age range and language backgrounds, infants who were not exposed to Cantonese showed robust discrimination of the two non-native lexical tone contrasts. Contrary to this overall finding, the statistical model assessing native discrimination by Cantonese-learning infants failed to yield significant effects. These findings indicate that lexical tone sensitivity is maintained from 5 to 17 months in infants acquiring tone and non-tone languages, challenging the generalisability of the existing theoretical accounts of perceptual narrowing in the first months of life. RESEARCH HIGHLIGHTS: This is a multi-language and multi-lab investigation of young infants' ability to discriminate lexical tones. This study included data from 13 laboratories testing 5-, 10-, and 17-month-old monolingual (tone, pitch-accent, non-tone) and bilingual (tone/non-tone, non-tone/non-tone) infants. Overall, infants discriminated a perceptually similar and a distinct non-native tone contrast, although there was no evidence of a native tone-language advantage in discrimination. These results demonstrate maintenance of tone discrimination throughout development.

Infants rationally infer the goals of other people's reaches in the absence of first-person experience with reaching actions

Does knowledge of other people's minds grow from concrete experience to abstract concepts? Cognitive scientists have hypothesized that infants' first-person experience, acting on their own goals, leads them to understand others' actions and goals. Indeed, classic developmental research suggests that before infants reach for objects, they do not see others' reaches as goal-directed. In five experiments (N = 117), we test an alternative hypothesis: Young infants view reaching as undertaken for a purpose but are open-minded about the specific goals that reaching actions are aimed to achieve. We first show that 3-month-old infants, who cannot reach for objects, lack the expectation that observed acts of reaching will be directed to objects rather than to places. Infants at the same age learned rapidly, however, that a specific agent's reaching action was directed either to an object or to a place, after seeing the agent reach for the same object regardless of where it was, or to the same place regardless of what was there. In a further experiment, 3-month-old infants did not demonstrate such inferences when they observed an actor engaging in passive movements. Thus, before infants have learned to reach and manipulate objects themselves, they infer that reaching actions are goal-directed, and they are open to learning that the goal of an action is either an object or a place. RESEARCH HIGHLIGHTS: In the present experiments, 3-month-old prereaching infants learned to attribute either object goals or place goals to other people's reaching actions. Prereaching infants view agents' actions as goal-directed, but do not expect these acts to be directed to specific objects, rather than to specific places. Prereaching infants are open-minded about the specific goal states that reaching actions aim to achieve.

Greater attention to socioeconomic status in developmental research can improve the external validity, generalizability, and replicability of developmental science

Psychological researchers have been criticized for making broad presumptions about human behavior based on limited sampling. In part, presumptive generalizability is reflected in the limited representation of sociodemographic variation in research reports. In this analysis, we examine time-trends in reporting of a key sociodemographic construct relevant to many aspects of child development-socioeconomic status (SES)-across six mainstream developmental journals (Infancy, Child Development, Developmental Science, Developmental Psychology, Infant and Child Development, and Infant Behavior & Development) between 2016 and 2022. Findings point to limited reporting of SES across developmental journals and across time. Reporting rates varied significantly by region and by topic of development. In terms of specific indicators of SES, there was consistent use of income and caregiver education as SES indicators. The epistemic costs of the lack of integration of socio-economic factors in developmental research are addressed. Pathways to greater integration of SES are proposed. RESEARCH HIGHLIGHTS: We analyzed reporting and representation of socioeconomic status in published studies on early child development. A large proportion of published studies did not report any socio-economic information. Suggestions for greater attention to socioeconomic status are proposed.

All together now: Assessing variation in maternal and nonmaternal handling of wild Colobus vellerosus infants

Primatologists have a long-standing interest in the study of maternal care and nonmaternal handling (NH) of infants stemming from recognition that early social relationships can have enduring consequences. Though maternal care and NH often include expression of similar behaviors, they are regularly studied in isolation from each other with nonoverlapping terminology, thereby overlooking possible interplay between them and obfuscating potential developmental ramifications that ensue from trade-offs made between maternal (MH) and NH during infancy. To that end, identifying how MH and NH patterns interact and contribute to the total handling (TH) infants receive is a critical first step. We present durational handling data collected from 25 wild Colobus vellerosus infants from 2016 to 2017 and assess the relationships between TH, MH, and NH. Patterns of social affiliation are shaped in part by surrounding context, and therefore, we also assess whether NH and TH differ in their responsivity to various infant and social group characteristics. Ninety-four percent of observed handling was MH, while just 5.5% was NH. Young infants who received more MH (excluding nursing) also received more NH; there was no relationship between the two in older infants. Infants in larger groups participated in more handling of all types. Additionally, NH time was associated with infant sex and group stability. Non-nursing TH time was associated with group stability and infant cohort size. Though NH variation likely confers social-networking advantage, in this population NH is not a major contributor to TH and would not effectively replace reduced MH. The positive association between MH and NH during early infancy suggests that colobus mothers may play a mediating role in shaping infant socialization. This is a first step in elucidating how different forms of handling relate to one another in wild primates and in identifying the impact of handling on infant socialization.

Photos Shared on Facebook in the Context of Safe Sleep Recommendations: Content Analysis of Images

Background

Sudden unexpected infant death (SUID) remains a leading cause of infant mortality; therefore, understanding parental practices of infant sleep at home is essential. Since social media analyses yield invaluable patient perspectives, understanding sleep practices in the context of safe sleep recommendations via a Facebook mothers' group is instrumental for policy makers, health care providers, and researchers.

Objective

This study aimed to identify photos shared by mothers discussing SUID and safe sleep online and assess their consistency with infant sleep guidelines per the American Academy of Pediatrics (AAP). We hypothesized the photos would not be consistent with guidelines based on prior research and increasing rates of accidental suffocation and strangulation in bed.

Methods

Data were extracted from a Facebook mothers' group in May 2019. After trialing various search terms, searching for the term "SIDS" on the selected Facebook group resulted in the most relevant discussions on SUID and safe sleep. The resulting data, including 20 posts and 912 comments among 512 mothers, were extracted and underwent qualitative descriptive content analysis. In completing the extraction and subsequent analysis, 24 shared personal photos were identified among the discussions. Of the photos, 14 pertained to the infant sleep environment. Photos of the infant sleep environment were then assessed for consistency with safe sleep guidelines per the AAP standards by 2 separate reviewers.

Results

Of the shared photos relating to the infant sleep environment, 86% (12/14) were not consistent with AAP safe sleep guidelines. Specific inconsistencies included prone sleeping, foreign objects in the sleeping environment, and use of infant sleeping devices. Use of infant monitoring devices was also identified.

Conclusions

This study is unique because the photos originated from the home setting, were in the context of SUID and safe sleep, and were obtained without researcher interference. Despite study limitations, the commonality of prone sleeping, foreign objects, and the use of both infant sleep and monitoring devices (ie, overall inconsistency regarding AAP safe sleep guidelines) sets the stage for future investigation regarding parental barriers to practicing safe infant sleep and has implications for policy makers, clinicians, and researchers.

The impact of parents' stress on parents' and young childrens' mental health-Short- and long-term effects of risk and resilience factors in families with children aged 0-3 in a representative sample

Stress in parents has a significant impact on parenting and infant's development. However, few studies have examined cross-sectional and longitudinal links on risk and resilience of burdened families. Thus, this study aimed to investigate subjective risk and resilience factors on family well-being. Data stem from the 2015 nationwide study "Children in Germany" ("Kinder in Deutschland" - KiD 0-3). Parents of children aged zero to 3 years (N = 8.063) were recruited from random probability-sampled paediatric clinics (n = 271) across Germany. Risk and resilience variables such as parents' perceived stress (PSS-4), competence, isolation and attachment (PSI), as well as parental inner anger (items from CAP), relationship quality (DAS-4) and the child's negative emotionality (items from SGKS) were assessed at baseline in addition to demographic variables to predict parents' mental health (PHQ-4) and negative emotionality of the child at baseline (T1) and in the 2-year follow-up (T2) using linear regression models. At baseline, parents' mental health was predicted by inner anger, the child's negative emotionality and being a single parent (R2 = 45.1%) at baseline, but only by parenting competence at the two-year-follow-up (R2 = 25.1%). The child's negative emotionality was predicted (R2 = 27.5%) by the child's age, and parental inner anger and competence, attachment, perceived stress, mental health as well as education background. At two-year-follow-up, the child's age, single parenthood, social welfare benefit, child's negative emotionality at baseline, relationship quality and competence were significant predictor variables (R2 = 22.8%). This study highlights the impact of specific risk and resilience factors not only on parents' mental health but also the child's negative emotionality in the short and long-term in early childhood. Universal, but also selective prevention programs should increase parents' resilience (e.g., focusing on self-efficacy, competence, coping strategies).

