Daniel N. Stern

The prosody of maternal speech: infant age and context related changes

The speech of 6 mothers to their healthy infants was examined longitudinally during the neonatal period and at 4, 12, and 24 months in a semi-naturalistic setting. Features of speech analysed were: contour of fundamental frequency, repetitiveness, timing (durations of vocalizations and pauses), tempo and MLU. The neonatal period was characterized by elongated pauses. During the 4-month period the extent of pitch contouring and repetitiveness was greater than at earlier or later ages. By 24 months, the duration of vocalizations and length of MLU became markedly greater. The period of intense face-to-face interaction around the fourth month proved to involve more changes in certain prosodic features. Some of the possible functions of these changes during this phase are discussed.

Attentional skills during the first 6 months of age in autism spectrum disorder.

OBJECTIVE To study the quality of early attention in autism spectrum disorder (ASD) through home movies. METHOD Fifteen home movies from the first 6 months of life of children who later received a diagnosis of ASD were compared with home movies of 15 normal children. The diagnosis was performed after the third year of life of children by two senior child and adolescent psychiatrists using a checklist of symptoms according to the. The films of the two groups were mixed and rated by blind observers through a Grid for the Assessment of Attentional Skills in Infants, composed of 13 items grouped into three developmental areas. RESULTS Using multivariate analysis of variance, the authors found significant differences between the two groups for the items in the social attention and the social behavior areas; on the contrary, there were no differences in nonsocial attention. CONCLUSIONS The authors pose some hypotheses about a specific early-appearing impairment of attention in ASD in which children shift their spontaneous attention mainly toward nonsocial stimuli rather than toward social stimuli. The importance of this finding for early diagnosis and treatment is underlined.

Explicating the implicit: the local level and the microprocess of change in the analytic situation.

This paper proposes a method of examining the micro‐events of the analytic process that borrows heavily from developmental research. The increasing importance of illuminating the microprocess of interaction to understanding the process of change in analytic treatment is emphasised. A set of constructs and terminology is proposed for the study of the moment‐to‐moment interactive process in psychoanalytic therapy referred to as the local level. A theory of therapeutic action based on ‘local‐level’ process is then explicated. Its central element involves a step‐by‐step process of ‘fitting together’, which leads to changes in implicit knowing through alteration of emotional procedures.

Engagement-Disengagement and Early Object Experiences

The last decade’s research has revolutionized our view of the capacities of the human infant in the early months, forcing a recognition of his considerable receptivity to environmental stimulation and his own capacity to seek stimulation and initiate social interactions. Particularly significant has been an appreciation of the central role of the infant’s capacity for vis-a-vis orientation and sustained visual regard, which are considered to be among the most fundamental paradigms of communication, and central to the developing attachment between mother and infant (Walters & Parke, 1965; Robson, 1967).

A model for conceptualizing the role of the mother's representational world in various mother-infant therapies

A model of the mother-infant interaction/relationship is presented that permits systematic descriptions of different therapeutic approaches. The model consists of four interdependent elements in constant dynamic equilibrium. These elements are (1) the infants overt interactive behavior; (2) the mothers overt interactive behavior (together these two constitute the interaction); (3) the infants representation of the interaction; and (4) the mothers representation of the interaction (together the four constitute the relationship). Different therapeutic approaches, including a psychoanalytically oriented therapy, interactional coaching, a behavioral pediatric approach, a behaviorist approach, and a family therapy approach are each described in terms of (1) which element in the model provides the clinical information and (2) which element in the model is the direct focus of therapeutic action. Educational, clinical, and research implications of this perspective are discussed. In particular, the importance of changing the mothers representation of the interaction for therapeutic change is stressed. Further, it is argued that the mothers representation can be changed sufficiently by both direct and indirect approaches.

Disturbances of Affect Expression in Failure-to-Thrive

Positive and negative affects were assessed in 28 6- to 36-month-old children with failure-to-thrive and 14 normally growing children in feeding and nonfeeding situations. The roles of malnutrition and severity of organic effects also were examined. Failure-to-thrive children expressed less positive affect in the feeding and nonfeeding situations and more negative affect in feeding than normally growing children. Among failure-to-thrive children, the presence of both acute and chronic malnutrition was associated with heightened negative affect during feeding, whereas the degree of organic contribution had no effect. These results, if replicated, may have implications for clinical assessment and are discussed in terms of current theories of failure-to-thrive.

An Early Manifestation of Differential Behavior toward Children of the Same and Opposite Sex

Summary Three- to five-year-old children (N = 134) approached each other in two experiments investigating age, sex, and dyadic sex composition differences in a social manifestation of the awareness of the sex of self and of others. Children of both sexes and at all ages both stopped and oriented their bodies farther away from opposite-sex peers than from same-sex peers, regardless of age-status or familiarity. A nonverbal technique, which is readily reproducible and experimentally manipulatable, is presented which measures an aspect of early awareness of ones own sex and that of others in an obviously meaningful interpersonal context.

The kiddie-infant descriptive instrument for emotional states (KIDIES): An instrument for the measurement of affective state in infancy and early childhood

An objective instrument is described for measuring several affect states in infants and young children (KIDIES). The scoring system is ethologically based, describing the intensity and the frequency of each affect. It is midway between a fine-grained microanalytic method and a global subjective one. It aims to achieve the balance between quantitative rigor and feasibility needed for large-number clinical research. This report includes a description of the KIDIES, its interrater reliability, interrater agreement, and a test of external validity. To evaluate outcome validity, a group of 20 children separated from their mothers for 6 days (because of maternal hospitalization for a Caeserian section birth) and a group of nonseparated children were tested with the KIDIES. Children were ages 2.6 to 4.6 and were sex and age matched between groups. The 6-day separated children (mother-hospitalized group) were found to be less happy, more sad, more distressed, less interested in things, more interested in persons, and had a lower attention span. These results are discussed in terms of the utility of the instrument particularly in assessing depressive phenomena during early childhood.

THE CASE OF SOPHIE

ABSTRACT: The analysis of a girl from ages 3 to 5 years old offers a clinical illustration of an alternativetheory of change. In this theory the process of change is organized around nodal points of exchangebetween patient and analyst, designated as “now moments” and “moments of meeting.” In the casepresented, these moments were preceded by an intensification of affect and were accompanied by a senseof openness and ambiguity. As often as not they were nonverbal and sometimes did not even involvesymbolic representation. The process resulted in a progressively expanded repertoire of ways of beingtogether and ways of doing things together. In a parallel and mutually influencing track, the child wastelling me a story that gave meaning to her world, and increased the coherence of her sense of self. RESUMEN: El ana´lisis de una nin˜ade3a5an˜os de edad ofrece una ilustracio´n cli´nica de otra teori´a sobreel cambio. En esta teori´a el proceso de cambio se organiza alrededor de puntos nodales de intercambioentre la paciente y el analista que se designan como “momentos de ahora” y “encuentros momenta´neos.”En el caso presentado, estos “momentos” fueron seguidos de una intensificacio´n del afecto y fueronacompan˜ados por un sentido de apertura y ambigu¨edad. Tan frecuente como nunca antes, fueron “mo-mentos” sin hablar y algunas veces no involucraron representacio´n simbo´lica. El proceso resulto´enunrepertorio progresivamente expandido de maneras de estar juntos y maneras de hacer cosas juntos. Enforma paralela y de influencia mutua, la nin˜a me estaba contando una historia que le dio significado a sumundo e incremento´ la coherencia de su sentido del yo.