Background: In spite of the importance of maternal sensitivity as a construct that fosters secure attachment and promotes a child’s social and cognitive development, no routine clinical screening currently identifies mothers at risk of poor maternal sensitivity. This is partly because researchers have not identified all the factors that influence maternal sensitivity. As a result, parenting interventions to promote maternal sensitivity and optimise child outcomes tend to focus on clinical groups. Thus, more attention is needed to identify possible determinant factors. The neurobiological mechanisms underlying natural variation in maternal sensitivity (i.e. sensitive and less sensitive mothers) are poorly understood, especially the putative role of the hormone Oxytocin (OT). Literature has suggested that this variation in maternal sensitivity is an outcome of interaction between maternal OT, as well as social factors (e.g. perceived parenting) and this interaction charts the discrete profile of the maternal brain that is mediated by stress- and reward-related neural systems. To date no study examined for the neurobiological correlates of maternal sensitivity in a distinct group of mothers representing natural variations in maternal sensitivity. Methods: Out of 105 women recruited from community antenatal clinics during their pregnancy, to complete a set of self-reported questionnaires assessing their psychosocial characteristics, a total of 80 new (i.e. early postpartum) mothers and their infants were followed up and underwent evaluation of maternal sensitivity at 4-6 months postpartum. Using a stepwise regression, we examined for predictors of maternal sensitivity among the sample (Study I). Later, at 7-9 months postpartum, 30 mothers, representing extremes in maternal sensitivity, were selected from this sample of 80: 15 mothers with higher scores (high sensitivity mothers - HSMs), and 15 with lower scores for maternal sensitivity (low sensitivity mothers - LSMs), underwent functional Magnetic Resonance Imaging (fMRI) to examine their brain responses when viewing videos of their own and an unknown infant. Maternal plasma OT levels were also measured before and following an interactive play with their infant (Study II). Results: Mothers’ self-reported experience of own parental care, and household income, independently predicted maternal sensitivity, accounting for 17% of the variance. Comparing mothers grouped by maternal sensitivity level, HSMs showed a drop in their plasma OT levels following the interaction with their infant. HSMs also showed significant brain activation in the right superior temporal gyrus in response to own infant (compared to unknown infant) when compared to LSMs. By contrast LSMs did not show any change in their plasma OT levels following interaction with their infant, and their brain responses to own infant did not show any significant brain activation when compared to HSMs. Conclusions: The findings may have implications for future novel approaches for early assessment of mothers at risk of low maternal sensitivity so they could be targeted by specialised assessments and consequently interventions to improve their parenting (Study I). Maternal sensitivity is accompanied by neural correlates that could act as a biomarker for future intervention studies that target vulnerable mothers (Study II).

Objective: The aim of this study was to investigate the differential effects of breastfeeding practice and having an intention to breastfeed (during pregnancy) on a mother’s maternal responsiveness to her infant after birth. Methods: Using longitudinal data from a subsample of 962 mother-infant dyads from a UK cohort study (Avon Longitudinal Study of Parents and Children), we investigated the influence of intention to breastfeed at 3 months pregnancy and breastfeeding practice and on mother-infant interactions at 12 months after birth. Breastfeeding intent and practice were assessed by questionnaires administered to the mothers. Intention to breastfeed in the first 3 months postpartum was measured at 32 weeks into the pregnancy, while breastfeeding practice (over first 12 months postpartum) was measured retrospectively at 15 months post partum. Results: Using logistic regression analyses, we found that intending to breastfeed at 32 weeks gestation significantly predicted maternal responsiveness, namely that an intention to breastfeed increased the odds of positive maternal responsiveness, independently of breastfeeding practice. However, we found the practice of breastfeeding was not an independent predictor of positive maternal responsiveness once intention to breastfeed was accounted for. Using a life course epidemiology approach we further demonstrated that maternal responsiveness is most positive when both the intention to breastfeed and breastfeeding practice are present. Conclusions: To our knowledge this is the first study to report that having the intention to breastfeed an infant is more strongly associated with positive maternal responsiveness than the act of breastfeeding itself. This may suggest that more responsive mothers choose to breastfeed rather than breastfeeding practice directly causing enhanced responsiveness. Further research will be needed to understand the nature of this intention and its relationships with maternal responsiveness. However, the results may also highlight the potential importance of parenting intentions/ preparations during pregnancy for a mothers developing abilities to be responsive to her infant after birth.

