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Recent models of the early emergence of autism spectrum disorder (ASD) propose an interaction between risk susceptibility and the infant's social environment, resulting in a progressively atypical developmental trajectory. The infant's early social environmental experience consists mostly of interaction with caregivers, yet there has been little systematic study of early parent-infant interaction in infants at risk of ASD. This study examined the global characteristics of parent-infant interaction in 6- to 10-month-old infants with an older sibling diagnosed with ASD (at-risk sibs), in comparison with a group of infants with no family history of ASD (low-risk sibs). As part of the British Autism Study of Infant Siblings (BASIS), 6-min videotaped unstructured play interactions of mother-infant dyads (45 at-risk sibs and 47 low-risk sibs) were rated on global aspects of parent-infant interaction, blind to participant information. Differences in global characteristics of interaction were observed in both infant and parent contributions in the at-risk group compared to low-risk controls. In analyses adjusted for age and developmental level, at-risk sib infants were less lively, and their parents showed higher directiveness, and lower sensitive responding (as a trend after adjustment). Level of infant liveliness was independent of other interactive behaviour. Consistent with reports in previous literature in older children with autism and in other neurodevelopmental disorders, our findings may suggest that infants at genetic risk are exposed to a more directive interactive style relatively early in infancy. We discuss possible explanations for these findings and implications for further developmental study and intervention. [ABSTRACT FROM AUTHOR]

This review aims to consider evidence for the impact of maternal psychopathology on the child's attachment to the mother, and the role of this in mediating the known transmission of developmental and clinical risk to children. The studies reviewed focus on mothers with depression and psychotic disorder. A number of studies (mainly of mothers with depression) demonstrate an association between insecure/disorganised infant attachments and severe maternal psychopathology, whether chronic or current, in the presence of comorbid disorder, maternal insecure or unresolved attachment state of mind, trauma/loss, or low parenting sensitivity. Whether such effects last into middle childhood, however, is unclear. Our understanding of the role of attachment in determining developmental trajectories in this group is at an early stage. Some evidence suggests that attachment may have a role in mediating the intergenerational transmission of internalizing and other problems in this group, although the presence of co-occurring contextual risk factors may account for the variability in findings. A multifactorial longitudinal approach is needed to elucidate such factors. However, the current literature highlights which subgroups are likely to be vulnerable and provides an evidence-based rationale for taking an attachment-based approach to intervention in this group. [ABSTRACT FROM AUTHOR]

This review evaluates empirical studies that have attempted to improve observed mother-infant relationships in order to inform a potential approach for mothers with schizophrenia, a growing group of vulnerable families where mothers are known to have relational difficulties. Parenting intervention studies in: (1) mothers with a mental disorder; (2) other vulnerable groups were reviewed. Only interventions that empirically evaluated observations of mother-child interaction or child attachment were included, and their potential usefulness for mothers with schizophrenia was examined. Nine studies involved mothers with mental disorder; none involved mothers with psychotic disorder specifically. Overall, approaches that emphasise the mother-child dyad, such as sensitivity-focused behavioural techniques and toddler-parent psychotherapy, were most efficacious for improving maternal sensitivity/child attachment. Although individual psychological therapies are the more conventional treatment, little current evidence suggests that mother-infant relations improve with symptom reduction. The usefulness of the available evidence for informing interventions with mothers with schizophrenia is discussed in the context of their clinical needs. Feasibility studies are needed, which provide a focus on enhancing maternal sensitivity directly within a multi-level support package. [ABSTRACT FROM AUTHOR]