Challenges in conducting prospective research of developmentally directed care in surgical neonates: a case study.

Background: Evaluation is fundamental to evidence-based practice. Due to practical constraints inherent in real-world clinical environments, however, innovations in clinical practice are often implemented without rigorous research. We set out to evaluate the effectiveness of developmentally directed care in surgical neonates using a randomised controlled trial with a Newborn Individualized Care and Assessment Program (NIDCAP) intervention.

Early development of children with major birth defects requiring newborn surgery.

Aim: To describe neurodevelopmental outcomes of neonates following cardiac or non-cardiac surgery for major birth defects.

Methods: From 1 June 2002 to 31 July 2004, infants born ≥ 33 weeks gestation who underwent major birth defect surgery were enrolled prospectively. Infants were assessed at a mean corrected age of 24 months (standard deviation (SD) = 8 months, range 18-36 months) using the Bayley Scales of Infant Development: Second Edition.

Mother-child interaction and child developmental capacities in toddlers with major birth defects requiring newborn surgery.

Background: Evidence exists of the important role of the mother-child relationship in child development, yet with the exception of prematurity, little is known of the impact of biologic risk on this relationship.

Aims: We investigated the quality of the mother-child interaction in association with early development in toddlers who had newborn surgery for major birth defects.

Methods: Ninety-three toddlers (Mean age=24.

Maternal depression: relations with maternal caregiving representations and emotional availability during the preschool years.

This longitudinal study aimed to determine whether maternal depression was related to caregiving behavior and further whether this relationship was mediated and/or moderated by maternal caregiving representations. Ninety-two mothers were assessed for symptoms of depression when their children were 4, 12, and 15 months, and later at 4 years of age. At 4 years of age, mothers' caregiving representations of their child and their relationship were examined using the Parent Development Interview (PDI), and aspects of maternal behaviors were rated during mother-child play interactions using the Emotional Availability Scales (EA).

Implications of resolving the diagnosis of PKU for parents and children.

Objective: To examine resolution of the diagnosis among parents of children with phenylketonuria (PKU) as a mechanism of adjustment for parents and children.

Methods: Reaction to diagnosis interviews were conducted with 52 mothers and 47 fathers of 55 children with PKU aged 2-12 years. The parents also completed questionnaires assessing their personal adjustment (stress symptoms), their child's adjustment (behavior problems), and coping variables (personal hopefulness and coping strategies).

Attachment, behavioral inhibition, and anxiety in preschool children.

This study examined the association between insecure attachment, behavioral inhibition, and anxiety in an at risk sample of preschool children. The relationship between maternal anxiety and child anxiety was also assessed. Participants were 104 children aged 3-4 years who were assessed for behavioral inhibition and mother-child attachment (using the Strange Situation procedure).

Caregiving representations of mothers of behaviorally inhibited and uninhibited preschool children.

This study examined differences in the caregiving representations of mothers of 3- to 4-year-old behaviorally inhibited and uninhibited children with secure or insecure attachments. Mothers of inhibited children perceived their children as more vulnerable than did mothers of uninhibited children, and they acknowledged difficulties associated with their children's inhibited temperament. However, mothers of insecure inhibited children were less likely than mothers of secure inhibited children to validate their children's emotional experiences and to be aware of their children's internal states and perspectives, and they showed higher levels of boundary violation and defense against negative affect.

Child care quality matters: how conclusions may vary with context.

Three studies examined associations between early child care and child outcomes among families different from those in the National Institute of Child Health and Human Development (NICHD) Early Child Care Research Network study. Results suggest that quality is an important influence on children's development and may be an important moderator of the amount of time in care. Thus, the generalizability of the NICHD findings may hinge on the context in which those results were obtained.

Maternal employment and infant-mother attachment security at 12 months postpartum.

This study assessed the association between aspects of mother's employment and security of infant-mother attachment, in combination with proximal (maternal sensitivity) and distal (demographic, maternal, child, child-care) factors. Participants were 145 Australian mothers and their firstborn children. Attachment security was assessed with the Strange Situation at 12 months.