Infant-directed communication: Examining the many dimensions of everyday caregiver-infant interactions

Everyday caregiver-infant interactions are dynamic and multidimensional. However, existing research underestimates the dimensionality of infants' experiences, often focusing on one or two communicative signals (e.g., speech alone, or speech and gesture together). Here, we introduce "infant-directed communication" (IDC): the suite of communicative signals from caregivers to infants including speech, action, gesture, emotion, and touch. We recorded 10 min of at-home play between 44 caregivers and their 18- to 24-month-old infants from predominantly white, middle-class, English-speaking families in the United States. Interactions were coded for five dimensions of IDC as well as infants' gestures and vocalizations. Most caregivers used all five dimensions of IDC throughout the interaction, and these dimensions frequently overlapped. For example, over 60% of the speech that infants heard was accompanied by one or more non-verbal communicative cues. However, we saw marked variation across caregivers in their use of IDC, likely reflecting tailored communication to the behaviors and abilities of their infant. Moreover, caregivers systematically increased the dimensionality of IDC, using more overlapping cues in response to infant gestures and vocalizations, and more IDC with infants who had smaller vocabularies. Understanding how and when caregivers use all five signals-together and separately-in interactions with infants has the potential to redefine how developmental scientists conceive of infants' communicative environments, and enhance our understanding of the relations between caregiver input and early learning. RESEARCH HIGHLIGHTS: Infants' everyday interactions with caregivers are dynamic and multimodal, but existing research has underestimated the multidimensionality (i.e., the diversity of simultaneously occurring communicative cues) inherent in infant-directed communication. Over 60% of the speech that infants encounter during at-home, free play interactions overlap with one or more of a variety of non-speech communicative cues. The multidimensionality of caregivers' communicative cues increases in response to infants' gestures and vocalizations, providing new information about how infants' own behaviors shape their input. These findings emphasize the importance of understanding how caregivers use a diverse set of communicative behaviors-both separately and together-during everyday interactions with infants.

To sleep or to breastfeed: Associations between feeding method and sleep in infants and children

AIM

This study aimed to understand the association between feeding method, specifically breastfeeding versus non-breastfeeding, at 6 and 12 months and infant sleep over the first 3 years of life.

METHODS

A sample of 444 mother-infant dyads from the Maternal Adversity, Vulnerability and Neurodevelopment cohort were analysed. Based on retrospective maternal reports between 3-24 months, infants' breastfeeding status was determined at 6 and 12 months. Nocturnal sleep duration, longest period of consecutive sleep, and total sleep over 24 h were measured by maternal reports at 6, 12, 24 and 36 months.

RESULTS

Generalized Estimating Equations revealed no significant association between feeding status, both at 6 and 12 months, and nocturnal sleep duration or total sleep over 24 h between 6-36 months (p > 0.05). However, breastfeeding at both 6 and 12 months was associated with shorter periods of consecutive sleep, at 6 and 12 months (p < 0.05) but not at 24 and 36 months (p > 0.05).

CONCLUSION

Our findings suggest that breastfeeding seems to be associated with more infant sleep fragmentation but not with total sleep duration in early infancy. However, this sleep fragmentation does not persist into later infancy and early toddlerhood.

Selective Action Prediction in Infancy Depending on Linguistic Cues: An EEG and Eyetracker Study

Humans' capacity to predict actions and to socially categorize individuals is at the basis of social cognition. Such capacities emerge in early infancy. By 6 months of age, infants predict others' reaching actions considering others' epistemic state. At a similar age, infants are biased to attend to and interact with more familiar individuals, considering adult-like social categories such as the language people speak. We report that these two core processes are interrelated early on in infancy. In a belief-based action prediction task, 6-month-old infants (males and females) presented with a native speaker generated online predictions about the agent's actions, as revealed by the activation of participants' sensorimotor areas before the agent's movement. However, infants who were presented with a foreign speaker did not recruit their motor system before the agent's action. The eyetracker analysis provided further evidence that linguistic group familiarity influences how infants predict others' actions, as only infants presented with a native speaker modified their attention to the stimuli as a function of the agent's forthcoming behavior. The current findings suggest that infants' emerging capacity to predict others' actions is modulated by social cues, such as others' linguistic group. A facilitation to predict and encode the actions of native speakers relative to foreign speakers may explain, in part, why infants preferentially attend to, imitate, and learn from the actions of native speakers.

Contact with caregivers is associated with composition of the infant gastrointestinal microbiome in the first 6 months of life

OBJECTIVES

Little is known about how physical contact at birth and early caregiving environments influence the colonization of the infant gastrointestinal microbiome. We investigated how infant contact with caregivers at birth and within the first 2 weeks of life relates to the composition of the gastrointestinal microbiome in a sample of U.S. infants (n = 60).

METHODS

Skin-to-skin and physical contact with caregivers at birth and early caregiving environments were surveyed at 2 weeks postpartum. Stool samples were collected from infants at 2 weeks, 2, 6, and 12 months of age and underwent 16S rRNA sequencing as a proxy for the gastrointestinal microbiome. Associations between early caregiving environments and alpha and beta diversity, and differential abundance of bacteria at the genus level were assessed using PERMANOVA, and negative binomial mixed models in DEseq2.

RESULTS

Time in physical contact with caregivers explained 10% of variation in beta diversity at 2 weeks' age. The number of caregivers in the first few weeks of life explained 9% of variation in beta diversity at 2 weeks and the number of individuals in physical contact at birth explained 11% of variation in beta diversity at 6 months. Skin-to-skin contact on the day of birth was positively associated with the abundance of eight genera. Infants held for by more individuals had greater abundance of eight genera.

DISCUSSION

Results reveal a potential mechanism (skin-to-skin and physical contact) by which caregivers influence the infant gastrointestinal microbiome. Our findings contribute to work exploring the social transmission of microbes.

Infants of mothers with early remitted clinical depression and mothers with no postpartum depression: Adaptive functioning in the second year of life

Whether and how remitted clinical depression in postpartum motherhood contributes to poor infant adaptive functioning is inconclusive. The present longitudinal study examines adaptive functioning in infants of mothers diagnosed as clinically depressed at 5 months but remitted at 15 and 24 months. Fifty-five U. S. mothers with early, remitted clinical depression and 132 mothers without postpartum depression completed the Vineland Adaptive Behavior Scales about their infants at 15 and 24 months. Between groups, mothers were equivalent in age, ethnicity, marital status, and receptive vocabulary (a proxy for verbal intelligence), and infants were equivalent in age and distribution of gender. Controlling for maternal education and parity, mothers with early, remitted clinical depression and mothers with no postpartum depression rated their infants similarly on communication, daily living skills, and socialization. Mothers with early, remitted clinical depression rated their infants poorer in motor skills. Girls were rated more advanced than boys in communication at 24 months and daily living skills at 15 and 24 months. Rated infant adaptive behavior skills increased from 15 to 24 months. With exceptions, adaptive functioning in infants may be robust to early, remitted maternal depression, and adaptive functioning presents a domain to promote positive development in this otherwise vulnerable population.

Lung function changes in children exposed to mine fire smoke in infancy

BACKGROUND AND OBJECTIVE

Chronic, low-intensity air pollution exposure has been consistently associated with reduced lung function throughout childhood. However, there is limited research regarding the implications of acute, high-intensity air pollution exposure. We aimed to determine whether there were any associations between early life exposure to such an episode and lung growth trajectories.

