Search

Background: Early relational health (ERH) interventions can buffer toxic stress and improve the developmental trajectories of neonatal intensive care unit (NICU) infants. Purpose: The purpose was to examine the current state of the science related to multimodal, dyadic ERH interventions implemented in the NICU setting in the United States and identify gaps in the current literature. Data Sources: PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycInfo were searched in November 2022 and November 2023 for original studies and conference proceedings from 1970 to present in the English language. Gray literature searches were performed in February 2023 and December 2023. Study Selection: English language, original research, with a focus on multimodal, dyadic ERH interventions that took place primarily in a NICU in the United States were included. Outcome measures could be related to implementation, relational health, or physical and/or mental health outcomes of parent and/or infant. Eighteen of 2021 reviewed articles met the inclusion criteria. Data Extraction: Data were extracted for author, year, intervention, purpose, methods, sample, paternal inclusion, dyadic components, non-dyadic components, and major outcomes/results and distilled for study characteristics, multimodal, dyadic intervention characteristics, and outcome measures. Results: Several multimodal dyadic interventions exist to aid ERH in the NICU, providing evidence of improved outcomes for infants and families. More research is required using higher sample sizes and replication studies. Implications for Practice and Research: ERH interventions show promise in improving neurodevelopmental, behavioral, and maternal mental health outcomes and should be considered for implementation into NICU services. [ABSTRACT FROM AUTHOR]

Copyright of Cukurova Medical Journal / Çukurova Üniversitesi Tip Fakültesi Dergisi is the property of Cukurova University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Parents and infants in the neonatal intensive care unit (NICU) are exposed to considerable stress, and infant-family mental health (IFMH) services foster emotional well-being in the context of the parent-infant relationship. This mixed-methods study examined the role of an IFMH program introduced in a level 4 NICU. The study included (1) retrospective medical record review of NICU patients who were referred to the IFMH program and (2) qualitative interviews with NICU nurse managers, neonatologists, and medical social workers to explore their understanding of the IFMH program, explore the referral pathways and factors that supported family engagement, and identify specific recommendations for program improvement. Of the 311 infant-parent dyads referred to the IFMH program, 62% had at least one session and Spanish-speaking families were more likely to engage. Of those families receiving services, about one-third had brief intervention, one-third had 4 to 10 sessions, and one-third had long-term services, including in-home after-discharge services. Qualitative interviews with health providers identified unique qualities of the IFMH program and why families were and were not referred to the program. Recommendations centered on adding a full-time IFMH mental health provider to the NICU and increasing communication and integration between the IFMH program and the medical team. [ABSTRACT FROM AUTHOR]

This paper provides a summary of literature on epigenetic effects and infant health outcomes of maternal psychosocial stress during pregnancy. A search of literature yielded a large body of publications between 2008 and 2018. Relevant articles were selected, and additional sources were located from ancestry searches of reference lists. Results implicate maternal prenatal stress as a source of epigenetic mechanisms that affect fetal brain development and program risk for emotional dysregulation and mental disorders over a lifetime and across generations. Implications for nursing practice are explored at multiple levels of policy advocacy, public education, primary prevention, screening and intervention. [ABSTRACT FROM AUTHOR]

Parents and healthcare providers are reported to be "desperate" for solutions for dealing with temper tantrums and other extreme "disruptive behaviors." Reports state that at least 10,000 and as many as 20,000 infants under the age of two in 2014 were prescribed drugs such as risperidone, quetiapine, and other antipsychotic medications, suggesting that parents may have lost faith in their inner abilities to create an environment for their infant. Dr. Maria Montessori, concluded from her work that the nervous troubles of many "difficult" children can be traced to one of the most "harmful forms of repressive action" an adult can take, that of "interference" with or interrupting a child's self-chosen activity. This paper explores alternatives to adult interruption that begins with shushing crying infants and may extend to demanding medications with the intention of stopping behaviors. It discusses a tiered infant mental health care system in which conservative care, the first tier or step can be restored with nonpharmacological gentle remedies. Gentle remedies are neither better than nor are they a replacement for pharmaceutical drugs, the fourth and last step of the tiered system due to their known short term and potential long-term risks. The gentle remedies first step approach begins with parents engaging in environment and lifestyle management. Examples of other gentle remedies discussed for use in helping infants to discharge stress and frustration include lullabies, hot water bottles, infant massage education, oatmeal baths and other herbal simples, and Bach Flower Remedies. [ABSTRACT FROM AUTHOR]

