Douglas M. Teti - US grants

The present longitudinal study investigated the role of security of child-mother attachment in the development of infant-firstborn relations in two-child families. Its aims are threefold: 1) To assess the extent to which security of firstborn-mother attachment can predict the quality of firstborns' reaction to the birth of the second child; 2) to examine the joint impact of firstborn-mother and infant-mother attachment on the development of infant-sibling relations during the first two years of the infant's life; and 3) to assess the degree to which the quality of early sibling relationships is sensitive to maternal psychosocial functioning (e.g., life stress, marital harmony, psychiatric functioning) and to longitudinal changes therein. Subjects will be 200 two-parent families recruited over a 3-year period when mothers are in their second trimester of pregnancy with their second child. Firstborns will be between 2-4 years of age at recruitment. Each family will be visited at the second and third trimester of pregnancy and at 1-2, 6-8, 12-14, and 21-24 months post-partum. Analyses will focus on predicting the quality of infant-firstborn relations from the quality of each child's attachment to mother, with firstborn perspective-taking ability as a potentially important mediating variable. Structural equation modeling will also be employed to explore directions of influence among measures of maternal functioning, child-mother interaction, child-mother attachment, and infant-sibling relations.

biomedical equipment purchase;

DESCRIPTION (provided by applicant): Premature birth is a major cause of developmental delay, and the need remains for cost effective, replicable methods to promote development in preterm children. Despite the success of first generation interventions, little is understood about why early intervention does not affect all parents and preterms to the same degree. This randomized clinical trial aims to 1) evaluate the efficacy of an integrated, replicable intervention designed to facilitate parent-infant interaction, infant physical development, mental and motor development, and socioemotional development in a group of infants at medical and environmental risk for developmental delay; and 2) explore the role of mothers' and fathers' states of mind with regard to attachment and parents' commitment to the intervention, as moderators of intervention efficacy. The study will recruit 240 urban, single, African-American mothers and fathers of preterm (<37 weeks gestational age), low birthweight (< 2,500 grams at birth) infants admitted to the neonatal intensive care unit. Half of the families will be randomly assigned to an intervention group, and half to a control group. Both groups will be comparable with respect to race, maternal parity, education, income, presence/absence of partner, infant gestational age, infant small-for-date status, and infant gender. The intervention integrates a videotape about preterm infant competencies, serial administrations of the Brazelton Neonatal Behavioral Assessment Scale with increasing parental involvement, and parent-administered infant massage, beginning when infants are 32-to-36 weeks post-conceptual age (PCA) and terminating at 52-to-56 weeks PCA. Intervention efficacy, and the moderating roles of adult attachment and parental commitment to intervention, will be evaluated along dimensions of infant physical, mental, motor, and social development, and parental adjustment and sensitivity to the infant during the first two years.