METHODS

We conducted a prospective cohort study of children who lived in the vicinity of the Hazelwood coalmine fire. Lung function was measured using respiratory oscillometry. Z-scores were calculated for resistance (R5 ) and reactance at 5 Hz (X5 ) and area under the reactance curve (AX). Two sets of analyses were conducted: (i) linear regression to assess the cross-sectional relationship between post-natal exposure to mine fire-related particulate matter with an aerodynamic diameter of less than 2.5 micrometres (PM2.5 ) and lung function at the 7-year follow-up and (ii) linear mixed-effects models to determine whether there was any association between exposure and changes in lung function between the 3- and 7-year follow-ups.

RESULTS

There were no associations between mine fire-related PM2.5 and any of the lung function measures, 7-years later. There were moderate improvements in X5 (β: -0.37 [-0.64, -0.10] p = 0.009) and AX (β: -0.40 [-0.72, -0.08] p = 0.014), between the 3- and 7-year follow-ups that were associated with mean PM2.5 , in the unadjusted and covariance-adjusted models. Similar trends were observed with maximum PM2.5 .

CONCLUSION

There was a moderate improvement in lung stiffness of children exposed to PM2.5 from a local coalmine fire in infancy, consistent with an early deficit in lung function at 3-years after the fire that had resolved by 7-years.

Bedtime to the brain: how infants' sleep behaviours intertwine with non-rapid eye movement sleep electroencephalography features

Adequate sleep is critical for development and facilitates the maturation of the neurophysiological circuitries at the basis of cognitive and behavioural function. Observational research has associated early life sleep problems with worse later cognitive, psychosocial, and somatic health outcomes. Yet, the extent to which day-to-day sleep behaviours (e.g., duration, regularity) in early life relate to non-rapid eye movement (NREM) neurophysiology-acutely and the long-term-remains to be studied. We measured sleep behaviours in 32 healthy 6-month-olds assessed with actimetry and neurophysiology with high-density electroencephalography (EEG) to investigate the association between NREM sleep and habitual sleep behaviours. Our study revealed four findings: first, daytime sleep behaviours are related to EEG slow-wave activity (SWA). Second, night-time movement and awakenings from sleep are connected with spindle density. Third, habitual sleep timing is linked to neurophysiological connectivity quantified as delta coherence. And lastly, delta coherence at 6 months predicts night-time sleep duration at 12 months. These novel findings widen our understanding that infants' sleep behaviours are closely intertwined with three particular levels of neurophysiology: sleep pressure (determined by SWA), the maturation of the thalamocortical system (spindles), and the maturation of cortical connectivity (coherence). The crucial next step is to extend this concept to clinical groups to objectively characterise infants' sleep behaviours 'at risk' that foster later neurodevelopmental problems.

Investigating Father or Partner Involvement in Family Integrated Care in Neonatal Units: Protocol for a Prospective, Multicenter, Multiphase Study

BACKGROUND

Neonatal unit (NU) admissions for premature babies can last for months, which can significantly impact parental mental health (MH) with symptoms of depression, stress, and anxiety. Literature suggests fathers experience comparable MH symptoms to mothers. Family integrated care (FICare) is a culture where parents are collaborators and partners in caring for their hospitalized newborns. FICare improves infant outcomes and maternal MH. Similar reports on fathers are limited.

OBJECTIVE

The primary aim of this study is to investigate the impact of supporting father or partner engagement in FICare of preterm infants on their MH up to 6 weeks postdischarge. The secondary aim is to investigate the impact on maternal MH.

METHODS

This is a 2-phase study: phase 1 to gather baseline information and phase 2 to assess the impact of enhanced father or partner engagement in FICare on their MH, involving 2 NUs (tertiary and level 2). Enhanced FICare will be developed and introduced (eg, information booklet, workbook, classes, and a father peer-support group) alongside standard FICare practices. Father or partner MH will be assessed with semistructured qualitative interviews and validated questionnaires: Generalized Anxiety Disorder Assessment, Patient Health Questionnaire, and Parental Stressor Scale: Neonatal Intensive Care Unit from NU admission to 6 weeks postdischarge. Mothers will be assessed by focus groups and the same questionnaires. Descriptive statistics and appropriate comparative tests, such as the 2-tailed t test, will be used to analyze and compare phase 1 and 2 data. Qualitative data will be coded line by line with the use of NVivo (Lumivero) and thematically analyzed. Simultaneously, systematic reviews (SRs) of fathers' experiences of FICare and their MH outcomes will be conducted. The study was approved by the National Research Ethics Committee (22/EM/0140) in August 2022. A parent advisory group was formed to advise on the study methodology, materials, involvement of participant parents, and dissemination of study findings.

RESULTS

A recent SR demonstrated that data saturation is likely to be achieved by interviewing 9 to 17 participants. We will study a maximum of 20 parents of infants born at less than 33 weeks' gestation in each phase. As of October 2023, the study was ongoing. The SR studies are registered with the PROSPERO database (324275 and 306760). The projected end date for data collection is July 2024; data analysis will be conducted in November 2024 and publication will occur in 2025.

CONCLUSIONS

The study aims to demonstrate the feasibility of using a father or partner-sensitive FICare model for parents of premature babies with a positive impact on their MH. It will demonstrate the feasibility of providing FICare to extremely premature babies receiving intensive care. This study may support the development of inclusive FICare guidelines for nonbirthing parents and their extremely premature infants.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT06022991; https://classic.clinicaltrials.gov/ct2/show/NCT06022991.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/53160.

Identifying elevated child weight from 3 to 24 months: Early transitions into nonparental care and to solid foods

BACKGROUND

Early entry into nonparental care (NPC) and introduction to solid foods (ITS) have been linked to elevated weight, however, little research exists on the combined influence of these transitions on child weight over time.

OBJECTIVES

Identify groups of children based on early NPC and ITS timing and examine whether NPC-ITS groups differentially affect child weight over time.

METHOD

Data were drawn from STRONG Kids2 (n = 468). Primary predictors include NPC (by 3M)-ITS (< or ≥6M) groups; outcome variables include child weight-for-length/height z-scores (WFL/WFHz) (3, 12, 18, and 24 months). Multilevel regression was used to examine the NPC-ITS groups as predictors of child WFL/WFHz.

RESULTS

Six groups were identified: 27% Parental Care-ITS before 6M, 31% Parental Care-ITS after 6M, 12% Daycare-ITS before 6M, 14% Daycare-ITS after 6M, 10% Kincare-ITS before 6M, and 7% Kincare-ITS after 6M. Children who were in daycare (regardless of ITS) or kincare-ITS before 6M demonstrated the highest WFL/WFHz over time, compared to their parental care counterparts.

CONCLUSIONS

NPC-ITS combinations on child WFL/WFHz across the first 2 years of life highlight the need for a partnership approach among parental and nonparental caregivers to support the feeding of infants throughout the transition to solid foods.

Love on the developing brain: Maternal sensitivity and infants' neural responses to emotion in the dorsolateral prefrontal cortex

Infancy is a sensitive period of development, during which experiences of parental care are particularly important for shaping the developing brain. In a longitudinal study of N = 95 mothers and infants, we examined links between caregiving behavior (maternal sensitivity observed during a mother-infant free-play) and infants' neural response to emotion (happy, angry, and fearful faces) at 5 and 7 months of age. Neural activity was assessed using functional Near-Infrared Spectroscopy (fNIRS) in the dorsolateral prefrontal cortex (dlPFC), a region involved in cognitive control and emotion regulation. Maternal sensitivity was positively correlated with infants' neural responses to happy faces in the bilateral dlPFC and was associated with relative increases in such responses from 5 to 7 months. Multilevel analyses revealed caregiving-related individual differences in infants' neural responses to happy compared to fearful faces in the bilateral dlPFC, as well as other brain regions. We suggest that variability in dlPFC responses to emotion in the developing brain may be one correlate of early experiences of caregiving, with implications for social-emotional functioning and self-regulation.

I'll Never Give Up: A Qualitative Study of Caregivers' Perceptions and Decisional Processes When Feeding Infants and Toddlers Novel and Disliked Foods

OBJECTIVE

To better understand caregivers' decisional processes related to offering novel and disliked foods to their infants and toddlers.