Abstract This paper provides a summary of literature on epigenetic effects and infant health outcomes of maternal psychosocial stress during pregnancy. A search of literature yielded a large body of publications between 2008 and 2018. Relevant articles were selected, and additional sources were located from ancestry searches of reference lists. Results implicate maternal prenatal stress as a source of epigenetic mechanisms that affect fetal brain development and program risk for emotional dysregulation and mental disorders over a lifetime and across generations. Implications for nursing practice are explored at multiple levels of policy advocacy, public education, primary prevention, screening and intervention. [ABSTRACT FROM AUTHOR]

• Growing body of research shows a link between birth-related PTSD symptoms and the poorer mother-infant relationship quality. • Study objective was to assess the strength of the association between birth-related PTSD and the mother-infant relationship. • Results revealed a significant association between birth-related PTSD and poorer mother-infant relationship quality. • Need for further investigation into preventing birth trauma to enhance infant mental health and reduce social and economic costs. There is a growing body of research showing that birth related posttraumatic stress disorder (PTSD) symptoms may impact the mother-infant relationship. The present study assessed the strength of the association between birth related PTSD symptoms and the mother-infant relationship. A total of twelve studies (5,572 participants) were included based on database searches using PubMed, EBSCO and ProQuest. The findings showed that greater levels of birth related PTSD symptoms were associated with poorer mother-infant relationship, r = −0.36, 95% CI: [−0.43 - −0.28], random effects model. The outcomes appeared to be heterogeneous (Q (11) = 81.63, p <.001, tau2 = 0.0123, I2 = 80.73%), despite all outcomes being in the same direction as the overall outcome. The results indicated that birth related PTSD symptoms are negatively associated with the mother-infant relationship. Further investigation into the prevention of birth related trauma is suggested. Improving birthing experiences for mothers is likely to contribute to improved infant mental health, thereby reducing overall social and economic costs. [ABSTRACT FROM AUTHOR]

Infant mental health (IMH) is best promoted through a continuum of services underpinned by strong service capacity. However, service providers often lack fundamental IMH knowledge and skills. Using the Ready, Steady, Grow (RSG) initiative as a case study of a capacity-building model (P., Hawe, L., King, M., Noort, C., Jordens, & B., Llyod, 2000), this article contributes to the field by investigating the facilitators and challenges to IMH promotion in a disadvantaged community in Ireland. A mixed-methods study assessed the degree to which RSG has developed the local service community capacity. Data included semistructured interviews (n = 23) and a survey with service stakeholders from nursing, speech and language, early childhood care and education, social work, family support, physiotherapy, and youth work (n = 40). The findings indicated that RSG has enhanced IMH capacity among service stakeholders by establishing a strong groundwork and enthusiasm for IMH, in addition to building preliminary IMH skills, although scope remains for further engagement and training. Ongoing barriers to capacity building include a dearth of resources and concern about sustainability. This case study offers theoretical and practical insights to those interested in promoting child health using a capacity-building model. [ABSTRACT FROM AUTHOR]

Infants and toddlers are exposed to abuse and neglect at disproportionate rates compared to other children, setting a trajectory for disrupted developmental processes and increased vulnerability to future traumatic exposure. Social workers encounter trauma- exposed young children across a number of systems, including but not limited to early childcare, family physical and mental health, court, and child welfare. It benefits social workers to have a working understanding of current research related to the bio-psycho- social impact of trauma on infants and young children and an awareness of current, research-driven interventions that can support young, at-risk children and families. This article reviews trauma-impacted development throughout the first two years of life with a discussion of current research exploring attachment and brain development and then discusses caregiver-child based interventions that work to repair disrupted attachment patterns, repair impaired regulatory processes, and return the caregiver-child relationship to a healthy developmental path. [ABSTRACT FROM AUTHOR]

