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Most infants exhibit an attentional bias for faces and fearful facial expressions. These biases reduce toward the third year of life, but little is known about the development of the biases beyond early childhood. We used the same methodology longitudinally to assess attention disengagement patterns from nonface control pictures and faces (neutral, happy, and fearful expressions) in a large sample of children at 8, 30, and 60 months (N = 389/393/492, respectively; N = 72 for data in all three assessment; girls >45.3% in each assessment). "Face bias" was measured as a difference in disengagement probability (DP) from faces (neutral/happy) versus nonface patterns. "Fear bias" was calculated as a difference in DP for fearful versus happy/neutral faces. At group level, DPs followed a nonlinear longitudinal trajectory in all face conditions, being lowest at 8 months, highest at 30 months, and intermediate at 60 months. Face bias declined between 8 and 30 months, but did not change between 30 and 60 months. Fear bias declined linearly from 8 to 60 months. Individual differences in disengagement were generally not stable across age, but weak correlations were found in face bias between 8- and 60-month, and in DPs between 30- and 60-month (rs = 0.22-0.41). The results suggest that prioritized attention to faces--that is, a hallmark of infant cognition and a key aspect of human social behavior--follows a nonlinear trajectory in early childhood and may have only weak continuity from infancy to mid childhood.

Maternal responses to infant facial expressions were examined in two socioeconomically diverse samples of South African mothers (Study I, N = 111; and Study II, N = 214; age: 17-44 years) using pupil and gaze tracking. Study I showed increased pupil response to infant distress expressions in groups recruited from private as compared to public maternity clinics, possibly reflecting underlying differences in socioeconomic status (SES) across the groups. Study II, sampling uniformly low-SES neighborhoods, found increased pupil dilation and faster orientation to expressions of infant distress, but only in the highest income group. These results are consistent with maternal physiological and attentional sensitivity to infant distress cues but challenge the universality of this sensitivity across socioeconomic diversity.

Background Effective integration of home visit interventions focused on early childhood development into existing service platforms is important for expanding access in low- and middle-income countries (LMICs). We designed and evaluated a home visit intervention integrated into community health worker (CHW) operations in South Africa. Methods and findings We conducted a cluster-randomized controlled trial in Limpopo Province, South Africa. CHWs operating in ward-based outreach teams (WBOTs; clusters) and caregiver-child dyads they served were randomized to the intervention or control group. Group assignment was masked from all data collectors. Dyads were eligible if they resided within a participating CHW catchment area, the caregiver was at least 18 years old, and the child was born after December 15, 2017. Intervention CHWs were trained on a job aid that included content on child health, nutrition, developmental milestones, and encouragement to engage in developmentally appropriate play-based activities, for use during regular monthly home visits with caregivers of children under 2 years of age. Control CHWs provided the local standard of care. Household surveys were administered to the full study sample at baseline and endline. Data were collected on household demographics and assets; caregiver engagement; and child diet, anthropometry, and development scores. In a subsample of children, electroencephalography (EEG) and eye-tracking measures of neural function were assessed at a lab concurrent with endline and at 2 interim time points. Primary outcomes were as follows: height-for-age z-scores (HAZs) and stunting; child development scores measured using the Malawi Developmental Assessment Tool (MDAT); EEG absolute gamma and total power; relative EEG gamma power; and saccadic reaction time (SRT)-an eye-tracking measure of visual processing speed. In the main analysis, unadjusted and adjusted impacts were estimated using intention-to-treat analysis. Adjusted models included a set of demographic covariates measured at baseline. On September 1, 2017, we randomly assigned 51 clusters to intervention (26 clusters, 607 caregiver-child dyads) or control (25 clusters, 488 caregiver-child dyads). At endline (last assessment June 11, 2021), 432 dyads (71%) in 26 clusters remained in the intervention group, and 332 dyads (68%) in 25 clusters remained in the control group. In total, 316 dyads attended the first lab visit, 316 dyads the second lab visit, and 284 dyads the third lab visit. In adjusted models, the intervention had no significant impact on HAZ (adjusted mean difference (aMD) 0.11 [95% confidence interval (CI): -0.07, 0.30]; p = 0.220) or stunting (adjusted odds ratio (aOR) 0.63 [0.32, 1.25]; p = 0.184), nor did the intervention significantly impact gross motor skills (aMD 0.04 [-0.15, 0.24]; p = 0.656), fine motor skills (aMD -0.04 [-0.19, 0.11]; p = 0.610), language skills (aMD -0.02 [-0.18, 0.14]; p = 0.820), or social-emotional skills (aMD -0.02 [-0.20, 0.16]; p = 0.816). In the lab subsample, the intervention had a significant impact on SRT (aMD -7.13 [-12.69, -1.58]; p = 0.012), absolute EEG gamma power (aMD -0.14 [-0.24, -0.04]; p = 0.005), and total EEG power (aMD -0.15 [-0.23, -0.08]; p < 0.001), and no significant impact on relative gamma power (aMD 0.02 [-0.78, 0.83]; p = 0.959). While the effect on SRT was observed at the first 2 lab visits, it was no longer present at the third visit, which coincided with the overall endline assessment. At the end of the first year of the intervention period, 43% of CHWs adhered to monthly home visits. Due to the COVID-19 pandemic, we were not able to assess outcomes until 1 year after the end of the intervention period. Conclusions While the home visit intervention did not significantly impact linear growth or skills, we found significant improvement in SRT. This study contributes to a growing literature documenting the positive effects of home visit interventions on child development in LMICs. This study also demonstrates the feasibility of collecting markers of neural function like EEG power and SRT in low-resource settings. Trial registration PACTR 201710002683810; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=2683; South African Clinical Trials Registry, SANCTR 4407, Author(s): Peter C. Rockers 1,*, Jukka M. Leppänen 2, Amanda Tarullo 3, Lezanie Coetzee 4, Günther Fink 5,6, Davidson H. Hamer 1,7, Aisha K. Yousafzai 8, Denise Evans 4 Introduction [...]

