Gal Meiri

Infant sleep development from 3 to 6 months postpartum: links with maternal sleep and paternal involvement.

The aims of this longitudinal study were to examine (a) development of infant sleep and maternal sleep from 3 to 6 months postpartum; (b) concomitant and prospective links between maternal sleep and infant sleep; and (c) triadic links between paternal involvement in infant caregiving and maternal and infant sleep. The study included 57 families that were recruited during pregnancy. Maternal and infant sleep was assessed using actigraphy and sleep diaries for 5 nights. Both fathers and mothers completed a questionnaire assessing the involvement of fathers relative to mothers in infant caregiving. The results demonstrated moderate improvement in infant and maternal sleep percent between 3 and 6 months. Maternal sleep percent at 3 months significantly predicted infant sleep percent at 6 months. Greater paternal involvement in infant daytime and nighttime caregiving at 3 months significantly predicted more consolidated maternal and infant sleep at 6 months. These findings suggest that maternal sleep is an important predictor of infant sleep and that increased involvement of fathers in infant caregiving responsibilities may contribute to improvements in both maternal and infant sleep during the first 6 months postpartum.

Maternal Worries about Child Underweight Mediate and Moderate the Relationship Between Child Feeding Disorders and Mother–Child Feeding Interactions

OBJECTIVE To examine the role of maternal worries about child underweight and undereating in mother-child feeding interactions with children having a feeding disorder (FD). METHOD Participants were 27 children diagnosed with nonorganic-based FD and 28 children without FD. Mothers were interviewed about their worries about child underweight and undereating. Mother-child interactions were videotaped during feeding. RESULTS Maternal child weight-related worries acted as both a mediator and a moderator. The more negative mother-child interactions found in the FD group, compared to the control group, were explained by greater maternal worry regarding child underweight. Furthermore, mother-child interactions within the FD group were not at risk per se, but only when coupled with high maternal worries about childrens underweight. CONCLUSION Worry about child underweight partially explains the development of negative feeding interactions when having children with FD, signifying clinical implications for the treatment of FD.

THE ROLE OF THE FATHER IN CHILD SLEEP DISTURBANCE: CHILD, PARENT, AND PARENT–CHILD RELATIONSHIP

The majority of studies on child sleep problems focus primarily on mothers, neglecting paternal influences. Guided by the transactional framework, we explored how child temperament, paternal and maternal stress, and the parent-child interactions differ between families having children with sleep disturbances and a selected comparison group. The role of paternal involvement in child caregiving as a moderator of these differences was assessed. The sample consisted of 51 children (1-3 years old) and their mothers and fathers. Data were collected during home visits, when mothers and fathers completed questionnaires and were interviewed. In addition, mother-child and father-child interactions were videotaped. Results indicate that compared to the comparison group, fathers rated children with sleep disturbances as fussier, both their mothers and fathers experienced higher levels of stress, and reported using more bedtime interactions that interfere with childs sleep-wake self-regulation. In addition, their fathers were less sensitive during father-child interaction and less involved in child caregiving. Finally, paternal involvement moderated the group differences seen in maternal stress, suggesting that high paternal involvement acted as a buffer to protect parents of children with sleep disturbances from experiencing parental stress. The important role of fathers in families having children with sleep disturbances is discussed.

Mealtime Dynamics in Child Feeding Disorder: The Role of Child Temperament, Parental Sense of Competence, and Paternal Involvement

OBJECTIVE We examined how child temperament, parental sense of competence, and paternal involvement predicted observed mealtime dynamics. METHOD 97 families of children with feeding disorder (FD), sleep problems (SP), and typically developing (TD) children participated in the study. Data were collected during home visits, where mother-child and father-child mealtime dynamics were videotaped and parents completed questionnaires. RESULTS More mother-child and father-child conflict and control was observed during mealtimes in the FD than SP and TD groups. Among the FD group, maternal sense of competence was negatively correlated with mother-child conflict and control, and child temperament was linked to father-child conflict and control, but only for families in which fathers were highly involved. These correlations were not significant among the SP and TD groups. CONCLUSION Different patterns of results were seen for mothers and fathers and among the FD and control groups. Clinical implications for the treatment of FD are discussed.