Infants and families who have received care through NICUs experience multiple prolonged physiological, social, and emotional challenges. In addition to their NICU experiences, many families are presenting with increasingly diverse family structures and complex social conditions. In this article, the current state of knowledge on the concept of trauma-informed care will be reviewed from the perspective of infant and early childhood mental health development. This is the second part of a two- part series on trauma-informed care. The first part addressed this approach from a woman-centered care perspective. Recognizing the impact of trauma and implementing trauma-informed practices in the NICU holds potential for improving outcomes for infants. [ABSTRACT FROM AUTHOR]

In New Zealand the field of infant mental health is relatively new in terms of service development and provision. This paper discusses traditional Māori practices with infants and young children and suggests contributions that could inform both theory and practice. Ohomairangi Trust, a Kaupapa Māori early intervention service, was approached to culturally adapt and pilot Mellow Parenting, an intensive parenting program designed to focus on relationship difficulties between "hard to engage" mothers and their young children (0-5 years). The qualitative findings are discussed within a Kaupapa Māori theoretical framework. AIM: Parenting programs have been shown to improve children's relationships with their parents/caregivers, and reduce problem behaviours, but little research has focused on outcomes for Indigenous families. The aim of this pilot study was to evaluate the acceptability and effectiveness of Hoki ki te Rito (HKTR)/Mellow Parenting program, for Māori mothers in South Auckland, New Zealand. DESIGN: Open trial design. SETTING: Ohomairangi Trust--one of the few Indigenous Kaupapa Māori providers of early intervention services (across special education, infant mental health, disability, and general health and welfare) in Aotearoa NZ. PARTICIPANTS: Māori mothers from socially disadvantaged areas, with children aged 0-5 years where relationship difficulties were present along with child behaviour difficulties. Some had Child Youth and Family Services involved with their families before commencing the program, while others were at risk of losing custody of their children to the state welfare system. INTERVENTION: Mellow Parenting Program -- HKTR being culturally adapted for M ori parents. MAIN OUTCOME MEASURES: Mother's self reported competence, stress, and wellbeing, and coded videos of mother--child interactions on home videos. Children's behaviour and development was assessed using parents' self reports and observation of videos. RESULTS: Māori mothers and grandmothers attending the pilot study of HKTR parenting program reported a significant increase in their own well being, their ability to cope with their parenting role/children's behaviours, their feelings of self esteem and adequacy, and confidence in their cultural identity, along with a reduction in unwanted problematic behaviours from their children, and an increase in children's social skills. Qualitative data showed extremely positive responses to the program resources, content, and process. There were a number of requests for a program that fathers could attend. We are reporting solely on focus group feedback in this paper. CONCLUSIONS: This study provides qualitative support for the effectiveness and acceptability of this culturally adapted version of Mellow Parenting -- HKTR, delivered by Ohomairangi Trust, in community settings in South Auckland. The outcome of this study may be seen as a significant step in increasing appropriate service provision for Māori and reducing barriers to accessing available services in the community. [ABSTRACT FROM AUTHOR]

This Article aims to promote discussion around the area of infant mental health, and where it fits within the current understanding of child development and therapeutic intervention. It further considers what this information means for occupational therapists working with children and explores some therapeutic possibilities that appear viable within the framework of the Irish Health Care System. In exploring the literature in this area it is beneficial to view the brain as a social organ and to endeavour to understand it from an interpersonal neurobiological perspective. That is to see the brain as a constantly changing and evolving structure that grows and adapts based on different experiences and interactions (Cozolino, 2006). Current literature suggests that brain development is best understood as a complex interplay between genetics, structures, and the fundamental changes that everyday experiences bring, all embedded in a matrix of relationships. Never is this interplay as important as during the intricate "dance" of the parent-child interaction in the early years of life, due to the disproportionate amount of neural development that takes place during this time (Chungai,1998; Derrington, Shapiro, & Smith, 1999). The importance of the parent's/care giver's role in Occupational Therapy intervention in achieving outcomes is established firmly. [ABSTRACT FROM AUTHOR]

