Helen Marwick

Reactive attachment disorder—a theoretical model beyond attachment

Despite its importance in public health, reactive attachment disorder (RAD) is an under-researched and little used clinical category. Abnormalities of social relatedness have long been documented in children who have been abused, neglected or institutionalised, but there have been more recent efforts to define these behaviours within the psychiatric nosology. There has been an implicit assumption that the central deficit in RAD is in the attachment system, but this has caused controversy and may have blocked research. We propose that RAD is better construed within the framework of intersubjectivity, which has a central role in the development of core brain and social functions and may also have had an important role in the evolution of a key human characteristic—complex social functioning. This broader framework may potentially explain apparently diverse symptoms such as indiscriminate friendliness and negative or unpredictable reunion responses. Finally, we suggest that a change of name may be useful in progressing the field, but accept that this may be difficult until there is better agreement in the clinical and scientific communities about the core features and aetiology of this disorder.

Predictors of diagnosis of child psychiatric disorder in adult-infant social-communicative interaction at 12 months.

To establish which social interactive behaviours predict later psychiatric diagnosis, we examined 180 videos of a parent-infant interaction when children were aged one year, from within the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Sixty of the videos involved infants who were later diagnosed with a psychiatric disorder at seven years, and 120 were a randomly selected sex-matched control group. Interactive behaviours for both the caregiver and the one year old infant were coded from the videos according to eight holistic categories of interpersonal engagement: Well-being, Contingent Responsiveness, Cooperativeness, Involvement, Activity, Playfulness, Fussiness, and Speech. Lower levels of adult activity and speech in interaction at one year significantly predicted overall diagnosis of child psychiatric disorder.

Association between parent-infant interactions in infancy and disruptive behaviour disorders at age seven: a nested, case-control ALSPAC study.

BackgroundEffective early intervention to prevent oppositional/conduct disorders requires early identification of children at risk. Patterns of parent-child interaction may predict oppositional/conduct disorders but large community-based prospective studies are needed to evaluate this possibility.MethodsWe sought to examine whether the Mellow Parenting Observational System (MPOS) used to assess parent-infant interactions at one year was associated with psychopathology at age 7. The MPOS assesses positive and negative interactions between parent and child. It examines six dimensions: anticipation of child’s needs, responsiveness, autonomy, cooperation, containment of child distress, and control/conflict; these are summed to produce measures of total positive and negative interactions. We examined videos from the Avon Longitudinal Study of Parents and Children (ALSPAC) sub-cohort who attended the ‘Children in Focus’ clinic at one year of age. Our sample comprised 180 videos of parent-infant interaction: 60 from infants who received a psychiatric diagnostic categorisation at seven years and 120 randomly selected controls who were group-matched on sex.ResultsA negative association between positive interactions and oppositional/conduct disorders was found. With the exception of pervasive developmental disorders (autism), an increase of one positive interaction per minute predicted a 15% (95% CI: 4% to 26%) reduction in the odds of the infant being case diagnosed. There was no statistically significant relationship between negative parenting interactions and oppositional/conduct disorders, although negative interactions were rarely observed in this setting.ConclusionsThe Mellow Parenting Observation System, specifically low scores for positive parenting interactions (such as Responsiveness which encompasses parental warmth towards the infant), predicted later psychiatric diagnostic categorisation of oppositional/conduct disorders.

Motor activity at age one year does not predict ADHD at seven years

We have examined the predictive utility of motor activity in infancy towards diagnosis of attention deficit hyperactivity disorder (ADHD) in later childhood. We conducted a nested case‐control study using videos of infants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Sixty videos of children who received any Development and Well‐being Assessment (DAWBA) psychiatric diagnosis at age 91 months (including 16 with ADHD) plus two controls per case were selected for data analysis. Body movements were measured at age one year: associations between motor activity‐derived variables using factor analysis, and later ADHD diagnoses were sought. No significant association was found between infant motor activity and later ADHD. A positive association between motor activity and inattentive ADHD was found in males. Motor activity at age one year did not predict ADHD at age seven years. The positive association with inattentive ADHD in males requires further investigation. Copyright

Parent-infant vocalisations at 12 months predict psychopathology at 7 years.

Highlights ► Reduced caregiver vocalisations were associated with development of disruptive behaviour disorders. ► Higher infant vocalisations were associated with disruptive behaviour disorders. ► Study into parental vocalisation behaviours early in life may be clinically important.

Inexpensive video cameras used by parents to record social communication in epidemiological investigations in early childhood: A feasibility study

We tested the feasibility of parents recording social interactions with their infants using inexpensive camcorders, as a potential method of effective, convenient, and economical large scale data gathering on social communication. Participants were asked to record two short video clips during either play or a mealtime, and return the data. Sixty-five video clips (32 pairs) were returned by 33 families, comprising 8.5% of families contacted, 44.6% of respondents and 51.6% of those sent a camcorder, and the general visual and sound quality of the data was assessed. Audio and video quality were adequate for analysis in 85% of clips and several social behaviours, including social engagement and contingent responsiveness, could be assessed in 97% of clips. We examined two quantifiable social behaviours quantitatively in both adults and infants: gaze direction and duration, and vocalization occurrence and duration. It proved difficult for most observers to obtain a simultaneous clear view of the parents and infants face. Video clips obtained by parents are informative and usable for analysis. Further work is required to establish the acceptability of this technique in longitudinal studies of child development and to maximize the return of usable data.