Abstract The aim of this study was to determine whether maternal sensitivity acts as a mediator in the associations between a mother‟s childhood history of care and her child‟s emotion regulation and attachment security at 2 ½ years of age. It was hypothesized that children of mothers who perceived their own childhood experiences with parents as caring and accepting would display more adaptive regulatory behaviors in fear-eliciting contexts and be more securely attached than children of mothers who recollected rejection in their own childhood experiences, with maternal sensitivity mediating these associations. Participants were 82 toddlers and their mothers. Mothers rated their childhood experiences of care and acceptance with their own parents prior to the laboratory procedure. Each child was presented with four novel stimuli, with mothers present, but not involved for the first two tasks and involved in the remaining two. Presentation of the novel stimuli was in pairs including one toy task (i.e., monster or robot) and one person task (i.e., clown or masks). Children‟s emotion regulation behaviors were coded continuously during the mother not involved condition, whereas observed maternal sensitivity was rated in the mother involved condition. Information about maternal sensitivity and children‟s attachment behaviors was reported by mothers using a diary technique. A path analysis was used to test the model examining the relationship between maternal history of care and sensitivity and children‟s attachment security and emotion regulation behaviors (i.e., distraction, withdrawal, contact with mother). Maternal sensitivity mediated the association between a mother‟s childhood history of care and acceptance and child attachment. Post-hoc analysis showed that this conditional indirect effect was significant only for children of mothers with less than a complete college education. In contrast, a childhood history of care and acceptance did not predict children‟s emotional regulation behaviors, although it interacted with education to predict distraction. Maternal sensitivity was associated positively with distraction and negatively with withdrawal, whereas children‟s attachment security was not associated with any emotion regulation behavior. Results are discussed in relation to attachment theory and continuities and discontinuities in the transmission process in mother-child relationships.

Multisensory integration enables young children to combine information across their senses to create rich, coordinated perceptual experiences. Events with high intersensory redundancy across the senses provide salient experiences which aid in the integration process and facilitate perceptual learning. Thus, this study’s first objective was to evaluate if toddlers’ multisensory integration abilities generalize across social/nonsocial conditions, and if multisensory integration abilities predict 24-month-old’s language development. Additionally, previous research has not examined contextual factors, such as socioeconomic status or parenting behaviors, that may influence the development of multisensory integration skills. As such, this study’s second aim was to evaluate whether maternal sensitivity and SES moderate the proposed relationship between multisensory integration and language outcomes. Results indicated that toddlers’ multisensory integration abilities, F(1,33) = 4.191, p = .049, but not their general attention control skills, differed as a function of condition (social or nonsocial), and that social multisensory integration significantly predicted toddlers’ expressive vocabularies at 24-months old, β = .530, p = .007. However, no evidence was found to suggest that SES or maternal sensitivity moderated the detected relationship between multisensory integration abilities and language outcomes; rather, mothers’ maternal sensitivity scores directly predicted toddlers’ expressive language outcomes, β = .320, p = .044, in addition to their social multisensory integration skills. These findings suggest that at 24-months of age, both sensitive maternal behaviors and the ability to integrate social multisensory information are important to the development of early expressive language outcomes. / M. S. / Multisensory integration allows children to make sense of information received across their senses. Previous research has shown that events containing simultaneous and overlapping sensory information aid children in learning about objects. However, research has yet to evaluate whether children’s' multisensory integration abilities are related to language learning. Thus, this study’s first goal was to look at whether toddlers are equally skilled at integrating multisensory information in social and nonsocial contexts, and if multisensory integration skills are related to toddlers' language skills. This study’s second goal was to examine whether parenting behaviors and/or familial access to resources (i.e., socioeconomic status) play a role in the hypothesized relationship between multisensory integration and language in toddlerhood. Results indicated that toddlers show better multisensory integration abilities when viewing social as opposed to nonsocial sensory information, and that social multisensory integration skills were significantly related to their language skills. Also, maternal parenting behaviors, but not socioeconomic status, were significantly related to toddlers' language abilities. These findings suggest that at 24-months of age, both sensitive maternal parenting and the ability to integrate social multisensory information are important to the development of language in toddlerhood.