DESCRIPTION (provided by applicant): A child's inability to get a good night's sleep has become a major public health concern. Among children of preschool age and older, sleep disturbances are linked to daytime behavior problems, sleepiness and poor attention, and academic underachievement. Very little, by contrast, is known about the impact of sleep problems in infancy on infant day time functioning. This is noteworthy, in light of the fact that significant sleep disruptions can become evident in the first year of life, tend to remain stable over time, and present as a chief complaint of parents to pediatricians. This application is consistent with the stated mission of NICHD and responds to PA-05-046, "Research on Sleep and Sleep Disorders" and has three inter-related aims. Aim 1: To investigate linkages between infant sleep quality, infant socio-emotional and cognitive developmental outcomes, and parent-infant relationship outcomes during the infant's first two years. Outcomes of interest include infant stress reactivity (cortisol), emotion regulation in responses to stress, security of infant-mother attachment, infant behavior problems and behavior competencies, quality of compliance to maternal directives, information processing ability, and quality of maternal-infant emotional availability during interaction. In addressing aim 1, we will document individual differences in when, during the course of the first two years, linkages between infant sleep quality and infant developmental outcomes emerge, to what degree they are associated with severity and chronicity of sleep disruption, and whether and when these linkages dissipate if infants develop more organized, regulated sleep with age. Aim 2: To examine the role of parenting practices in sleep contexts in predicting infant sleep quality, and the role of infant temperamental difficulty (from parent report and observational assessment) in moderating these relations. Aim 3: To examine parents'adaptation to infant sleep behavior, the determinants of such adaptation, and the role of parental adaptation to infant sleep in predicting infant sleep quality and infant and parent daytime functioning. The focus on parental adaptation is based on emergent information that whether or not a child is identified with a sleep problem, and whether that problem has consequences beyond the sleep context, depends greatly upon parents'perception and tolerance of child sleep behavior. This focus is also rooted in theoretical formulations that developmental problems in infancy and early childhood can only be understood in the context of the child's relationships with caregivers. This study will provide important information about the inter-linkages between infant sleep quality and infant day time outcomes, and the role of parenting and parental adaptation in accounting for these links. PUBLIC HEALTH RELEVANCE: A child's inability to get a good night's sleep is major public health concern. Sleep disruption in children of preschool age and older is linked to behavior problems, daytime sleepiness, poor attention, and academic underachievement. Very little, by contrast, is known about the impact of infant sleep problems, or the role of parenting in relation to them, on infant cognitive and emotional development. This study's findings will have immediate relevance for parents and health care providers because it will clarify the most important predictors of infant sleep behavior and provide suggestions for pediatric practice.

DESCRIPTION (provided by applicant): Parenting is regarded as integral to understanding child psychopathology. Despite widespread agreement that parenting is complex and emotionally-laden, however, studies of on-line emotion processing and emotion regulation in parents, and linkages between these processes and parenting competence, are rare. Recent discoveries in the field of affective neuroscience hold great promise for clarifying neuro-affective processes that under parenting quality. The goal of the present study is to make use of the tools of affective neuroscience to further an understanding of emotion regulatory processes in parenting and their relation to parenting at risk. We see this work as consistent with NICHD's goal of understanding child development and the factors that influence it. The planned work will use high-density EEG to study prefrontal cortical (PFC) asymmetries, in the alpha bandwidth, in mothers of infants in response to child-created emotional events. The study has three major aims: (1) To investigate the degree to which phasic and tonic parental PFC asymmetries are associated with mothers'observed and self-reported emotions in response to "on-line" child-created emotional events;(2) To examine change in rate and magnitude of PFC asymmetry in response to child emotional events, in conjunction with maternal emotions, as an index of mothers'capacity for emotion regulation and as a predictor of parenting quality;and (3) To assess linkages between maternal emotion-asymmetry profiles and mothers'perceptions about children's abilities, adequacy of family resources, life stress, parenting stress, partner conflict, quality of co-parenting, infant temperament, and mothers'their own psychological functioning in interpersonal contexts. We will also assess differences in mothers'EEG and emotional responses to their own infants and from an unfamiliar infant, in order to determine if mothers'responses to their own children are of greater import in predicting parenting quality. From this work, we hope to identify valid procedures for assessing emotion regulatory capacities in mothers in the context of parenting that (1) can be used in an ongoing program of research examining the precursors and impact of parenting at risk, and (2) can contribute to a broader, more comprehensive understanding of the processes that underlie problem parenting and child psychopathology. PUBLIC HEALTH RELEVANCE: Parenting at risk is commonly discussed in emotional terms, and dysregulated parental emotion is believed to place children at risk for disturbed parent-child relationships, poor peer relations, and elevated psychiatric symptoms. However, parenting at risk has most often been studied with respect to static psychiatric (e.g., maternal depression), medical (e.g., low birth weight), or "social address" (e.g., poverty) conditions. Actual studies of how parents regulate their emotions in response to child provocations, and how this relates to actual parenting quality, are rare. The present study will use the tools of affective neuroscience to characterize neuro-affective processes that underlie parenting at risk. Study findings should have immediate relevance to parents and interventionists in (1) clarifying the complex linkages between parents'on-line emotional responding to their children and parenting quality, and (2) suggesting strategies for intervention. PHS 398/2590 (Rev. 09/04, Reissued 4/2006) Page Continuation Format Page

