Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Disertacijoje tirtas vaizdo analizės metodu pagrįstos, trumpalaikės, nukreiptos į motinos ir kūdikio sąveiką, prieraišumo santykius koreguojančios intervencijos (VIPP, Juffer, Bakermans-Kranenburg, & Van IJzendoorn, 2008) poveikis motinų jautrumui kūdikio signalams bei kūdikių prieraišumo saugumui. Tiriamieji buvo (N = 54) nepakankamai jautrios kūdikio signalams, klinikinių sutrikimų neturinčios, viduriniosios klasės motinos ir kūdikiai. Motinos jautrumas kūdikio signalams buvo vertinamas klasikine Ainsworth skale pagal nufilmuotą motinos ir kūdikio laisvą žaidimą, o kūdikių prieraišumo saugumas vertintas Waters‘o „Prieraišumo Q-rūšiavimo metodika“ (stebint kūdikį ir motiną namuose). Ilgalaikį dalyvavimo korekcijos programoje poveikį vaikų elgesio sunkumams vertinome CBCL metodika. Nustatyta, kad dalyvavimas korekcijos programoje reikšmingai padidino motinų jautrumą kūdikių signalams, net kai buvo kontroliuojamas motinos amžius, išsilavinimas, kasdienis stresas, saviveiksmingumas, kūdikių lytis ir temperamentas. Kūdikių prieraišumo saugumas eksperimentinėje grupėje nepadidėjo, kai eksperimentinės grupės tiriamieji baigė dalyvauti programoje, lyginant su kontroline grupe. Aukštesniu ir žemesniu neigiamu emocionalumu pasižymintys kūdikiai gavo tiek pat naudos iš dalyvavimo programoje. Eksperimentinės, kontrolinės grupių ir pakankamai jautrių motinų vaikai patyrė panašiai tiek pat elgesio sunkumų dviejų metų amžiuje. Disertacijoje analizuojami veiksniai, susiję su motinų... [toliau žr. visą tekstą] / The randomized control trial examined the effects of a short-term, interaction focused and attachment-based video-feedback intervention (VIPP, Juffer, Bakermans-Kranenburg, & Van IJzendoorn, 2008) on mothers’ sensitive responsiveness and infant-mother attachment security in a sample (N = 54) of low sensitive, non-clinical, middle class Lithuanian mothers. Maternal sensitivity was assessed in a free play session with the Ainsworth sensitivity scale, and attachment security was observed using the Attachment Q sort for home observations. The long-term intervention effect on children behavior problems was assessed with CBCL. We found that the intervention mothers indeed significantly improved their sensitive responsiveness through participation in the intervention. VIPP enhanced maternal sensitive responsiveness even when maternal age, educational level, daily hassles, efficacy, infant gender, and infant negative and positive affect were controlled for. However, attachment security in the intervention group infants was not enhanced after the intervention, compared to the control infants, and the infants did not seem to differential susceptible to the increase in maternal sensitivity. Experimental, control groups children and sensitive mothers’ children experienced the same level of behavior problems at two years. Factors associated with maternal sensitivity and children behavior problems were analyzed.

Advances in neonatology have led to increased numbers of high-risk neonates surviving and intensified interest in the developmental outcomes of this population. In the South African context prematurity and low birth weight are the most common causes of death in the perinatal period and the same risk factors that contribute to infant mortality also contribute to the surviving infants’ increased risk for developmental delays. As a result of the interacting biological and environmental risk factors of prematurity, low birth weight, poverty and HIV and AIDS in the South African context Kangaroo Mother Care (KMC) has been developed as best practice to promote infant survival and to facilitate mother-infant attachment. Mother-infant attachment may lead to synchronous interaction patterns between the mother and infant which forms the basis of early communication development. Early communication intervention (ECI) services are recommended as early as possible as high-risk infants are especially at risk for feeding difficulties and communication developmental delays. It is, however, not clear what the content of an ECI programme should be and how it should be implemented according to the changing communication and feeding developmental needs of the infant while receiving KMC. There appears to be a dearth of research on the earliest stages of communication development in high-risk neonates, which should form the foundation of such a programme. A descriptive survey was conducted to describe the development of 25 high-risk infants and their mothers’ changing needs from admission to discharge from a KMC unit. Each participant and mother dyad was followed up over an average of 11 days of data collection with three to four data collection sessions. Data was collected by means of direct observation during routine care-giving activities. The different developmental subsystems of the participants’ feeding, communication, neuro-behavioural organization and mother-neonate interaction were described. The results demonstrated that subtle, but definite changes could be observed in the participants’ development. Development in all the different areas occurred over time as the participants progressed through the three developmental states of the in-turned state, coming-out state and reciprocity state. As the participants progressed during the 11 days of data collection and were increasingly able to attend to their environment, they also developed the ability to regulate and organize their own behaviour in order to develop more complex communication, feeding and interaction skills with their mothers. The functioning of the participants’ sensory systems developed in a specific order namely tactile, auditory and then visual. Although the participants developed consistently throughout their stay in the KMC unit, mother-neonate interaction never reached optimal levels. The importance of an individualized training programme for each mother is reflected in the finding that the neonate’s developmental level and progress needs to be considered when implementing the ECI programme. The need for speech-language therapy involvement in KMC is emphasized in the light of a shortage of practicing speech-language therapists in South Africa. It is therefore imperative that the prevention of communication delays and feeding difficulties in high-risk neonates as well as parent training assume priority. / Dissertation (MCommunication Pathology)--University of Pretoria, 2008. / Speech-Language Pathology and Audiology / unrestricted