The primary aim of this article is to give a theoretical and empirical background for clinical interventions in family-oriented treatment for substance use disorders. The article refers to an ongoing research project, which is based on the concepts of mentalization and parental reflective functioning. Theory of mentalization and attachment theory is explored as explanatory tools of both addictive problem and risk/resilience factors in offspring. Mentalization is defined as the competence to envision mental states in self and others and to understand behaviour in terms of mental states. Substance use is discussed as clinical expressions of impaired mentalizing skills and disorders of state- and affect regulation. Parental reflective function particularly refers to parents' competences to interpret the mind of their own infant or child. Parental reflective functioning, as 'minding the baby', promotes sensitive care, which again serves to protect the infant and the immature brain from potentially dangerous stress and physiological arousal. Substance use often makes the parent 'absent-minded' and thus imposes a risk of impaired interactions between caregivers and the extra vulnerable substance exposed child. Without a lifeline to the caregivers' mind, the development of self regulation and social competences is endangered. High-risk families need substantial support to break the burden of intergenerational transmission of internal representations of caregiving experiences, and to promote good enough care for the infant. The mentalization-based treatment programs (MBT) briefly outlined here, propose a long-term multidisciplinary treatment and follow-up. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Clínica Psicológica is the property of Fundacion AIGLE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article reports on a relationship-focused early intervention approach in a young child's social and emotional development. It mentions that a positive sense of self and others can be developed in the context of relationships. The study aims to describe a relationship-focused approach to early intervention called "promoting first relationship."Secondly, it aims to present some encouraging initial results from a research and training project using the approach to enhance the relationship-focused skills of personnel serving young children with disabilities and their families.

Drawmg on the take-home messages from recent neuroscience and developmental research, this article focuses on the challenge of using that knowledge in the service of a more appropriate policy framework to support the healthy development of infants and toddlers and to better support their families and other caregivers. Using data from a recent 50 state study of current health, child care and family support policies, the article maps the current policy status against the research knowl- edge base, and finds the current framework wanting, particularly for the lack of policy attention to promoting health relationships right from the start. It then highlights 5 core policy challenges: en- acting a national family leave, expanding access to child and family programs like Early Head Start, providing policy incentives and resources for high-quality infant and toddler child care, strength- ening the early identification and treatment for infants and toddlers at risk of poor development, and building a policy framework to support, in every state, an infant and early childhood mental health infrastructure. The article concludes with a set of research-informed principles that could guide a next generation of targeted infant-toddler policies that address these critical challenges. [ABSTRACT FROM AUTHOR]

This article describes the rationale, philosophy, and implementation of a relationship-based model for promoting social emotional (SE) development in Part C early intervention (EI). The goal is to support, SE development for all children in EI and to more effectively identify and serve children with SE concerns and their families. The comprehensive approach provides relationship based training, addition of a SE specialist to the El entry points, reflective consultation for managers, reflective supervision and case consultation for service coordinators, and professional development and networking for providers. Evaluation results indicate that this is a cost-effective approach that produces positive changes in staff knowledge, practice, and role satisfaction, and increases the early identification of SE concerns and provision of appropriate services. The Illinois Bureau of Early Intervention is funding the rollout of the pilot model statewide. [ABSTRACT FROM AUTHOR]

Training approaches in the arena of infant mental health are evolving, demand for training experiences is growing, and recognition of challenges to building the infant-family workforce is improving understanding of training needs. The diversity in the prospective workforce creates challenges for training programs, for example, how to clearly define appropriate training objectives, how to define relevant knowledge base and skills, how to structure training approaches for such a heterogeneous population as the infant-family workforce, and how to provide training experiences that facilitate ongoing professional development for individual practitioners. Workforce diversity is not the only or even the most important challenge however. Work with infants, toddlers, and their families is made up of a great variety of problematic situations, each unique to a baby and its family, each requiring naming and framing. Thus, the complexity of training in infant mental health can be construed as the twin challenges of acquiring needed knowledge bases and also gaining the skills of naming and framing, or of problem setting, which are necessary for effective and reflective practice. The challenges for educators in infant mental health are not only to transmit appropriate knowledge bases in the training process but also to prepare the trainee to work within an ongoing relationship with each family These training issues will be addressed through an attempt to characterize the work of infant mental health using Schon's framework of reflective practice to further develop the tasks of problem setting in the indeterminate swampy zone of infant mental health practice. [ABSTRACT FROM AUTHOR]