? DESCRIPTION (provided by applicant): The transition to kindergarten is one of the most impactful transitions in the life of a young child, requiring new social, emotional, and cognitive competencies across a variety of domains and an emphasis on formal instruction and evaluation never experienced before. For many children in full-time kindergarten, kindergarten now functions as the new first grade, and the social and academic competencies observed during this time set the stage for later school success. Unfortunately, although many children make successful transitions to school, some do not. School adjustment is multi-faceted and, not surprisingly, multiply determined. However, one particular determinant, child sleep, is largely understudied as a predictor of early school success, despite growing evidence that sleep problems in children and adults predict externalizing and internalizing behavior problems, emotion dysregulation, sleepiness, and attentional difficulties during daytime hours. The present study draws upon work by the principal investigator and others in his investigative team and focuses on the unique role of sleep in young children in predicting children's adjustment across the kindergarten year, and the role of parenting in shaping good sleep habits in young children during this transition. We make use of an innovative measurement-burst design to assess child sleep (quality, duration, and lability), parenting, and coparenting and personal distress as predictors of child sleep characteristics, with assessments obtained before kindergarten begins (pre-K), early in the transition year (late September-early October), mid-transition (November), and late- transition (April). Children's learning engagement, academic progress, socio-emotional functioning, executive functioning, and literacy skills will be assessed at early-, mid-, and late-transition timepoints. Analyses will focus on trajectories of child sleep as predictors of school adjustment, and parenting and couple distress as predictors of child sleep across the kindergarten year. This research will provide an important foundation for understanding the role of children's sleep in predicting children's transition to K across the full year of school, and th role of parenting and parental distress in shaping children's sleep during this pivotal time.

Project Summary/Abstract Although infant sleep regulation across the first year proceeds well for many infants, for many infants that is not the case, and estimates of sleep problems among infants and preschoolers range between 25%-33%. Dysregulated infant sleep is predictive of poor parent sleep, and chronic sleep disruption can place families in turmoil, with consequences for the marital and coparenting relationship. Further, mothers reporting early coparenting distress are at risk for personal distress and poor bedtime and nighttime parenting, which in turn predicts infant sleep problems and insecure infant attachment. This application proposes a randomized clinical trial (RCT) to evaluate the effects of a sleep-enhanced adaptation of an evidence-based transition-to-parenting coparenting intervention program [Family Foundations - FF). The rationale for this study is twofold. First, recent findings from the PI's Project SIESTA (R01HD052809) indicate that poor coparenting at one month post-partum predicts persistent infant-parent co-sleeping across the first year, elevated maternal depressive symptoms, emotionally unavailable bedtime parenting, and insecure infant-mother attachments. Second, whereas FF as originally developed has been successful in improving coparenting, marital adjustment, and overall parenting quality, it gives little specific attention to coparenting in infant sleep contexts, which SIESTA findings identify as critically important to parent and infant outcomes later in the first year. The proposed 3-arm RCT responds to these concerns. In one arm, families will experience FF as originally formulated; in the second, families will receive an adapted FF that emphasizes coparenting in infant sleep contexts; the third arm will serve as controls. Assessments of coparenting and parenting in infant sleep contexts, parental adjustment to infant sleep behavior, choices about sleep arrangements, infant and parent sleep quality, and infant socio- emotional functioning, will serve as outcomes. Our central hypotheses are: (1) Compared to controls, parents in both FF groups will report improved overall coparenting and reduced overall distress, but parents in the adapted FF group will show greater improvements in coparenting and individual parenting in infant sleep contexts, better infant and parent sleep, and better child adjustment; (2) early coparenting around infant sleep will be a central mechanism by which both interventions exert their effects. This research is foundational to a broader understanding of coparenting processes that underlie successful family transitions and contributes to the refinement of a successful coparenting program. Study results will be of immediate use to obstetric and pediatric services interested in augmenting childbirth education material with information on coparenting practices in infant sleep contexts.