Trevarthen C, Aitken K J
Department of Psychology, The University of Edinburgh, UK.
J Child Psychol Psychiatry. 2001 Jan;42(1):3-48.
We review research evidence on the emergence and development of active "self-and-other" awareness in infancy, and examine the importance of its motives and emotions to mental health practice with children. This relates to how communication begins and develops in infancy, how it influences the individual subject's movement, perception, and learning, and how the infant's biologically grounded self-regulation of internal state and self-conscious purposefulness is sustained through active engagement with sympathetic others. Mutual self-other-consciousness is found to play the lead role in developing a child's cooperative intelligence for cultural learning and language. A variety of preconceptions have animated rival research traditions investigating infant communication and cognition. We distinguish the concept of "intersubjectivity", and outline the history of its use in developmental research. The transforming body and brain of a human individual grows in active engagement with an environment of human factors--organic at first, then psychological or inter-mental. Adaptive, human-responsive processes are generated first by interneuronal activity within the developing brain as formation of the human embryo is regulated in a support-system of maternal tissues. Neural structures are further elaborated with the benefit of intra-uterine stimuli in the foetus, then supported in the rapidly growing forebrain and cerebellum of the young child by experience of the intuitive responses of parents and other human companions. We focus particularly on intrinsic patterns and processes in pre-natal and post-natal brain maturation that anticipate psychosocial support in infancy. The operation of an intrinsic motive formation (IMF) that developed in the core of the brain before birth is evident in the tightly integrated intermodal sensory-motor coordination of a newborn infant's orienting to stimuli and preferential learning of human signals, by the temporal coherence and intrinsic rhythms of infant behaviour, especially in communication, and neonates' extraordinary capacities for reactive and evocative imitation. The correct functioning of this integrated neural motivating system is found to be essential to the development of both the infant's purposeful consciousness and his or her ability to cooperate with other persons' actions and interests, and to learn from them. The relevance of infants' inherent intersubjectivity to major child mental health issues is highlighted by examining selected areas of clinical concern. We review recent findings on postnatal depression, prematurity, autism, ADHD, specific language impairments, and central auditory processing deficits, and comment on the efficacy of interventions that aim to support intrinsic motives for intersubjective communication when these are not developing normally.
我们回顾了关于婴儿期主动“自我与他人”意识的出现和发展的研究证据，并探讨了其动机和情感对儿童心理健康实践的重要性。这涉及到婴儿期沟通如何开始和发展，如何影响个体主体的运动、感知和学习，以及婴儿如何通过与有同情心的他人积极互动来维持其基于生物学的内部状态自我调节和自我意识的目的性。相互的自我与他人意识在发展儿童的文化学习和语言合作智能方面起着主导作用。各种先入之见激发了研究婴儿沟通和认知的相互竞争的研究传统。我们区分了“主体间性”的概念，并概述了其在发展研究中的使用历史。人类个体不断变化的身体和大脑在与人为因素环境的积极互动中成长——起初是有机的，然后是心理的或人际间的。适应性的、对人类有反应的过程首先由发育中的大脑内的神经元间活动产生，因为人类胚胎的形成在母体组织的支持系统中受到调节。神经结构在胎儿期通过子宫内刺激进一步细化，然后在幼儿快速生长的前脑和小脑中，通过父母和其他人类同伴的直观反应经验得到支持。我们特别关注产前和产后大脑成熟中的内在模式和过程，这些模式和过程预示着婴儿期的社会心理支持。出生前在大脑核心形成的内在动机形成（IMF）的运作，在新生儿对刺激的定向以及对人类信号的优先学习的紧密整合的多模态感觉运动协调中很明显，通过婴儿行为的时间连贯性和内在节奏，特别是在沟通中，以及新生儿非凡的反应性和启发性模仿能力。发现这个整合的神经激励系统的正常运作对于婴儿有目的意识的发展以及他或她与他人行动和兴趣合作并从中学习的能力至关重要。通过检查选定的临床关注领域，强调了婴儿固有的主体间性与主要儿童心理健康问题的相关性。我们回顾了关于产后抑郁症、早产、自闭症、注意力缺陷多动障碍、特定语言障碍和中枢听觉处理缺陷的最新研究结果，并评论了旨在支持主体间沟通内在动机（当这些动机不能正常发展时）的干预措施的有效性。