DESIGN

As part of a parent study on young children's food acceptance that took place in Denver, CO, this secondary analysis used a basic qualitative approach to explore caregivers' decisional processes related to repeated exposure and children's food rejection.

PARTICIPANTS

English-speaking caregivers of infants and toddlers (aged 6-24 months; n = 106) were recruited via flyers and social media and interviewed (from July, 2017 to January, 2018) during a laboratory visit focused on introducing a novel food.

PHENOMENON OF INTEREST

Factors influencing caregiver decisions to (dis)continue offering novel or disliked foods.

ANALYSIS

Using a combined deductive and inductive coding approach, trained researchers coded transcripts and codes, which were reviewed and discussed by all investigators to identify themes.

RESULTS

Three major themes (and 2 subthemes) were generated regarding caregivers' decisions about re-offering rejected foods: 1) Caregivers understand that multiple experiences with new foods are needed because children's reactions can be unpredictable and depend upon time, developmental stage, and child traits; 2) Caregivers vary in their persistence and decisions to keep offering foods depending on responsiveness to child cues (sub-theme) and adult-centered beliefs, needs, and decisions (sub-theme); 3) Child food acceptance will change with time, circumstances, and development if you keep trying.

CONCLUSIONS AND IMPLICATIONS

Although caregivers are aware of repeated exposure, additional implementation research focused on translating theory into effective home practices could assist caregivers to persist in offering novel or disliked foods.

Precursors to infant sensorimotor synchronization to speech and non-speech rhythms: A longitudinal study

Impaired sensorimotor synchronization (SMS) to acoustic rhythm may be a marker of atypical language development. Here, Motion Capture was used to assess gross motor rhythmic movement at six time points between 5- and 11 months of age. Infants were recorded drumming to acoustic stimuli of varying linguistic and temporal complexity: drumbeats, repeated syllables and nursery rhymes. Here we show, for the first time, developmental change in infants' movement timing in response to auditory stimuli over the first year of life. Longitudinal analyses revealed that whilst infants could not yet reliably synchronize their movement to auditory rhythms, infant spontaneous motor tempo became faster with age, and by 11 months, a subset of infants decelerate from their spontaneous motor tempo, which better accords with the incoming tempo. Further, infants became more regular drummers with age, with marked decreases in the variability of spontaneous motor tempo and variability in response to drumbeats. This latter effect was subdued in response to linguistic stimuli. The current work lays the foundation for using individual differences in precursors of SMS in infancy to predict later language outcomes. RESEARCH HIGHLIGHT: We present the first longitudinal investigation of infant rhythmic movement over the first year of life Whilst infants generally move more quickly and with higher regularity over their first year, by 11 months infants begin to counter this pattern when hearing slower infant-directed song Infant movement is more variable to speech than non-speech stimuli In the context of the larger Cambridge UK BabyRhythm Project, we lay the foundation for rhythmic movement in infancy to predict later language outcomes.

Mini-Puberty, Physiological and Disordered: Consequences, and Potential for Therapeutic Replacement

There are 3 physiological waves of central hypothalamic-pituitary-gonadal (HPG) axis activity over the lifetime. The first occurs during fetal life, the second-termed "mini-puberty"-in the first months after birth, and the third at puberty. After adolescence, the axis remains active all through adulthood. Congenital hypogonadotropic hypogonadism (CHH) is a rare genetic disorder characterized by a deficiency in hypothalamic gonadotropin-releasing hormone (GnRH) secretion or action. In cases of severe CHH, all 3 waves of GnRH pulsatility are absent. The absence of fetal HPG axis activation manifests in around 50% of male newborns with micropenis and/or undescended testes (cryptorchidism). In these boys, the lack of the mini-puberty phase accentuates testicular immaturity. This is characterized by a low number of Sertoli cells, which are important for future reproductive capacity. Thus, absent mini-puberty will have detrimental effects on later fertility in these males. The diagnosis of CHH is often missed in infants, and even if recognized, there is no consensus on optimal therapeutic management. Here we review physiological mini-puberty and consequences of central HPG axis disorders; provide a diagnostic approach to allow for early identification of these conditions; and review current treatment options for replacement of mini-puberty in male infants with CHH. There is evidence from small case series that replacement with gonadotropins to mimic "mini-puberty" in males could have beneficial outcomes not only regarding testis descent, but also normalization of testis and penile sizes. Moreover, such therapeutic replacement regimens in disordered mini-puberty could address both reproductive and nonreproductive implications.

Infant vocal productions coincide with body movements

Producing recognizable words is a difficult motor task; a one-syllable word can require the coordination of over 80 muscles. Thus, it is not surprising that the development of word productions in infancy lags considerably behind receptive language and is a known limiting factor in language development. A large literature has focused on the vocal apparatus, its articulators, and language development. There has been limited study of the relations between non-speech motor skills and the quality of early speech productions. Here we present evidence that the spontaneous vocalizations of 9- to 24-month-old infants recruit extraneous, synergistic co-activations of hand and head movements and that the temporal precision of the co-activation of vocal and extraneous muscle groups tightens with age and improved recognizability of speech. These results implicate an interaction between the muscle groups that produce speech and other body movements and provide new empirical pathways for understanding the role of motor development in language acquisition. RESEARCH HIGHLIGHTS: The spontaneous vocalizations of 9- to 24-month-old infants recruit extraneous, synergistic co-activations of hand and head movements. The temporal precision of these hand and head movements during vocal production tighten with age and improved speech recognition. These results implicate an interaction between the muscle groups producing speech with other body movements. These results provide new empirical pathways for understanding the role of motor development in language acquisition.

Personalized Infant Risk Prediction for Severe Respiratory Syncytial Virus Lower Respiratory Tract Infection Requiring Intensive Care Unit Admission

Background

Currently, there are no available tools to identify infants at the highest risk of significant morbidity and mortality from respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) who would benefit most from RSV prevention products. The objective was to develop and internally validate a personalized risk prediction tool for use among all newborns that uses readily available birth/postnatal data to predict RSV LRTI requiring intensive care unit (ICU) admission.

Methods

We conducted a population-based birth cohort study of infants born from 1995 to 2007, insured by the Tennessee Medicaid Program, and who did not receive RSV immunoprophylaxis during the first year of life. The primary outcome was severe RSV LRTI requiring ICU admission during the first year of life. We built a multivariable logistic regression model including demographic and clinical variables available at or shortly after birth to predict the primary outcome.

Results

In a population-based sample of 429 365 infants, 713 (0.2%) had severe RSV LRTI requiring ICU admission. The median age of admission was 66 days (interquartile range, 37-120). Our tool, including 19 variables, demonstrated good predictive accuracy (area under the curve, 0.78; 95% confidence interval, 0.77-0.80) and identified infants who did not qualify for palivizumab, based on American Academy of Pediatrics guidelines, but had higher predicted risk levels than infants who qualified (27% of noneligible infants with >0.16% predicted probabilities [lower quartile for eligible infants]).

Conclusions

We developed a personalized tool that identified infants at increased risk for severe RSV LRTI requiring ICU admission, expected to benefit most from immunoprophylaxis.

Birth, cognitive and behavioral effects of intrauterine cannabis exposure in infants and children: A systematic review and meta-analysis

BACKGROUND AND AIMS

Δ9-tetrahydrocannabinol (THC), the principal psychoactive component of cannabis, has been implicated in affecting fetal neurodevelopment by readily crossing the placenta. However, little is known regarding the long-term effects of intrauterine cannabis exposure. This systematic review and meta-analysis synthesized prospective and cross-sectional human studies to measure the effects of intrauterine cannabis exposure on birth, behavioral, psychological and cognitive outcomes in infancy until early childhood.

METHODS

Reporting according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, cross-sectional and prospective studies published from database inception until June 2023, investigating developmental outcomes of infants, toddlers and young children with intrauterine cannabis exposure were considered. All articles were obtained from PubMed or PsycINFO databases.