A baby’s early experiences have a crucial effect on their later development and adjustment. Early maternal sensitivity is a concept which has been associated with a crucial influence on these later child outcomes, including behavioural outcomes. Results from large longitudinal population based studies have provided conflicting evidence in relation to early maternal sensitivity, particularly sensitivity to non-distress, and later child behaviour and a need for further research in this area exists. The current study investigated early maternal sensitivity and its association with later child behaviour in a UK based population sample using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). The study used a subsample of 766 mother-infant pairs who had data on observed maternal responsiveness at 12 months and on child behavioural difficulties derived from the Revised Rutter Parent Scale for Preschool Children at 42 months. Data for a number of potentially confounding variables, including maternal and child-based variables were also included in the analysis. Hypotheses were tested regarding an association between lower maternal responsiveness and higher child behavioural difficulties as well as regarding associations with further behavioural subscales of the Rutter scale, including a prosocial behaviour subscale. Results were analysed using a linear regression model with adjustments for groups of confounding variables. There was no evidence to support a relationship between lower maternal responsiveness and higher behavioural difficulties at 42 months although there was suggestion of a trend in the expected direction. Similar results were found for the subscales of the Rutter scale. The conclusion is that maternal sensitivity measured in this way does not have a strong relationship with child behaviour. One interpretation of these results is that there is a need to distinguish between maternal sensitivity to non-distress and to distress and ensure that the appropriate aspect of maternal sensitivity in relation to child behavioural outcomes is assessed. Limitations of the study are discussed and the effects of potential improvements are considered.

The relationship between maternal sensitivity (MS) and child outcomes has been examined by earlier research. There is some evidence that MS plays a role in shaping temperament development in early childhood. Child temperament outcomes are a significant predictor for functioning in later life. The study is based on 952 mother-infant pairs from the Avon Longitudinal Study of Parents and Children (ALSPAC). MS was observed at 12-months and temperament at 24-months. Linear regression was used to investigate the association between MS and temperament, adjusting for a range of confounders (temperament at 6 months, gender, SES, maternal mental health, maternal preconceptions of her child, parental conflict, gestation and maternal age). Multiple imputation was used to account for attrition. Mother-child interactions rated as “cool/moderate” were associated with more difficult temperament on the dimensions of “approach” (Coef 0.35, CI 0.09, 0.60),“rhythmicity”(Coef 0.43, CI 0.19, 0.68) and “adaptability” (Coef 0.24, CI 0.00, 0.49). The associations remained after adjusting for confounders in the imputed data set. There is evidence that maternal warmth may be influential in the development of child temperament, particularly positive affect, sociability and affect regulation. Further research is needed to replicate these findings.

The aim of this thesis was to increase understanding of how rumination, defined as the behaviours and thoughts that focus an individual’s attention on their depressive symptoms and on the implications of these symptoms (Nolen-Hoeksema, 1991), affects the relationship between postnatal depressive symptoms and maternal sensitivity. Study 1 examined the impact of self-reported maternal rumination on perceived maternal attunement and mood, and the role of perceived social support and infant temperament in this relationship in a community sample of mothers (N = 203). Rumination mediated the relationship between maternal depressive symptoms and maternal responsiveness when infant negative affect was low but not high. Contrary to predictions, rumination did not mediate the relationship between social support and maternal attunement. Study 2 incorporated a second assessment point approximately six months later with the same sample. Prospective analyses were undertaken to examine the directional relationship between rumination and maternal attunement in the context of depressive symptoms. Unexpectedly, analyses revealed that maternal bonding prospectively predicted rumination at six months, after controlling for rumination at baseline. The converse relationship was not significant. This was contrary to the thesis hypothesis that increased rumination would predict impaired attunement at six months. Partially consistent with the thesis hypotheses, the relationship between rumination and maternal attunement was moderated by depressive symptoms at baseline; such that mothers who were low in depressive symptoms and had lower bonding at baseline reported higher levels of rumination at 6 months. Study 3 also explored the directional relationships between maternal mood, rumination and maternal attunement at a state level in a daily diary study with a community sample of mothers (N = 94) with infants aged between 3 and 14 months. Consistent with the findings of study 2, state maternal bonding at Time 1 predicted both state maternal rumination and state maternal mood at Time 2, and state rumination at Time 2 mediated the relationship between state bonding at Time 1 and state mood at Time 2. In the final study, the causal relationships between an experimentally induced state of ruminative thinking and observed maternal behaviours in a mother-infant interaction task were examined in a sample of dysphoric and non-dysphoric mothers (N = 79) and their infants. The analyses examined change in mother-infant interaction quality from baseline to post rumination induction, and subsequent change following an infant stressor task. Findings revealed a significant reduction in maternal sensitivity and mother-infant dyadic synchrony in the rumination group, but not the control group. For maternal sensitivity, the effect of rumination was exacerbated following the stressor task. Contrary to predictions, this relationship was not moderated by dysphoric symptoms. The findings of this thesis indicate that ruminative thinking directly impairs observed maternal behaviours, but that perceived poorer maternal attunement also increases self-reported ruminative thinking. The significance of these findings for theoretical explanations of rumination in a postnatal context are considered, and the clinical implications for parenting programmes and interventions for both mothers in the community as well as those considered at risk are discussed.

