Chapter 2: Enhancing Carefiver-Infant Attachment, Interaction & Socio-communicative Development

Question 1

(Postnatal Attachment) Two significant factors that should be stressed following the birth of an infant:

Answer 1

1. Healthy infant is most alert, responsive and especially appealing 60 to 90 min. after birth (Infant is more alert during this time than during next 6 to 8 hrs)
2. Woman around the world, regardless of age or birthing practices, have the same response following birth of their child. (ie: ask about sex & health status, then request to see child)

Question 2

Postnatal Attachment

Answer 2

An early opportunity for the mother and baby to get to know one another; essential for the process of attachment to begin.

Question 3

Seeing- Touching- Holding: Seeing

Answer 3

Initial interest in making visual contact with baby –> leads parents to align their face in same parallel plane as the infant –> initiation of maternal caretaking responses.

Question 4

Seeing- Touching- Holding: Touching & Holding

Answer 4

Initial touching by mother involves use of fingertips in stroking infant’s extremities –> progresses to using palm to massage/ stroke child’s trunk

Question 5

Early caretaking provided by the mother is the most important factor in the formation of ____________.

Answer 5

Optimal Attachment

Question 6

What are the three basic steps of caretaking?

Answer 6

1. Infant makes a demand (i.e.: fussing, crying) & may represent one of several needs (ie: hunger, discomfort, fear)
2. Parent attempts to meet child’s demand
3. Infant responds to caretaker’s attempts to meet expressed demands

Question 7

For healthy infants and involved caregivers, attachment is the __________ result of caretaking opportunity.

Answer 7

Natural

Question 8

Six characteristics of parent infant interaction:

Answer 8

1. Synchrony (parent adapts behavior to child’s)
2. Symmetry (parent recognizes child’s capacity for attention, interaction styles & preferences)
3. Contingency (Parent’s desire to interact depends on child’s desire to do so)
4. Entrainment (accomplished when rhythm of interaction is established)
5. Play (marks period where child learns they have control over caregivers)
6. Autonomy ( accomplished over time as child becomes aware of control they have over interactions)

Question 9

The ongoing process of social interaction between caregiver and infant has the potential of _______ or _______ the effects of any prenatal/postnatal difficulties.

Answer 9

minimizing; maximizing

Question 10

Optimal child development is a process that is characterized by the interaction of _______ and _______ factors.

Answer 10

Biological and enviornmental

Question 11

T or F: Human relationships are crucially important for a child’s physical, cognitive, and emotional development and for his full participation in society and culture.

Answer 11

TRUE

Question 12

T or F: What goes on between a child and those close to him does not influence their development.

Answer 12

FALSE; What goes on between a child and those close to him is of crucial influence to a child’s development, both in general and specific domains.

Question 13

Infants and caregivers who are able to form optimal patterns of interaction (synchrony) ________ potential for appropriate communication development.

Answer 13

Increase

Question 14

Mothers and Infants, through mutual exchange, respond to each other on a variety of social and sensory levels which forms the basis for what?

Answer 14

The basis upon which later communication development depends

Question 15

Infants come into the world uniquely ________ to interact with it.

Answer 15

Predisposed

(**This predisposition is coordinated with the caregiver’s readiness to meet the child’s needs & begin process of attachment & interaction)

Question 16

What kind of interaction pattern does an ill infant demonstrate?

Answer 16

An ill infant will demonstrate a less organized orientation to the enviornment.

Question 17

Less organized to the enviornment is characterized by?

Answer 17

• immature motor patterns
• excessive tuning out of stressful stimuli
• lessened ability to self regulate state

*these differences may pesist into the first year and beyond

Question 18

Premature infants are just as responsive and organized in interactions as those born at full term. True or false?

Answer 18

False; Premature infants are less responsive and more disorganized in all of their interactions than full term infants.

Question 19

Premature vs Full term Infants: Patterns of Interaction

Answer 19

Premature babies vocalize, coo, smile, look around, look at objects, cry, and play less frequently and are less attentive than full term babies.

Question 20

There is a relationship between the patterns of delayed communication seen in high risk infants and early interaction patterns. T or F?

Answer 20

TRUE

Question 21

What implications result if biological factors restrict a child’s exposure to its world or the ability to interact with it?

Answer 21

There are short and long term implications for the development of age appropriate communication skills.

Question 22

A mother’s interaction with her infant is influenced by what?

Answer 22

By the infant’s contribution to their relationship

Infants help their caregivers feel and be effective by being readable, predictable, and responsive.

Question 23

Do ill infants evoke caregiver responses?

Answer 23

Yes, but the responses differ quantitively and qualitively from those elicited by healthy children. In turn these differences have an effect on interaction patterns displayed by their mothers.

Question 24

What interaction patterns do mother’s of ill infants demonstrate?

Answer 24

They demonstrate patterns characterized by increased anxiety, stress and depression. Mothers often report that they cry more, feel guilty, and worry more.

After several months, mothers are less responsive to infant cues, tend to be overeactive, demonstrate less affective behavior, talked less frequently to child, and show less affection.

Question 25

In optimal circumstances, infant responses elicit caretaker behaviors by the mother that set in motion….

Answer 25

the process of attachment and interaction.

Question 26

What contributes to to differences in how a mother of an ill infant perceives & interacts with her child?

Answer 26

• presence of illness
• lack of opportunity to care for the child
• ongoing illness
• maternal fear and anxiety
• specifc stressors dependent on child/mother
• unusual difficulties to care for child
• maternal medical/ mental health concerns

Question 27

What is the primary domain that that differentiates a healthy child from an ill child?

Answer 27

communicative development and performance

Question 28

When does communication delay begin?

Answer 28

In at risk children, many times it is observed when proper patterns of attachment and interaction do not form.

Question 29

Caregiver response to a Medically Fragile Infant

Answer 29

Parents must adapt to a set of circumstances that are difficult and uncertain. Some parents adapt well, with others displaying long term pattern of behavior suggestive of incomplete adjustment.

Question 30

The first set of adjustments that parents must face (early adjustments) revolves around what?

Answer 30

They revolve around the initial shock of having premature, ill or disabled children.

Question 31

Taylor and Hall’s stark adjustments made by parents of medically fragile children:

Answer 31

1. fragile, small, sick & at risk child replaces the expected full term infant.
2. unresponsive baby vs responsive baby
3. mother had expected unrestricted, close & frequent contact with the baby
4. expected to care for the baby at home, not hospital setting

Question 32

Support for families of children who are critically ill is offered by?

Answer 32

social workers, clergy, psychologists, psychiatrists, hospital staff, nurses & doctors.

Question 33

“chronic sorrow”

Answer 33

ongoing range of adjustments that parents of special needs children face

Question 34

A barrier to caregiver involvement may be?

Answer 34

the nature of relationship between the caregiver and EI

Question 35

What parents say about interventionists

Answer 35

1. “Interventionists don’t listen to us.”
2. “Interventionists talk in strange ways.”
3. “Interventionists don’t answer our questions.”
4. “Interventionists don’t guess why.”
5. “Interventionists keep information from us.”
6. “Interventionists dont ask for our opinion.”

Question 36

Caregiving Issues

Answer 36

Feeding concerns, infection control, feelings of less involvement, and decision making.

Question 37

Prenatal Attachment: 9 step process

Answer 37

1. planning the pregnancy
2. confirming pregnancy
3. accepting pregnancy
4. fetal movement
5. accepting the fetus as an individual
6. birth
7. seeing & hearing the baby
8. touching & holding the baby
9. caretaking