Krijnen L J G, Verhoeven M, van Baar A L
Child and Adolescent Studies, Utrecht University, Utrecht, Netherlands.
Front Child Adolesc Psychiatry. 2023 Sep 7;2:1176560. doi: 10.3389/frcha.2023.1176560. eCollection 2023.
High quality of mother-child interaction is associated with better psychosocial outcomes in children. However, this association might depend on the context in which mother-child interaction is observed as well as specific child characteristics. In this study, we examine differences in the assessment of mother-child interaction in a free-play and a structured task context. In addition, it will be investigated whether the behaviors per context are differently associated with preterm vs. term born toddlers' psychosocial outcomes.
A total of 201 Dutch mother-child dyads participated in the study, of whom 108 children were moderate to late preterm (MLP) and 93 were born at term. Mother-child interaction was observed in a free-play and a structured task context when the child was 18 months of (corrected) age. Six subscales of mother-child interaction were assessed using the Coding Interactive Behavior scheme: maternal stimulation, maternal warmth, child's negative affect, active mother and child engagement, dyadic synchrony and tense interaction. Psychosocial outcomes were assessed at 24 months of (corrected) age using the Ages and Stages Questionnaire - Social Emotional and the Child Behavior Checklist.
Mother-child interaction was reliably assessed (α > .60) in each context, except for tense interaction during free-play (α = .41) and child's negative affect when averaged across contexts (α = 0.55). Compared to the free-play context, during the structured task, more child's negative affect, tense interaction and active mother and child engagement was observed in MLP and term born children, and less dyadic synchrony in MLP children ('s < .01). Only during a structured task and for term born children, active mother and child engagement was related to less social-emotional difficulties, internalizing and externalizing behaviors. Only during free-play and for MLP children, active mother and child engagement was related to less externalizing behaviors. Dyadic synchrony during a structured task was associated with less social-emotional difficulties in MLP and term born children, and dyadic synchrony during free-play was only associated with less social-emotional difficulties in term born children (all 's < .05).
Most mother-child interactive behaviors can be reliably assessed in both contexts. The structured task context elicited more varied behaviors than the free-play context. With the observations in the structured task context, more associations with children's psychosocial outcomes were found than with the observations in the free-play context. Mother-child interactions characterized by active, engaged and synchronous behaviors were associated with better psychosocial outcomes in toddlers, with some differences observed for MLP vs. term born children and for the free-play vs. the structured task context. Suggestions for future research as well as clinical practice are provided.
高质量的母婴互动与儿童更好的心理社会结果相关。然而，这种关联可能取决于观察母婴互动的背景以及儿童的特定特征。在本研究中，我们考察了在自由玩耍和结构化任务背景下母婴互动评估的差异。此外，还将研究每种背景下的行为与早产和足月出生幼儿的心理社会结果之间的关联是否不同。
共有201对荷兰母婴二元组参与了该研究，其中108名儿童为中度至晚期早产（MLP），93名儿童为足月出生。当儿童18个月（矫正）大时，在自由玩耍和结构化任务背景下观察母婴互动。使用互动行为编码方案评估母婴互动的六个子量表：母亲刺激、母亲温暖、儿童消极情绪、母婴积极参与、二元同步性和紧张互动。在24个月（矫正）大时，使用年龄与阶段问卷 - 社会情绪量表和儿童行为清单评估心理社会结果。
除自由玩耍期间的紧张互动（α = 0.41）和跨背景平均后的儿童消极情绪（α = 0.55）外，每种背景下母婴互动均能得到可靠评估（α > 0.60）。与自由玩耍背景相比，在结构化任务期间，MLP儿童和足月出生儿童表现出更多的儿童消极情绪、紧张互动和母婴积极参与，而MLP儿童的二元同步性更少（p < 0.01）。仅在结构化任务期间且对于足月出生儿童，母婴积极参与与较少的社会情绪困难、内化和外化行为相关。仅在自由玩耍期间且对于MLP儿童，母婴积极参与与较少的外化行为相关。结构化任务期间的二元同步性与MLP儿童和足月出生儿童较少的社会情绪困难相关，自由玩耍期间的二元同步性仅与足月出生儿童较少的社会情绪困难相关（所有p < 0.05）。
大多数母婴互动行为在两种背景下都能得到可靠评估。结构化任务背景比自由玩耍背景引发更多样化的行为。与自由玩耍背景下的观察结果相比，在结构化任务背景下发现与儿童心理社会结果的关联更多。以积极、参与和同步行为为特征的母婴互动与幼儿更好的心理社会结果相关，在MLP儿童与足月出生儿童以及自由玩耍与结构化任务背景之间观察到一些差异。提供了对未来研究以及临床实践的建议。