Supporting Concordant Intersubjectivity and Sense of ‘Belonging’ for Under Three-Year-Olds in Early Years Settings

Through concordant intersubjective interactions, in which mutual consciousness is supported in positive companionship (Minnis H, Marwick H, Arthur J, McLaughlin A. Eur Child Adolesc Psychiatry 15(6):336–342, 2006; Trevarthen C. The concept and foundations of infant intersubjectivity. In: Braten S (eds) Intersubjective communication and emotion in early ontogeny. Cambridge University Press, Cambridge, pp 15–46, 1998; Trevarthen C. Infant Child Dev 20(1): 119–135, 2011), across the first months and years, infants and young children develop their understanding of themselves and other people. Familiar shared experiences, playful interactions, and co-creation of meanings develop their growing understanding of emotionality and intentionality in themselves and others, and their expectations about other people’s acts and feelings (Marwick H, Murray L. The effects of maternal depression on the ‘musicality’ of infant directed speech and conversational engagement. In: Malloch S, Trevarthen C (eds) Communicative musicality: narratives of expressive gesture and being human. Oxford University Press, Oxford, pp. 281–300, 2008), and lead to a growing sense of self-identity in relation to others, which brings with it a reliable sense of ‘belonging’, or ‘awareness of a collective level of knowing’, and meaning within their interpersonal world (Gratier M, Trevarthen C. J Conscious Stud 15(10–11): 122–158, 2008). This positive confidence in understanding of self and other can become vulnerable in the transition into, and experience of, the group environment of an early years setting, in which existing expectations, perspectives and intentions of the participants may contrast and vary, and lead to discordant intersubjective experience of communication and shared understandings for a child (Marwick H, Murray L. The effects of maternal depression on the ‘musicality’ of infant directed speech and conversational engagement. In: Malloch S, Trevarthen C (eds) Communicative musicality: narratives of expressive gesture and being human. Oxford University Press, Oxford, pp. 281–300, 2008). This chapter examines the challenges inherent in supporting concordant intersubjectivity and a sense of ‘belonging’ for under –3-year-olds in group based infant and toddler settings, and models of pedagogy and interaction applied in such settings.

Eliciting student teacher’s views on educational research to support practice in the modern diverse classroom: a workshop approach

ABSTRACT Teachers’ professionalism includes using educational research to support their work in the modern diverse classroom. Student teachers’ views as they enter the profession are therefore important. Within a Higher Education Academy social science priority research strand, ‘Supporting research-informed teacher education in a changing policy environment’, this study developed workshops to ascertain student teachers’ views on educational research, preparing materials suitable for primary and secondary sectors. These could be updated, and used by other higher education courses. Face-to-face or email workshops asked participants about their current uses of educational research, and to read and comment upon one policy research extract and one ‘what works’ research review. Small-scale piloting suggested the workshops readily elicited views, and students identified some personal changes following participation. Participants were generally unfamiliar with the principles of ‘what works’ research. Thematic analysis suggested students considered educational research was often inaccessible, but wanted accessible research to inform their practice.

Philosophy with Children, Self-Regulation and Engaged Participation for Children with Emotional-Behavioural and Social Communication Needs.

ABSTRACT This study examined the effectiveness of Community of Philosophical Inquiry (CoPI) as an inclusive pedagogical approach by which to support the communicative interaction and opportunities for collaborative dialogue for children with social, emotional and behavioural needs in two mainstream classes. There is currently no empirical work that considers children with these particular needs participating in practical philosophy, particularly in CoPI. Two groups of children, aged between nine and twelve, engaged in CoPI over a period of 10 weeks. The philosophy sessions were conducted as part of the regular class work. The results show that the children were able to engage in collaborative, philosophical dialogue with their peers without being any more disruptive than their classmates. The findings of this study lead to the assertion that it is the structure of CoPI that supported the children’s engaged participation and self-regulation and that this might usefully be considered in creating classroom activities for all children.

Fostering citizenship in marginalised children through participation in Community of Philosophical Inquiry

Given the key drivers around citizenship education, children’s rights, voice, and participation, it is essential that all children are supported to engage in the society in which they live. This article explores how McCall’s Community of Philosophical Inquiry might offer that support to children who are potentially marginalised due to their specific needs. The article presents three case studies of children at risk of being marginalised in school settings who participated in Community of Philosophical Inquiry over a period of 10 weeks. Community of Philosophical Inquiry has features that may be conducive to the achievement of broad goals associated with children’s voice and citizenship education. The article explores the ways in which these particular children engaged with Community of Philosophical Inquiry and the impact of participation on their behaviour. The analysis of the accounts of their teachers supports the hypothesis that potentially marginalised children appear to benefit from the structure that is inherent in this form of practical philosophy.