Objective: The overall aim of this study was to investigate whether maternal emotion recognition of infant faces in a facial morphing task differed by maternal attachment style, and if this was moderated by a secure attachment prime, such that it would ameliorate the effects of maternal attachment insecurity. Method: 87 mothers of children aged 0-18 months completed measures of global and mother-specific trait attachment, post-natal depression, mood and state attachment alongside 2 sessions of an emotion recognition task. This task was made up of short movies created from photographs of infant faces, changing from neutral to either happy or sad. It was designed to assess sensitivity (accuracy of responses and intensity of emotion required to recognize the emotion) to changes in emotions expressed in the faces of infants. Participants also underwent a prime manipulation that was either attachment-based (experimental group) or neutral (control group). Results: There were no significant effects for global attachment scores (i.e., avoidant, anxious). However, there was a significant interaction effect of condition x maternal avoidant attachment for accuracy of recognition of happy infant faces. Explication of this interaction yielded an unexpected finding: participants reporting avoidant attachment relationships with their own mothers were less accurate in recognizing happy infant faces following the attachment prime than participants with maternal avoidant attachment in the control condition. Conclusions: Future research directions suggest ways to improve strength of effects and variability in attachment insecurity. Clinical implications of the study center on the preliminary evidence presented that supports carefully selected and executed interventions for mothers with attachment problems.

abstract: The ability to self-regulate is arguably the single most important skill a child develops early in life. Self-regulation skills are consistently linked to indices of health, success, and wellbeing. The predominating perspective in self-regulation developmental research has emphasized the role of the early caregiving environment, specifically maternal characteristics and behavior, in shaping infants’ emerging regulatory skills. Using two complementary studies, this dissertation draws from a longitudinal sample of 322 low-income, Mexican American mother-infant dyads to better understand mothers’ and infants’ unique roles in contributing to emerging infant regulatory processes. The first study explores the unique contributions of intrinsic (i.e., infant gaze) and extrinsic (i.e., maternal gaze) factors in understanding infant dysregulated emotion and behavior during mother-infant interactions. Using actor partner interdependent models (APIMs), the role of infant and maternal gaze in understanding infant dysregulation were examined longitudinally across three mother-infant interaction tasks (i.e., soothing, teaching, and peekaboo), as well as within task. The expected relations among gaze and dysregulation did not emerge in the longitudinal model; however, differential patterns of associations emerged by task. Findings are discussed within the intersection of risk, culture, and the dyadic interaction context. The second study connects patterns of specific maternal behaviors (i.e., acknowledging, gaze, vocal appropriateness, appropriate range of affect, consistency of style, resourcefulness, and touch) associated with maternal sensitivity to infant cortisol reactivity and recovery. Latent profile analysis (LPA) revealed four distinct combinations of maternal sensitivity behaviors. One pattern emerged as a risk profile—differentiated by higher maternal stress—and was associated with significantly more infant cortisol recovery compared to other profiles. Both studies offer a more nuanced understanding of the respective roles of infant and maternal factors in the development of self-regulation. Further explication of developmental processes involved in early regulatory functioning has implications for advancing both scientific knowledge and improved targeting of prevention and early intervention efforts to promote optimal child outcomes, particularly in populations that at increased risk for developmental psychopathology. / Dissertation/Thesis / Doctoral Dissertation Family and Human Development 2019

The current study sought to examine predictors of language acquisition for deaf children who received cochlear implants in a large, multi-center trial. General maternal sensitivity as well as two specific types of maternal sensitivity, cognitive and linguistic stimulation, were all evaluated in relation to speech production. Characteristics of the family and child (e.g. maternal education, family income, age at implantation, etc.) were also evaluated. The hypotheses tested were: 1) child age at implantation and gender, maternal education, and family income were expected to predict speech production across 6 and 12 months post-implantation, 2) both Cognitive and Linguistic Stimulation were expected to predict the growth of speech production at 6 and 12 months post-implantation, and 3) Cognitive and Linguistic Stimulation were expected to predict speech production above and beyond that predicted by general Maternal Sensitivity. Results indicated that, of the demographic variables, only child age at implantation was a significant predictor of speech production. Cognitive and linguistic stimulation were significantly associated with the development of speech production in the first year following activation of the implant. Furthermore, these important maternal behaviors accounted for gains in speech production beyond that accounted for by general maternal sensitivity. These findings have several clinical implications, including the development of formalized training for parents of children who receive cochlear implants.