Infants need to develop effective, secure attachment to their primary caregivers in the first year of life. Researchers have not been able to identify all the factors that may influence the development of infant attachment. Most of the studies in this area have been done without regard to infant feeding as a potential factor. Maternal responsiveness appears to be key in the child's development of secure attachment behaviors, yet even after decades of research on infant attachment and maternal responsiveness, there is little evidence available to assist with early identification of families at risk and few interventions known to be effective in promoting maternal responsiveness.The research questions for this study were: 1) Do mothers who exclusively breastfed their infants for at least 6 weeks report more maternal responsiveness behaviors 2-4 months after delivery compared to mothers who exclusively formula feed their infants? 2) How well does breastfeeding duration predict self-reported maternal responsiveness at 2-4 months once socio-demographics and maternal characteristics (i.e., self-esteem, satisfaction with life) are statistically controlled?A cross-sectional survey design was used to assess the variables of maternal responsiveness, feeding patterns, and maternal characteristics in a convenience sample of 200 mothers in the first 2-4 months after delivery. The 60-item instrument included scales to measure maternal responsiveness (MIRI: Amankwaa et al., 2002), self-esteem (RSE: Rosenberg, 1965), and satisfaction with life (SWLS: Diener et al., 1985) as well as infant feeding and socio-demographic questions. A mixed mode data collection strategy was used combining Internet data collection with traditional paper-and-pencil survey methods.Somewhat surprisingly, mothers who exclusively breastfed for at least 6 weeks did not report any more maternal responsiveness behaviors compared to mothers who formula fed their infants. Hierarchical multiple regression analysis revealed that satisfaction with life, self-esteem, and parity, but not breastfeeding, explained a significant portion of the variance in self-reported maternal responsiveness scores. Further research in this area is needed. It should be noted that this is one of few studies of maternal responsiveness using a self-report instrument and may also be the first study of maternal responsiveness using Internet data collection.

John Bowlby made a profound contribution to the field of early parenting with his theory of attachment. He suggested that attachment theory has universal applicability. However, it has been argued that attachment theory is based upon a Western worldview, and as such, lacks applicability in cross-cultural contexts. In light of this objection, this study aimed to examine the relevancy of attachment theory within the South African context. In order to do this, a qualitative research design, employing focus groups, was set up to explore isiZulu-speaking mothers’ constructions of infant-caregiver relationships. Participants were recruited from two Non-Governmental Organizations (NGOs) in KwaZulu-Natal. Each participant partook in three focus groups. The focus group data was analyzed using a form of thematic analysis. The group discussion provided support for attachment theory in the South African context. However, there appeared to be some cultural variations in the ways in which the attachment relationship is carried out within this context. In particular, it appeared that isiZulu-speaking mothers employ physical touch and a rapid response style with their infants. Furthermore, evidence emerged to suggest that there are certain barriers to the attachment relationship in South Africa. Finally, this research study showed that urbanization has had an important impact on parenting. As such, from this research, it can be concluded that attachment interventions are useful in South Africa, yet these may need to occur alongside other interventions. There is also room for further research to explore understandings of attachment within broader population groups, including fathers and grandmothers. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.