Eye tracking research has shown that infants develop a repertoire of attentional capacities during the first year. The majority of studies examining the early development of attention comes from Western, high-resource countries. We examined visual attention in a heterogeneous sample of infants in rural Malawi (N = 312-376, depending on analysis). Infants were assessed with eye-tracking-based tests that targeted visual orienting, anticipatory looking, and attention to faces at 7 and 9 months. Consistent with prior research, infants exhibited active visual search for salient visual targets, anticipatory saccades to predictable events, and a robust attentional bias for happy and fearful faces. Individual variations in these processes had low to moderate odd-even split-half and test-retest reliability. There were no consistent associations between attention measures and gestational age, nutritional status, or characteristics of the rearing environment (i.e., maternal cognition, psychosocial well-being, socioeconomic status, and care practices). The results replicate infants' early attentional biases in a large, unique sample, and suggest that some of these biases (e.g., bias for faces) are pronounced in low-resource settings. The results provided no evidence that the initial manifestation of infants' attentional capacities is associated with risk factors that are common in low-resource environments.

This study examined approach-motivation related brain activity (frontal electroencephalogram [EEG] asymmetry) in response to direct and averted gaze in 3- to 6-year-old typically developing (TD) children, children with autism spectrum disorder (ASD), and those with intellectual disability (ID). We found that, in TD children, direct gaze elicited greater approach-related frontal EEG activity than did downcast gaze. This pattern of activity was in contrast to that observed in children with ASD, who showed greater approach-related activity in response to downcast gaze than to direct gaze. ID children did not differ in their responses to different gaze conditions. These findings indicate that another person's direct gaze does not elicit approach-motivation related brain activity in young children with ASD.

This study examined approach-motivation related brain activity (frontal electroencephalogram [EEG] asymmetry) in response to direct and averted gaze in 3- to 6-year-old typically developing (TD) children, children with autism spectrum disorder (ASD), and those with intellectual disability (ID). We found that, in TD children, direct gaze elicited greater approach-related frontal EEG activity than did downcast gaze. This pattern of activity was in contrast to that observed in children with ASD, who showed greater approach-related activity in response to downcast gaze than to direct gaze. ID children did not differ in their responses to different gaze conditions. These findings indicate that another person's direct gaze does not elicit approach-motivation related brain activity in young children with ASD., Author(s): Jenni Lauttia [sup.1] , Terhi M. Helminen [sup.1] , Jukka M. Leppänen [sup.2] , Santeri Yrttiaho [sup.2] , Kai Eriksson [sup.3] [sup.4] , Jari K. Hietanen [sup.1] , Anneli [...]

Maternal responses to infant facial expressions were examined in two socioeconomically diverse samples of South African mothers (Study I, N = 111; and Study II, N = 214; age: 17–44 years) using pupil and gaze tracking. Study I showed increased pupil response to infant distress expressions in groups recruited from private as compared to public maternity clinics, possibly reflecting underlying differences in socioeconomic status (SES) across the groups. Study II, sampling uniformly low‐SES neighborhoods, found increased pupil dilation and faster orientation to expressions of infant distress, but only in the highest income group. These results are consistent with maternal physiological and attentional sensitivity to infant distress cues but challenge the universality of this sensitivity across socioeconomic diversity. [ABSTRACT FROM AUTHOR]

We examined how infants' attentional disengagement from happy, fearful, neutral, and phase-scrambled faces at 8 months, as assessed by eye tracking, is associated with trajectories of maternal depressive symptoms from early pregnancy to 6 months postpartum (decreasing n = 48, increasing n = 34, and consistently low symptom levels n = 280). The sample (mother-infant dyads belonging to a larger FinnBrain Birth Cohort Study) was collected between 5/2013-6/2016. The overall disengagement probability from faces to distractors was not related to maternal depressive symptoms, but fear bias was heightened in infants whose mothers reported decreasing or increasing depressive symptoms. Exacerbated attention to fearful faces in infants of mothers with depressive symptoms may be independent of the timing of the symptoms in the pre- and postnatal stages. [ABSTRACT FROM AUTHOR]