RESULTS

The literature search resulted in 932 studies, in which 57 articles met eligibility criteria. The meta-analysis revealed that intrauterine cannabis exposure increases the risk of preterm delivery [odds ratio (OR) = 1.68, 95% confidence interval (CI) = 1.05-2.71, P = 0.03], low birth weight (OR = 2.60, CI = 1.71-3.94, P < 0.001) and requirement for neonatal intensive care unit (NICU) admission (OR = 2.51, CI = 1.46-4.31; P < 0.001). Our qualitative synthesis suggests that intrauterine cannabis exposure may be associated with poorer attention and externalizing problems in infancy and early childhood. We found no evidence for impairments in other cognitive domains or internalizing behaviors.

CONCLUSIONS

Prenatal cannabis use appears to be associated with lower birth weight, preterm birth and neonatal intensive care unit admission in newborns, but there is little evidence that prenatal cannabis exposure adversely impacts behavioral or cognitive outcomes in early childhood, with the exception of attention and externalizing problems.

Infant and early childhood teleconsultation and training: Program description and feasibility outcomes from a statewide implementation

To address high rates of mental health and developmental concerns facing young children ages 0-6 in the United States and internationally, providers across professional sectors need Infant and early childhood mental health (IECMH) training and support. The training and teleconsultation program (TTP) is a state-funded program developed in one Mountain West state in the United States to provide free IECMH training and teleconsultation to any provider working with young children. The TTP included access to webinars and individual or group consultation with licensed mental health providers. Webinars focused on increasing awareness and knowledge related to attachment and child development, supporting parents and caregivers, trauma-informed practice, supporting emotional health of staff and providers, and culturally responsive practices with infants, young children, and caregivers. Teleconsultation included case consultation, reflective individual and group supervision, and collaboration supports/referrals. During the 18-month evaluation period, 1568 unique providers engaged in either training or teleconsultation services, an average of 9% growth in new providers each month, with representation from all professional sectors and all state counties. This program demonstrates the feasibility and need for statewide training and teleconsultation programs to help meet the needs of providers who interact with and support young children and caregivers.

Controlling the input: How one-year-old infants sustain visual attention

Traditionally, the exogenous control of gaze by external saliencies and the endogenous control of gaze by knowledge and context have been viewed as competing systems, with late infancy seen as a period of strengthening top-down control over the vagaries of the input. Here we found that one-year-old infants control sustained attention through head movements that increase the visibility of the attended object. Freely moving one-year-old infants (n = 45) wore head-mounted eye trackers and head motion sensors while exploring sets of toys of the same physical size. The visual size of the objects, a well-documented salience, varied naturally with the infant's moment-to-moment posture and head movements. Sustained attention to an object was characterized by the tight control of head movements that created and then stabilized a visual size advantage for the attended object for sustained attention. The findings show collaboration between exogenous and endogenous attentional systems and suggest new hypotheses about the development of sustained visual attention.

"Catastrophic" set size limits on infants' capacity to represent objects: A systematic review and Bayesian meta-analysis

Decades of research has revealed that humans can concurrently represent small quantities of three-dimensional objects as those objects move through space or into occlusion. For infants (but not older children or adults), this ability apparently comes with a significant limitation: when the number of occluded objects exceeds three, infants experience what has been characterized as a "catastrophic" set size limit, failing to represent even the approximate quantity of the hidden array. Infants' apparent catastrophic representational failures suggest a significant information processing limitation in the first years of life, and the evidence has been used as support for prominent theories of the development of object and numerical cognition. However, the evidence for catastrophic failure consists of individual small-n experiments that use null hypothesis significance testing to obtain null results (i.e., p > 0.05). Whether catastrophic representational failures are robust or reliable across studies, methods, and labs is not known. Here we report a systematic review and Bayesian meta-analysis to examine the strength of the evidence in favor of catastrophic representational failures in infancy. Our analysis of 22 experiments across 12 reports, with a combined total of n = 367 infants aged 10-20 months, revealed strong support for the evidence for catastrophic set size limits. A complementary analysis found moderate support for infants' success when representing fewer than four objects. We discuss the implications of our findings for theories of object and numerical cognitive development. RESEARCH HIGHLIGHTS: Previous work has suggested that infants are unable to concurrently represent four or more objects-a "catastrophic" set size limit. We reviewed this work and conducted a Bayesian meta-analysis to examine the robustness of this limit across individual small-n experiments. We found strong support for the evidence for catastrophic set size limits, and moderate support for infants' success when representing fewer than four objects.

Measurement of Head Circumference Using a Smartphone: Feasibility Cohort Study

BACKGROUND

Accurate head circumference (HC) measurement is essential when assessing neonates and infants. Tape measure HC measurements are prone to errors, particularly when performed by parents/guardians, due to individual differences in head shape, hair style and texture, subject cooperation, and examiner techniques, including tape measure placement and tautness. There is, therefore, the need for a more reliable method.

OBJECTIVE

The primary objective of this study was to evaluate the validity, reliability, and consistency of HC app measurement compared to the current standard of practice, serving as a proof-of-concept for use by health care professionals.

METHODS

We recruited infants attending the neurosurgery clinic, and parents/guardians were approached and consented to participate in the study. Along with the standard head circumference measurement, measurements were taken with the head circumference app (HC app) developed in-house, and we also collected baseline medical history and characteristics. For the statistical analysis, we used RStudio (version 4.1.1). In summary, we analyzed covariance and intraclass correlation coefficient (ICC) to compare the measurement's within-rater and interrater reliability. The F test was used to analyze the variance between measurements and the Bland-Altman agreement, t test, and correlation coefficients were used to compare the tape measurement to the measures taken by the HC app. We also used nonvalidated questionnaires to explore parental or guardians' experiences, assess their views on app utility, and collect feedback.

RESULTS

The total number of recruited patients was 37. Comparison between the app measurements and the measurements with a tape measure showed poor reliability (ICC=0.177) and wide within-app variations (ICC=0.341). The agreement between the measurements done by parents/guardians and the tape measurements done by the researcher was good (ICC=0.901). Parental/guardian feedback was overall very positive, with most of the parents/guardians reporting that the app was easy to use (n=31, 84%) and that they are happy to use the app in an unsupervised setting, provided that they are assured of the measurement quality.

CONCLUSIONS

We developed this project as a proof-of-concept study, and as such, the app has shown great potential to be used both in a clinical setting and by parents/guardians in their own homes.

Words and arbitrary actions in early object categorization: weak evidence for a word advantage

Both words and gestures have been shown to influence object categorization, often even overriding perceptual similarities to cue category membership. However, gestures are often meaningful to infants while words are arbitrarily related to an object they refer to, more similar to arbitrary actions that can be performed on objects. In this study, we examine how words and arbitrary actions shape category formation. Across three conditions (word cue, action cue, word-action cue), we presented infants (N = 90) with eight videos of single-category objects which vary in colour and other perceptual features. The objects were either accompanied by a word and/or an action that is being performed on the object. Infants in the word and action condition showed a decrease in looking over the course of the familiarization phase indicating habituation to the category, but infants in the word-action condition did not. At test, infants saw a novel object of the just-learned category and a novel object from another category side-by-side on the screen. There was some evidence for an advantage for words in shaping early object categorization, although we note that this was not robust across analyses.

Social motivation in infancy is associated with familial recurrence of ASD

Pre-diagnostic deficits in social motivation are hypothesized to contribute to autism spectrum disorder (ASD), a heritable neurodevelopmental condition. We evaluated psychometric properties of a social motivation index (SMI) using parent-report item-level data from 597 participants in a prospective cohort of infant siblings at high and low familial risk for ASD. We tested whether lower SMI scores at 6, 12, and 24 months were associated with a 24-month ASD diagnosis and whether social motivation's course differed relative to familial ASD liability. The SMI displayed good internal consistency and temporal stability. Children diagnosed with ASD displayed lower mean SMI T-scores at all ages and a decrease in mean T-scores across age. Lower group-level 6-month scores corresponded with higher familial ASD liability. Among high-risk infants, strong decline in SMI T-scores was associated with 10-fold odds of diagnosis. Infant social motivation is quantifiable by parental report, differentiates children with versus without later ASD by age 6 months, and tracks with familial ASD liability, consistent with a diagnostic and susceptibility marker of ASD. Early decrements and decline in social motivation indicate increased likelihood of ASD, highlighting social motivation's importance to risk assessment and clarification of the ontogeny of ASD.

