Eleonora Mascheroni

Paths of cognitive and language development in healthy preterm infants

OBJECTIVE Despite the presence of many studies on difficulties related to premature birth, findings on developmental outcomes are heterogeneous. This could be explained from a biological and environmental point of view, but also from a methodological one. The aims of this study were as follows: assess cognitive and linguistic performance using the BSID-III in a population of healthy preterm infants at 24 and 36 months (corrected age); analyze whether the correction for prematurity should be applied, decide when to stop using corrected age and evaluate possible improvements between 24 and 36 months. METHODS Developmental outcome was assessed at 24 and 36 months (corrected age) with the BSID-III in 75 healthy preterm (GA=32.5±1.97; BW=1631.55±453.92) and 69 term-born children (GA=39.77±1.00; BW=3298.95±457.27). RESULTS Preterm infants had significantly lower scores than those of term infants in Cognitive (COG) and Language (LANG REC, LANG EC) scales of the BSID-III at both 24 and 36 months, considering both corrected (CA) and chronological (UCA) age. At 24 months, significant differences between corrected and chronological scores were found for each BSID-III scale, while at 36 months, significant differences between corrected and chronological scores were found for LANG scales. Only the scores in the COG scale were statistically different between 24 and 36 months (F=4.894, P=0.009, η(2)=0.075). Considering only the preterm sample at 24 months, the differences between CA and UCA scores in the COG scale were significantly correlated to GA (p=0.000) and days in hospital (p=0.002;), while differences between CA and UCA scores in the LANG ESP scale were significantly correlated to GA (p=0.010), days in hospital (p=0.001), and birth weight (p=0.007). At 36 months, no significant correlations were found. CONCLUSIONS Preterm birth is followed by poorer cognitive and language outcomes during infancy than full-term birth. Age correction of prematurity is useful if the child is under 2 years of age; however, our findings raise concerns about the need for age correction, considering that at later ages, healthy preterm children have a higher rate of developmental delay compared with term infants. With regard to cognitive development, preterm children seem to recover from their initial disadvantage; however, with regard to linguistic development, data confirm that preterm infants are at risk for language difficulties.

L'impatto delle esperienze di vita negative della madre sul bambino

Nel tentativo di indagare l’impatto delle esperienze di vita negative materne su attaccamento e adattamento del bambino, e stato condotto uno studio che si e avvalso della somministrazione del Parenting Stress Index - Short Form (PSI-SF; Guarino et al., 2008), del Los Angeles Symptoms Checklist (LASC; King et al., 1995), del Vulnerable Attachment Style Questionnaire (VASQ; Bifulco et al., 2003), della Child Behavior Checklist 1½-5 (Achenbach & Rescorla, 2000) e dell’Attachment Q-Sort (AQS; Cassibba & D’Odorico, 2000). Lo studio, che ha coinvolto 54 mamme (27 inserite in comunita mamma-bambino) e i loro bambini (48.1% femmine, eta tra 1 e 5 anni, M = 2.78, SD = 1.14), ha messo in luce come l’aver vissuto esperienze di vita negative possa impattare sul benessere psicologico della madre, sulla percezione di se come genitore, sulle modalita di relazioni con il figlio e, di conseguenza, sul benessere del bambino in termini di adattamento e di attaccamento.

Premature birth: complexities and difficulties in building the mother–child relationship

Abstract Aim: This paper aims to investigate if the dyadic interactive behaviours were influenced by parental stress and feelings both in preterm and full-term mother–child dyads. Methods: 45 mothers (age = 35.29 ± 5.38) and fathers (age = 36.77 ± 6.89) of preterm infants (GA = 30.25 ± 2.95; BW = 1288.02 ± 488.76), and 36 mothers (age = 32.60 ± 4.56) and fathers (age = 35.54 ± 5.16) of full-term (GA = 39.88 ± 1.38; BW = 3156.39 ± 493.81) were involved. Parents filled out the Impact of Event Scale Revised (IES-R), Profile of Mood States (POMS) and Parenting Stress Index Short Form (PSI-SF) and interactive behaviours (Global Rating Scale) was videotaped after 3 months. Results: Mothers of preterm children showed higher level of Intrusiveness (Mpreterm = 4.07 ± .74, Mfullterm = 4.39 ± .51, t = 2.22, p = .029) and Remoteness (Mpreterm = 4.45 ± .83, Mfullterm = 4.79 ± .34, t = 2.51, p = .015) than mothers of term children. In preterm mothers’ lower levels of Sensitivity, higher levels of Intrusiveness, Remoteness and Depression are associated with the presence of negative feelings and parental stress in both parents. Moreover, higher children Distress is associated to parental negative feelings, paternal stress and post-traumatic symptoms. A higher score of parental negative feelings and parental stress predicted lower scores in Global RatingScale dimensions. Conclusions: Our results underline that preterm birth could be a risk factor for the co-construction of interactive exchanges between mother and premature baby. This study could help practitioners to better consider parental roles and to carry out specific supportive interventions for both parents and children.

