Risk and protective factors in post-natal development Birth defects and prematurity place child at risk for developmental difficulties Impact of risk factors

  • View
    215

  • Download
    0

Embed Size (px)

Text of Risk and protective factors in post-natal development Birth defects and prematurity place child at...

  • Slide 1
  • Risk and protective factors in post-natal development Birth defects and prematurity place child at risk for developmental difficulties Impact of risk factors depends on post-natal environment -- parent-child relationship -- resources available to the parent
  • Slide 2
  • A. Assumptions of Transactional Model Everything depends on everything else RiskprotectiveRisk and protective factors operate at: -- all levels of Bronfenbrenner model -- all stages of development R and P factors affect all developmental tasks: cognition, language, socio-emotional
  • Slide 3
  • Person in context and time GENES COGNITIONS ANS CNS MOTIVES AFFECT PERSON BEHAVIOR SUPPORTIVENESS STRUCTURE FAMILY FUNCTIONING COMMUNITY ATTITUDES VIOLENCE LEGAL RESOURCES ATTITUDES STRUCTURE HEALTH SYSTEM SOCIETY
  • Slide 4
  • B. Evolution of transactional model in medicine and psychology a. Medicine: biological risk Continuum of reproductive casualty (Pasamanick) Direct relation between severity of impairment and severity of birth defect Conclusion based on retrospective data: (Do people with the same level of readingdisability have the same level of birth defect?). Retrospective study: Given the outcome, try to reconstruct the cause Retrospective study: Given the outcome, try to reconstruct the cause.
  • Slide 5
  • Continuum of caretaker casualty (Sameroff) Birth defects of similar severity are associated with range of outcomes Social class and family factors affect the link between severity of birth defects and severity of developmental problems. Based on prospective studies (Do people with same risk factor show the same outcome). Prospective study: Follow people with the same risk factor forward in time Prospective study: Follow people with the same risk factor forward in time.
  • Slide 6
  • Pasamanicks continuum of reproductive casualty Severity of biological injury mildsevere Severity of developmental prblems Normal Severe Normal mild
  • Slide 7
  • Continuum of reproductive casualty + Continuum of caretaking casualty = Transactional model Severity of biological injury Severity of developmental problem Normal Severe High risk caretaking environment Low risk caretaking environment Normal
  • Slide 8
  • C. Contribution of parent and child to post-natal parent-child relationship Normal term Childs contribution Premature childs contribution Nondepressed parents contribution Depressed parents contribution
  • Slide 9
  • Normally Developed Child At Birth 1. Visual discrimination -- movement -- borders of high contrast -- complex stimuli 2. Auditory discrimination -- frequencies within normal voice range -- vocal inflections -- high frequencies 3. Use attentional focus to control adult behavior Mutual reinforcement of feelings of effectiveness
  • Slide 10
  • Physically immature or impaired child 1. Less responsive and alert 2. Unreadable cry (respiration problems) 3. More fussy, squirmy
  • Slide 11
  • Response of parent of premature/impaired child 1. Less involved with child 2. Hold further from body 3. Touch less 4. Talk less 5. Place in face-to-face positions less A. Parents of premature infants try harder B. Differences decrease over time
  • Slide 12
  • Caretaker difficulties: Depressed mothers Reduction in effortful parenting 1. Response to infant: slower, less contingent, less consistent 2. Little positive affect 3. Less likely to use exaggerated speech 4. Can be more hostile, intrusive, or irritable
  • Slide 13
  • Infants of depressed mothers 1. Look less at the mother 2. Less happy 3. More fussy and irritable
  • Slide 14
  • Parent at risk + Child at risk (Bugenthal study)
  • Slide 15
  • D. Broader context of parent-child interaction - - What causes parents to become depressed, compromising caretaker-infant relationships? stressors in broader environment (Vaughn et al study) -- What can help reduce the negative outcomes in troubled caretaker-infant dyads? supports in the broader environment (Pianta et al study, Crockenberg)
  • Slide 16
  • Person in context and time GENES COGNITIONS ANS CNS MOTIVES AFFECT PERSON BEHAVIOR SUPPORTIVENESS STRUCTURE FAMILY FUNCTIONING COMMUNITY ATTITUDES VIOLENCE LEGAL RESOURCES ATTITUDES STRUCTURE HEALTH SYSTEM SOCIETY
  • Slide 17
  • Community Disadvantage
  • Slide 18
  • Linking stress, distress, parenting, child difficulties StressorsDistressReduction in effortful parenting Difficult child behavior - interpersonal -noninter- personal
  • Slide 19
  • Linking stress, distress, parenting, child difficulties StressorsDistressReduction in effortful parenting Difficult child behavior - interpersonal -noninter- personal SupportSupport
  • Slide 20
  • Stress
  • Slide 21
  • Stress and changes in attachment security Stress and changes in attachment security Minnesota Low Income Sample
  • Slide 22
  • How stress and support affect attachment Pianta, Sroufe, & Egeland Stress ----> decline in maternal sensitivity (responding appropriately to child) Support ---> increase in maternal sensitivity
  • Slide 23
  • Example: Crockenberg study Outcome: Infant Attachment at 12 mo Outcome: Infant Attachment at 12 mo. (Strange situation) Predictor variables: 1. Mother's responsiveness (3 mo.) (Time to respond to child distress) 2. Irritability ( 1 week) (Neonatal Behavioral Assessment) 3. Social support (3 mo.) (Mother's report of support - stress) Findings: 1. More support ----> Less insecure babies 2. Mother's unresponsiveness & infant irritability -----> insecure attachment only if support is low
  • Slide 24
  • Minnesota Study: Adult BPD Disorganized attachment Maltreatment Difficult Child Temperament Maternal Stress Maternal Hostility Note: Supportive adults promoted adult health
  • Slide 25
  • Slide 26
  • Slide 27
  • Slide 28
  • Slide 29
  • F. Implications of transactional model for research and intervention InterventionsInterventions --> reduce risk, increase protective factors multi-riskInterventions usually with multi-risk families: high risk, low protection Even if experiment works for group as whole it may not work for subgroup most in need
  • Slide 30
  • Slide 31
  • Slide 32
  • Slide 33
  • Slide 34
  • Slide 35
  • Slide 36