Fenfluramine below the age of 2 years in Dravet syndrome: What about safety and efficacy?

Dravet syndrome (DS) is a rare developmental and epileptic encephalopathy. Infants with DS are especially vulnerable to the detrimental effects of prolonged and frequent seizures on development. Fenfluramine (FFA) is approved for the treatment of DS in patients aged 2 years and older. This study aims to evaluate the safety and efficacy of FFA in patients with DS younger than 2 years. We analyzed safety, tolerability, seizure, and neuropsychological outcome in a real-world setting. Developmental profile was investigated using Griffiths Mental Development Scales (GMDS). Five patients received FFA at a mean age of 14.9 months (9.6-18.6). Median follow-up was 13 months (interquartile range [IQR] = 12.9-24.4). All patients showed good tolerance to FFA. No significant variation of body mass index or echocardiographic issue was observed. Monthly median convulsive seizure frequency (MCSF) was 1.71 (IQR = 1.56-3.27) at the 6-month baseline period and .92 (IQR = .43-1.28) at last follow-up, with a median 54.43 (IQR = 40.91-60.83) percentage reduction in MCSF. Two of five patients had a performance improvement on GMDS subscales. Overall, the use of FFA below the age of 2 years in our small sample of patients was safe and represents a promising opportunity for seizure control and for protection of the neurodevelopmental outcome.

Associations between oxidative stress biomarkers during pregnancy and infant cognition at 7.5 months

Oxidative stress has been identified as an important biological pathway leading to neurodevelopmental delay. However, studies assessing the effects of oxidative stress on cognitive outcomes during infancy, a critical period of neurodevelopment, are limited. Our analysis included a subset of those enrolled in the Illinois Kids Development Study (N = 144). Four oxidative stress biomarkers (8-isoprostane-PGF2α , 2,3-dinor-5,6-dihydro-8-iso-PGF2α , 2,3-dinor-8-iso-PGF2α , and prostaglandin-F2α ) were measured in second and third trimesters urine and were averaged. Infant cognition was measured using a visual recognition memory task consisting of five blocks, each with one familiarization trial (two identical stimuli) and two test trials (one familiar and one novel stimulus). Outcomes measured included average run duration (a measure of information processing speed), novelty preference (a measure of recognition memory), time to reach familiarization, and shift rate (measures of attention). Linear regression was used to estimate associations between individual oxidative stress biomarkers and each outcome. Increasing 8-isoprostane-PGF2α , 2,3-dinor-8-iso-PGF2α , and prostaglandin-F2α were associated with a decrease in novelty preference (β = -0.02, 95% confidence interval [CI] = -0.03, 0.00; β = -0.02, 95% CI = -0.04, 0.00; β = -0.01, 95% CI = -0.02, 0.00, respectively), as well as a modest increase in shift rate. These findings suggest that oxidative stress may be associated with poorer recognition memory in early infancy.

Differential effects of attachment security on visual fixation to facial expressions of emotion in 14-month-old infants: an eye-tracking study

Introduction

Models of attachment and information processing suggest that the attention infants allocate to social information might occur in a schema-driven processing manner according to their attachment pattern. A major source of social information for infants consists of facial expressions of emotion. We tested for differences in attention to facial expressions and emotional discrimination between infants classified as securely attached (B), insecure-avoidant (A), and insecure-resistant (C).

Methods

Sixty-one 14-month-old infants participated in the Strange Situation Procedure and an experimental task of Visual Habituation and Visual Paired-Comparison Task (VPC). In the Habituation phase, a Low-Arousal Happy face (habituation face) was presented followed by a VPC task of 6 trials composed of two contrasting emotional faces always involving the same actress: the one used in habituation (trial old face) and a new one (trial new face) portraying changes in valence (Low-Arousal Angry face), arousal (High-Arousal Happy face), or valence + arousal (High-Arousal Angry face). Measures of fixation time (FT) and number of fixations (FC) were obtained for the habituation face, the trial old face, the trial new face, and the difference between the trial old face and the trial new face using an eye-tracking system.

Results

We found a higher FT and FC for the trial new face when compared with the trial old face, regardless of the emotional condition (valence, arousal, valence + arousal contrasts), suggesting that 14-month-old infants were able to discriminate different emotional faces. However, this effect differed according to attachment pattern: resistant-attached infants (C) had significantly higher FT and FC for the new face than patterns B and A, indicating they may remain hypervigilant toward emotional change. On the contrary, avoidant infants (A) revealed significantly longer looking times to the trial old face, suggesting overall avoidance of novel expressions and thus less sensitivity to emotional change.

Discussion

Overall, these findings corroborate that attachment is associated with infants' social information processing.

Developmental trajectory of appetitive traits and their bidirectional relations with body mass index from infancy to early childhood

Appetitive traits, including food responsiveness, enjoyment of food, satiety responsiveness and slowness in eating, are associated with childhood body mass index. Change in appetitive traits from infancy to childhood and the direction of causality between appetitive traits and body mass index are unclear. The present study examined the developmental trajectory of appetitive traits and their bidirectional relations with body mass index, from infancy to early childhood. Mothers in the Pregnancy Eating Attributes Study and follow-up (n = 162) reported child appetitive traits using the Baby and Child Eating Behaviour Questionnaires at ages 6 months and 3.5 years, respectively. Standardized body mass index (zBMI) was calculated from child anthropometrics. Cross-lagged panel models estimated bidirectional relations between appetitive traits and zBMI. Food responsiveness, satiety responsiveness and slowness in eating increased from infancy to early childhood. In cross-lagged panel models, lower infant satiety responsiveness (B ± SE = -0.45 ± 0.19, p = .02) predicted greater child zBMI. Infant zBMI did not predict child appetitive traits (p-values >.36). From infancy to early childhood, appetitive traits may amplify. Appetitive traits, particularly satiety responsiveness, appear to influence body mass index during this period, suggesting early intervention targeting these traits may reduce childhood obesity.

Infant emotion regulation in the context of stress: Effects of heart rate variability and temperament

Stressful events are inherently emotional. As a result, the ability to regulate emotions is critical in responding effectively to stressors. Differential abilities in the management of stress appear very early in life, compelling a need to better understand factors that may shape the capacity for emotion regulation (ER). Variations in both biologic and behavioural characteristics are thought to influence individual differences in ER development. We sought to determine the differential contributions of temperament and heart rate variability (HRV; an indicator of autonomic nervous system function) to infant resting state emotionality and emotional reactivity in response to a stressor at 6 months of age. Participants included 108 mother-infant dyads. Mothers completed a measure of infant temperament at 6 months postnatal. Mother and infant also participated in a standardized stressor (the Repeated Still Face Paradigm) at that time. Electrocardiographic data were acquired from the infant during a baseline resting state and throughout the stressor. Fast Fourier Transformation was used to analyse the high frequency (HF) domain of HRV, a measure of parasympathetic nervous system activity. Infant ER was measured via standardized coding of emotional distress behaviours from video-records at baseline and throughout the stressor. Severity of mothers' depressive symptoms was included as a covariate in analyses. Results of linear regression indicate that neither temperament nor HRV were associated significantly with an infant's emotional resting state, although a small effect size was found for the relationship between infant negative affectivity and greater emotional distress (β = 0.23, p = 0.08) prior to the stressor. Higher HF-HRV (suggesting parasympathetic dominance) was related to greater emotional distress in response to the stressor (β = 0.34, p = 0.009). This greater emotional reactivity may reflect a more robust capacity to mount an emotional response to the stressor when infants encounter it from a bedrock of parasympathetic activation. Findings may inform eventual markers for assessment of ER in infancy and areas for intervention to enhance infant management of emotions, especially during stressful events.