Mothers and fathers facing their children’s phenylketonuria

ABSTRACT The aim of this study is to understand the impact of children’s phenylketonuria (PKU) on mothers and fathers and to assess the mutual influence of the psychological functioning of one parent on the other. 33 mothers and 33 fathers of PKU-affected children and 43 mothers and 43 fathers of non-PKU-affected children were involved. All of the parents filled out the Los Angeles Symptoms Checklist, the Profile of Mood Scale, the Parenting Stress Index-Short Form, and the Coping Health Inventory for Parents. We performed parametric intergroup analysis and multiple regressions. Results pointed out that there is a link between maternal stress and maternal negative states of mind, trauma-related symptoms, and paternal coping strategies. As regards fathers, there is a link between paternal stress and maternal trauma-related symptoms. Our findings suggest it will be important to better investigate the role played by paternal response in supporting mothers of a chronically ill child, since they confirm the importance of taking into account the points of view of both mothers and fathers and their mutual influences in responding to PKU diagnosis.

The impact of paternal feelings and stress on mother–child interactions and on the development of the preterm newborn

ABSTRACT This study aims to evaluate the influence of fathers’ negative feelings, parenting stress and post-traumatic symptomatology experienced after the premature birth of their infant onmother–child interaction and on infant’s development in the perinatal period. Forty-five fathers and 45 mothersof preterm infants (GA = 30.25 ± 2.95; birth weight = 1288.02 ± 488.76) filled out:Impact of Event Scale Revised, Profile of Mood States and Parenting Stress Index Short Form. At 3 months of infants’ corrected age, mother–child interactions were assessed by Global Rating Scales (GRS) and the development of the preterms was tested by Bayley Scales of Infant Development. Higher scores in paternal feelings, stress and post-traumatic symptomatology predicted lower scores in Global Rating Scales dimensions and in the Bayley Scales of Infant Development scales. Feelings and stress experienced by fathers of preterms should be considered risk factors for the building of mother-child interaction and for the early language development of preterms. Abbreviations: BSID-III: Bayley Scales of Infant Development third edition; BW: Birth weight; CA: Corrected age; COG: Cognitive Scale; GA: Gestational age; GRS: Global Rating Scale; IES-R: Impact of Event Scale Revised; LANG: Language Scale; LANG EC: Expressive Communication Subtest; LANG RC: Receptive Communication Subtest; NICU: Neonatal Intensive Care Unit; POMS: Profile of Mood States; PSI SF: Parenting Stress Index Short Form; PTSS: post-traumatic symptomatology

The Centrality of Events Scale for Italian Adolescents: Integrating Traumatic Experience Into One’s Identity and Its Relation to Posttraumatic Stress Disorder Symptomatology

Adolescents could develop areas of vulnerability, especially if they have had to deal with highly stressful and traumatic life events. Stressful experiences can work as traumatic memories that become central to one’s life and core topics for one’s identity and for the attribution of meaning to life experience. The present work evaluates (a) the internal structures of the 20-item Centrality of Event Scale in the Italian context and (b) the impact of stressful and traumatic experience during adolescence. The present work includes a convenience sample of 872 Italian adolescents -528 males, 344 females- aged between 11 and 21 years (M = 15.85; SD = 2.09). We performed a confirmatory factor analysis that confirmed a three-factor solution. Moreover, the perception of stressful event as central in the participants’ lives was significantly correlated with the presence of PTSD symptomatology, as measured by the Impact of Event Scale Revised. We found that participants with PTSD symptoms had significantly higher CES scores. These data show the validity of the CES with adolescent samples, emphasizing the sensitivity of this instrument in detecting the impact of negative life experiences even in a sample of adolescents.