Prematurity, ethnicity and personality: risk for postpartum emotional distress among Bedouin-Arab and Jewish women

Background: Mothers of preterm infants are at high risk for postpartum emotional distress. This risk is further increased for women from ethnic minority groups due to specific stressors such as lack of social support, low socioeconomic status and restricted access to health providers and facilities. Objective: This study focused on postpartum emotional distress among Bedouin-Arab mothers, an understudied ethnic minority group living in Israel. Specifically, we examined how premature birth, ethnicity and personality interact in placing Bedouin-Arab and Jewish mothers at risk for postpartum emotional distress. Methods: Participants included 156 mothers of preterm infant (48 Bedouin; 108 Jewish) and 177 mothers of full-term infants (55 Bedouin; 122 Jewish). Measures included maternal reports of emotional distress (i.e. depression symptoms and parental role alteration stress) and the personality trait of self-criticism. Results: Bedouin mothers of preterm infants experienced the highest level of depression symptoms and parental role alteration stress compared to all other mothers. Furthermore, although no group difference was found in self-criticism, Bedouin mothers were more vulnerable to the negative effect of self-criticism than Jewish mothers. Vulnerability to self-criticism varied between the full-term and preterm groups, and in the context of depression or parental role alteration stress. Conclusion: Results are discussed with regard to the unique characteristics of the Bedouin society and the social status of Bedouin women. Clinical implications stressing the need for culturally sensitive adjustments that should be implemented in NICU environment are suggested.

Mother–infant sleep patterns and parental functioning of room-sharing and solitary-sleeping families: a longitudinal study from 3 to 18 months

Study Objectives To examine longitudinally differences in (a) objective and subjective sleep patterns and (b) parenting functioning (i.e., maternal emotional distress, maternal separation anxiety and parental involvement in infant care( between room-sharing and solitary sleeping mother-infant dyads. Methods Maternal and infant sleep, sleeping arrangements and parental functioning were assessed at three (N=146), six (N=141), twelve (N=135), and eighteen (N=130) months postpartum. Maternal and infant sleep were assessed with actigraphy and sleep diaries for 5 nights. Questionnaires were used to assess sleeping arrangements, nighttime breastfeeding, and parental functioning. Results Persistent room-sharing mothers (i.e., sharing a room with the infant on at least three assessment points) had significantly lower actigraphy-based sleep percent, lower longest sleep periods and more night-wakings than persistent solitary sleeping mothers. For infants, differences in actigraphic sleep were found only in longest sleep period, although mothers of persistent room-sharing infants reported more infant night-wakings than mothers of persistent solitary sleeping infants. The trajectories of maternal and infant sleep in both room-sharing and solitary sleeping groups demonstrated that sleep became more consolidated with time. Group differences indicated higher maternal separation anxiety and lower paternal overall and nighttime involvement in infant caregiving in room-sharing families compared to solitary-sleeping families. Conclusions The findings are discussed in light of the latest American Academy of Pediatrics recommendation to room-share until 12 months postpartum. Although no causal effects can be inferred from this study, maternal sleep quality and certain parenting characteristics seem to be important factors to consider when parents consult about sleeping arrangements.