The emergence of the EEG dominant rhythm across the first year of life

The spectral composition of EEG provides important information on the function of the developing brain. For example, the frequency of the dominant rhythm, a salient features of EEG data, increases from infancy to adulthood. Changes of the dominant rhythm during infancy are yet to be fully characterized, in terms of their developmental trajectory and spectral characteristics. In this study, the development of dominant rhythm frequency was examined during a novel sustained attention task across 6-month-old (n = 39), 9-month-old (n = 30), and 12-month-old (n = 28) infants. During this task, computer-generated objects and faces floated down a computer screen for 10 s after a 5-second fixation cross. The peak frequency in the range between 5 and 9 Hz was calculated using center of gravity (CoG) and examined in response to faces and objects. Results indicated that peak frequency increased from 6 to 9 to 12 months of age in face and object conditions. We replicated the same result for the baseline. There was high reliability between the CoGs in the face, object, and baseline conditions across all channels. The developmental increase in CoG was more reliable than measures of mode frequency across different conditions. These findings suggest that CoG is a robust index of brain development across infancy.

Voice categorization in the four-month-old human brain

Voices are the most relevant social sounds for humans and therefore have crucial adaptive value in development. Neuroimaging studies in adults have demonstrated the existence of regions in the superior temporal sulcus that respond preferentially to voices. Yet, whether voices represent a functionally specific category in the young infant's mind is largely unknown. We developed a highly sensitive paradigm relying on fast periodic auditory stimulation (FPAS) combined with scalp electroencephalography (EEG) to demonstrate that the infant brain implements a reliable preferential response to voices early in life. Twenty-three 4-month-old infants listened to sequences containing non-vocal sounds from different categories presented at 3.33 Hz, with highly heterogeneous vocal sounds appearing every third stimulus (1.11 Hz). We were able to isolate a voice-selective response over temporal regions, and individual voice-selective responses were found in most infants within only a few minutes of stimulation. This selective response was significantly reduced for the same frequency-scrambled sounds, indicating that voice selectivity is not simply driven by the envelope and the spectral content of the sounds. Such a robust selective response to voices as early as 4 months of age suggests that the infant brain is endowed with the ability to rapidly develop a functional selectivity to this socially relevant category of sounds.

Exploring the Potential of a Behavior Theory-Informed Digital Intervention for Infant Fall Prevention: Mixed Methods Longitudinal Study

BACKGROUND

Falls are the most common hospitalized injury mechanism in children aged ≤1 years, and currently, there are no targeted prevention interventions. The prevention of falls in children of this age requires changes in the behavior of their caregivers, and theoretically informed digital behavior change interventions (DBCIs) may provide a unique mechanism for achieving effective intervention. However, user acceptance and the ability of DBCIs to effect the required changes in behavior are critical to their likelihood of success.

OBJECTIVE

This study aims to evaluate a behavior theory-informed digital intervention developed following a user-centered approach for user experience, the potential for this intervention to prevent infant falls, and its impact on behavioral drivers underpinning fall risk in young children.

METHODS

Parents of infants aged <1 year were recruited and asked to use the intervention for 3 months. A pre-post longitudinal design was used to examine the change in the potential to reduce the risk of falls after a 3-month exposure to the intervention. Postintervention data on behavioral drivers for fall prevention, user acceptability, and engagement with the app were also collected. Interviews were conducted to explore user experiences and identify areas for further improvement of the intervention.

RESULTS

A total of 62 parents participated in the study. A statistically significant effect on the potential to reduce falls was observed after the intervention. This effect was higher for new parents. Parents agreed that the intervention targeted most of the target behavior drivers. The impact of behavior drivers and intervention on the potential for fall prevention had a positive correlation. The intervention demonstrated good levels of acceptability. Feedback from participants was mostly positive, and the primary area identified for further improvement was widening the scope of the intervention.

CONCLUSIONS

This study demonstrated the promise of a newly developed digital intervention to reduce the risk of infant falls, particularly among new parents. It also showed a positive influence of the DBCI on the drivers of parental behaviors that are important for fall reduction among infants. The acceptability of the app was high, and important insights were gained from users about how to further improve the app.

Observations of Positive Parenting from Online Parent-Child Interactions at Age 1

Objective

Brief, reliable, and cost-effective methods to assess parenting are critical for advancing parenting research.

Design

We adapted the Three Bags task and Parent Child Interaction Rating System (PCIRS) for rating online visits with 219 parent-child dyads (White, n = 104 [47.5%], Black, n = 115 [52.5%]) and combined the video data with survey data collected during pregnancy and when children were aged 1.

Results

The PCIRS codes of positive regard, stimulation of child cognitive development, and sensitivity showed high reliability across the three parent-child interaction tasks. A latent positive parenting factor combining ratings across codes and tasks showed good model fit, which was similar regardless of parent self-identified race or ethnicity, age, socioeconomic disadvantage, marital/partnered status, and parity, as well as methodological factors relevant to the online video assessment method (e.g., phone vs. laptop/tablet). In support of construct validity, observed positive parenting was related to parent-reported positive parenting and child socioemotional development. Finally, parent reports of supportive relationships in pregnancy, but not neighborhood safety or pandemic worries, were prospectively related to higher positive parenting observed at age 1. With the exception of older parental age and married/partnered status, no other parent, child, sociodemographic, or methodological variables were related to higher overall video exclusions across tasks.

Conclusions

PCIRS may provide a reliable approach to rate positive parenting at age 1, providing future avenues for developing more ecologically valid assessments and implementing interventions through online encounters that may be more acceptable, accessible, or preferred among parents of young children.

A Pilot Trial of a Home-Based Parenting Intervention for High-Risk Infants: Effects on and Moderating Role of Effortful Control

Despite the important developmental outcomes associated with effortful control (EC), there is limited research demonstrating the efficacy of early interventions for improving EC and assessing the extent to which a child's level of baseline EC impacts the outcome of intervention on externalizing problems. This study aims to fill these gaps in the literature by assessing the efficacy of the Infant Behavior Program (IBP), a parenting intervention for infants with elevated levels of behavior problems, in improving infant EC and the moderating effect of baseline infant EC on intervention outcomes. Participants included 60 high-risk 12- to 15-month-old infants and their mothers. Families were randomized to receive the IBP or standard pediatric primary care. Parent-report measures of infant behavior and compliance were examined at baseline, post-intervention, and 3- and 6-month follow-up assessments. Results showed infants who received the IBP displayed significantly higher levels of EC at the post-intervention assessment compared to infants in the control group. Additionally, moderation analyses showed initial levels of EC moderated the effect of the IBP on externalizing problems and compliance, such that infants with higher levels of baseline EC displayed greater decreases in externalizing problems at post-intervention and greater increases in compliance at the 6-month follow-up. While these findings did not survive a false discovery rate correction, they offer preliminary support for the efficacy of the IBP in improving infants' EC and highlight the importance of considering EC as a factor associated with early intervention outcomes for externalizing problems.

Daily skin-to-skin contact alters microbiota development in healthy full-term infants

The gut microbiota is vital for human body development and function. Its development in early life is influenced by various environmental factors. In this randomized controlled trial, the gut microbiota was obtained as a secondary outcome measure in a study on the effects of one hour of daily skin-to-skin contact (SSC) for five weeks in healthy full-term infants. Specifically, we studied the effects on alpha/beta diversity, volatility, microbiota maturation, and bacterial and gut-brain-axis-related functional abundances in microbiota assessed thrice in the first year. Pregnant Dutch women (n = 116) were randomly assigned to the SSC or care-as-usual groups. The SSC group participants engaged in one hour of daily SSC from birth to five weeks of age. Stool samples were collected at two, five, and 52 weeks and the V4 region was sequenced. We observed significant differences in the microbiota composition, bacterial abundances, and predicted functional pathways between the groups. The SSC group exhibited lower microbiota volatility during early infancy. Microbiota maturation was slower in the SSC group during the first year and our results suggested that breastfeeding duration may have partially mediated this relation. Our findings provide evidence that postpartum SSC may influence microbiota development. Replication is necessary to validate and generalize these results. Future studies should include direct stress measurements and extend microbiota sampling beyond the first year to investigate stress as a mechanism and research SSC's impact on long-term microbiota maturation trajectories.

Multimodality imaging for comprehensive non-invasive diagnosis of aorto-left ventricular tunnel in infancy

BACKGROUND

Aorto-left ventricular tunnel (ALVT) is a paravalvular communication between aorta and left ventricle. It is one of the rare congenital heart diseases which could present with heart failure.