Training for infant mental health specialists involves unusual requirements for depth and breadth as it seeks to address 7 languages: the languages of the infant, the parent, the parent-infant relationship, the family, infant mental health specialists, collaboration, and self-reflection. The training approach in the Graduate Certificate Program in Infant Mental Health at Merrill-Palmer Institute, Wayne State University, built upon the training and intervention legacy of Selma Fraiberg (1980), includes graduate coursework, direct observational and clinical experience, reflective supervision, and a yearlong clinical seminar. The program's history, orientation, structure, resources, and outcomes are described. Essential aspects of the program include its focus on observational skills, knowledge of normative development in infancy, understanding of early relationship development, understanding of the family and cultural context of development, and clinical assessment and intervention skills. Since 1988, more than 75 graduate trainees have completed the program's special blend of interdisciplinary study and supervised clinical practice, earning their graduate certificates, and making important contributions to the field of infant mental health. [ABSTRACT FROM AUTHOR]

Unsatisfying mother--infant interaction has long-term consequences for the child, affecting both child health and development. It would therefore seem reasonable to try to detect possible problems in the parent-infant interaction in early infancy, in order to intervene to try to ensure a better outcome for the child. In this study, a group of primary health care nurses were trained to support mothers with newborn babies and to intervene early should problems be detected in the parenting. These mothers formed the Intervention group, and were contrasted with a Comparison group of mothers; the latter were seen by primary health care nurses who had had no additional training and worked with the mothers as they would ordinarily. At the initial assessment the Intervention and Comparison groups for all countries were relatively well matched in their interaction, showing very few differences. At two years the whole intervention had significant positive effects, as predicted, on mother-child interaction. The dearest effects were seen in the Greek sample, where the Intervention mothers provided more variety for the child, used less punishment, had a better relationship with the child and were more involved and more facilitative than the Comparison mothers. In the UK Intervention mothers were more responsive towards their children, provided more appropriate play material, had a better relationship with the children, were more involved and used less control than the Comparison mothers. Although there was no evidence of beneficial outcomes in interactive variables in the other countries, Finland showed positive change on the HOME Inventory as a result of the intervention. This contributes to the overall findings which, taken together, suggest that the intervention had a positive effect on the mothers' ability to maintain positive interaction with their children. [ABSTRACT FROM AUTHOR]

The numbers of young children who display mental health problems are on the rise. Recent surveys suggest that anywhere from 10% to 25% of young children may have mild to serious social-emotional disorders. In populations of children with disabilities and children at risk the probability of having significant mental health problems is even greater. Accumulating evidence suggests that when left untreated, mental health problems in very young children can grow in severity and require costly, long-term intervention that may or may not be successful. Evidence also suggests that a more effective and less costly approach is prevention and early identification and intervention. The development and establishment of prevention and early identification strategies has been inhibited by a number of serious barriers. However, the advent of family friendly first-level screening measures now permits the establishment of effective and economical early screening programs, Early screening programs are enhanced if they are linked directly to other critical services such as eligibility determination, intervention, and evaluation. [ABSTRACT FROM AUTHOR]

The Diagnostic and Statistical Manual for Primary Care (DSM-PC). Child and Adolescent Version, provides a comprehensive method to facilitate professional recognition, management, and referral of a wide spectrum of children's behavioral and developmental problems, as well as stressful situations. This article describes the utility of the DSM-PC for a multidisciplinary group of practitioners who work with infants and young children Four areas of potential application of the DSM-PC are described: (1) diagnosis and management of problems that are specific to infants and young children; (2) description of environmental stressors; (3) description of developmental variation and change in infant problem behaviors; and (4) implications for research concerning infants' behavioral and developmental problems. [ABSTRACT FROM AUTHOR]