Sleep disturbances are associated with specific sensory sensitivities in children with autism

BackgroundSensory abnormalities and sleep disturbances are highly prevalent in children with autism, but the potential relationship between these two domains has rarely been explored. Understanding such relationships is important for identifying children with autism who exhibit more homogeneous symptoms.MethodsHere, we examined this relationship using the Caregiver Sensory Profile and the Children’s Sleep Habits Questionnaire, which were completed by parents of 69 children with autism and 62 age-matched controls.ResultsIn line with previous studies, children with autism exhibited more severe sensory abnormalities and sleep disturbances than age-matched controls. The sleep disturbance scores were moderately associated with touch and oral sensitivities in the autism group and with touch and vestibular sensitivities in the control group. Hypersensitivity towards touch, in particular, exhibited the strongest relationship with sleep disturbances in the autism group and single-handedly explained 24% of the variance in total sleep disturbance scores. In contrast, sensitivity in other sensory domains such as vision and audition was not associated with sleep quality in either group.ConclusionsWhile it is often assumed that sensitivities in all sensory domains are similarly associated with sleep problems, our results suggest that hypersensitivity towards touch exhibits the strongest relationship with sleep disturbances when examining children autism. We speculate that hypersensitivity towards touch interferes with sleep onset and maintenance in a considerable number of children with autism who exhibit severe sleep disturbances. This may indicate the existence of a specific sleep disturbance mechanism that is associated with sensitivity to touch, which may be important to consider in future scientific and clinical studies.

The Negev hospital-university-based (HUB) autism database

Elucidating the heterogeneous etiologies of autism will require investment in comprehensive longitudinal data acquisition from large community based cohorts. With this in mind, we have established a hospital-university-based (HUB) database of autism which incorporates prospective and retrospective data from a large and ethnically diverse population. Here we present initial findings from 188 children who were diagnosed with autism during the first eighteen months of the study. The unique characteristics of this cohort included: significant differences between Bedouin and Jewish children in different risk factors and clinical characteristics; complete birth records for >90% of the children; and a high frequency of consanguineous marriages. Thus, the Negev HUB autism database comprises a remarkably unique resource to study different aspects of autism.

Sleep problems are associated with hypersensitivity to touch in children with autism

Background Sensory abnormalities and sleep disturbances are highly prevalent in children with autism, but the potential relationship between these two domains has rarely been explored. Understanding such relationships is important for identifying children with autism who exhibit more homogeneous symptoms. Methods Here we examined this relationship using the Caregiver Sensory Profile and the children’s sleep habit questionnaires, which were completed by parents of 69 children with autism and 62 frequency age-matched controls. Results In line with previous studies, children with autism exhibited more severe sensory abnormalities and sleep disturbances than age-matched controls. The sleep disturbance scores were strongly associated with touch and oral sensitivities in the autism group and with touch and vestibular sensitivities in the control group. Hyper sensitivity towards touch, in particular, exhibited the strongest relationship with sleep disturbances in the autism group and single-handedly explained 24% of the variance in sleep disturbance scores. In contrast, sensitivity in other sensory domains such as vision and audition was not associated with sleep quality in either group. Conclusions While it is often assumed that sensitivities in all sensory domains are similarly associated with sleep problems, our results suggest that hyper sensitivity towards touch exhibits the strongest relationship to sleep disturbances when examining children autism. We speculate that hyper sensitivity towards touch interferes with sleep onset and maintenance in a considerable number of children with autism who exhibit severe sleep disturbances. Studies that examine the effects of tactile sensory therapies/aids on sleep quality and behavioral improvement in these children are, therefore, highly warranted.

A Comparison Between Two Screening Approaches for ASD Among Toddlers in Israel

Systematic screening of autism spectrum disorder (ASD) can improve early diagnosis of ASD. We compared the efficacy of two ASD screening methods, the Global Developmental Screening (GDS), and the Modified Checklist for Autism in Toddlers-Revised, with Follow-Up (M-CHAT/F) in 1591 toddlers of ages 18–36 months from 35 government-funded clinics in south Israel. The M-CHAT/F performed better than the GDS in detecting toddlers with ASD (sensitivity: 70.0% vs. 50.0%, and specificity: 98.2% vs. 96.6% respectively). Both methods had an equivalent performance in detecting other forms of developmental delays (sensitivity = 63%; and specificity ~ 98%). In addition, remarkable inter-nurse variation was observed in the GDS referral decisions. Thus, employment of the M-CHAT/F in the Israeli health system may improve early detection of ASD among toddlers.