CASE PRESENTATION

A case of ALVT was diagnosed in infancy. Preliminary assessment was possible using conventional echocardiography; however, functional assessment and accurate anatomy of ALVT were further verified via variable imaging modalities starting from speckle tracking and three-dimensional echocardiography to cardiac CT angiogram. The tunnel was successfully repaired with uneventful recovery.

CONCLUSIONS

Multimodality imaging can accurately assess cardiac function and demonstrate the anatomy of ALVT noninvasively to plan for successful intervention.

Depression During the Postpartum Period and Impacts on Parent-Child Relationships: A Narrative Review

Although controversy exists around labels for postpartum depression (PPD), focusing efforts on terms distracts the research community from better understanding the impact of depression on parent-infant relationships. The purpose of this article is to provide a narrative review of research related to how depression experienced in the postpartum period impacts parent-infant relationships. Our review indicates that PPD is pervasive, symptoms often appear during pregnancy, and it has the potential to negatively impact parent-infant relationships. Based on the recent review of literature, intervention efforts should focus on identification and treatment of PPD as early as possible to mitigate detrimental long-term impacts on parent-child relationships.

Associations between infant amygdala functional connectivity and social engagement following a stressor: A preliminary investigation

Functional architecture of the infant brain, especially functional connectivity (FC) within the amygdala network and between the amygdala and other networks (i.e., default-mode [DMN] and salience [SAL] networks), provides a neural basis for infant socioemotional functioning. Yet, little is known about the extent to which early within- and between-network amygdala FC are related to infant stress recovery across the first year of life. In this study, we examined associations between amygdala FC (i.e., within-network amygdala connectivity, and between-network amygdala connectivity with the DMN and SAL) at 3 months and infant recovery from a mild social stressor at 3, 6 and 9 months. At 3 months, thirty-five infants (13 girls) underwent resting-state functional magnetic resonance imaging during natural sleep. Infants and their mothers completed the still-face paradigm at 3, 6, and 9 months, and infant stress recovery was assessed at each time point as the proportion of infant social engagement during the reunion episode. Bivariate correlations indicated that greater positive within-network amygdala FC and greater positive amygdala-SAL FC, but not amygdala-DMN FC, at 3 months predicted lower levels of stress recovery at 3 and 6 months, but were nonsignificant at 9 months. These findings provide preliminary evidence that early functional synchronization within the amygdala network, as well as segregation between the amygdala and the SAL, may contribute to infant stress recovery in the context of infant-mother interaction.

Everyday language input and production in 1,001 children from six continents

Language is a universal human ability, acquired readily by young children, who otherwise struggle with many basics of survival. And yet, language ability is variable across individuals. Naturalistic and experimental observations suggest that children's linguistic skills vary with factors like socioeconomic status and children's gender. But which factors really influence children's day-to-day language use? Here, we leverage speech technology in a big-data approach to report on a unique cross-cultural and diverse data set: >2,500 d-long, child-centered audio-recordings of 1,001 2- to 48-mo-olds from 12 countries spanning six continents across urban, farmer-forager, and subsistence-farming contexts. As expected, age and language-relevant clinical risks and diagnoses predicted how much speech (and speech-like vocalization) children produced. Critically, so too did adult talk in children's environments: Children who heard more talk from adults produced more speech. In contrast to previous conclusions based on more limited sampling methods and a different set of language proxies, socioeconomic status (operationalized as maternal education) was not significantly associated with children's productions over the first 4 y of life, and neither were gender or multilingualism. These findings from large-scale naturalistic data advance our understanding of which factors are robust predictors of variability in the speech behaviors of young learners in a wide range of everyday contexts.

Interactive synchrony and infants' vagal tone as an index of emotion regulation: associations within each mother- and father-infant dyad and across dyads

Introduction

Studies have shown that infants' emotion regulation capacities are closely linked to the quality of parent-infant interactions. However, these links have been mostly studied in mother-infant dyads and less is known about how the quality of father-infant interactions contributes to the development of emotion regulation during infancy. In this study, we aimed to investigate the links between interactive synchrony (i.e., an index of the quality of parent-infant coordination of interactive behaviors) and infants' vagal tone (i.e., a physiological index of emotion regulation). To understand the respective contributions of both parents, as well as the interrelations between the functioning of both dyads within a family, we observed mothers and fathers from 84 families interacting with their infants.

Methods

Synchrony was assessed by using the CARE-Index; infants' vagal tone was derived from the analysis of infants' electrocardiograms recorded during the interactions. Moreover, to take the play's order into account, we counterbalanced the procedure, so that approximately half of the mothers played first. We specified a first structural equation modeling (SEM) model to investigate the associations between interactive synchrony and the infants' root mean square of successive differences (RMSSD), an index of vagal regulation, in the two successive parts of the play. We conducted a multigroup analysis in a second SEM model to investigate the associations of the first SEM model in two groups based on the order of interaction.

Results

The results of the SEM models showed that greater synchrony was related to greater infant RMSSD within mother-infant dyads and across one dyad to the other dyad in the full sample and in the group of fathers who interacted first with the infants. The associations between synchrony and infant vagal tone within father-infant dyads never appeared to be significant, nor did any associations within each dyad and across dyads when mothers interacted first.

Discussion

This study highlights that the links between interactions and infants' vagal tone are sensitive to family members' interdependencies and some conditions (the order of interaction).

Three year outcomes in infants with a family history of autism and/or attention deficit hyperactivity disorder

Background

Most research on early outcomes in infants with a family history (FH) of autism has focussed on categorically defined autism, although some have language and developmental delays. Less is known about outcomes in infants with a FH of attention deficit hyperactivity disorder (ADHD).

Methods

Infants with and without a FH of autism and/or ADHD, due to a first-degree relative with either or both conditions, were recruited at 5 or 10 months. Three year outcomes were characterised using latent profile analysis (LPA) across measures of cognitive ability, adaptive functioning and autism, ADHD and anxiety traits (n = 131). We additionally ran an LPA using only autism and ADHD measures, and the broader LPA in an independent cohort (n = 139) and in both cohorts combined (n = 270).

Results

A Low Developmental Level + High Behavioural Concerns class had elevated autism, ADHD and anxiety scores, low cognitive and adaptive function, and included all but one child with autism. A Low Developmental Level + Typical Behaviour class had average cognitive ability and typical behaviour but low adaptive function. A Typical Developmental Level + Some Behavioural Concerns class had average cognitive and adaptive function but slightly elevated behaviour scores. A High Developmental Level + Typical Behaviour class had above average cognitive ability and typical behaviour. All four LPAs identified classes characterised by combinations of either, or both, Low Development Level and elevated behaviour scores, as well as a typically developing class. No classes had elevated autism or ADHD traits in isolation.

Conclusions

Some infants with a FH of autism or ADHD have atypical developmental and behavioural outcomes, but do not show strong autism or ADHD traits in isolation. The field needs to recalibrate aims and methods to embrace the broader transdiagnostic pattern of outcomes seen in these infants.

Direct and Observed Joint Attention Modulate 9-Month-Old Infants' Object Encoding

Sharing joint visual attention to an object with another person biases infants to encode qualitatively different object properties compared to a parallel attention situation lacking interpersonal sharedness. This study investigated whether merely observing joint attention amongst others shows the same effect. In Experiment 1 (first-party replication experiment), N = 36 9-month-old German infants were presented with a violation-of-expectation task during which they saw an adult looking either in the direction of the infant (eye contact) or to the side (no eye contact) before and after looking at an object. Following an occlusion phase, infants saw one of three different outcomes: the same object reappeared at the same screen position (no change), the same object reappeared at a novel position (location change), or a novel object appeared at the same position (identity change). We found that infants looked longer at identity change outcomes (vs. no changes) in the "eye contact" condition compared to the "no eye contact" condition. In contrast, infants' response to location changes was not influenced by the presence of eye contact. In Experiment 2, we found the same result pattern in a matched third-party design, in which another sample of N = 36 9-month-old German infants saw two adults establishing eye contact (or no eye contact) before alternating their gaze between an object and their partner without ever looking at the infant. These findings indicate that infants learn similarly from interacting with others and observing others interact, suggesting that infant cultural learning extends beyond infant-directed interactions.