The effects of a sound-modified environment on physiological variables in premature infants in neonatal intensive care

This study investigated the effects of sound reduction on physiological variables in premature infants in neonatal intensive care. Ten premature infants born between 27 and 36 weeks gestation wore a specially designed earmuff cap for a 45-minute rest period. Heart rate, respiration rate, oxygen saturation level and behavioral state were measured and compared to a similar 45-minute control period without the earmuff cap. Subjects showed a significant decrease (p =.050) in mean respiration rate, and a significant increase (p $<$.02) in mean oxygen saturation level with the earmuff cap on. No significant differences were found in heart rate between the experimental condition and the control condition. Behavioral state was documented only as a potentially confounding variable, however a significant decrease (p $<$.05) in the time spent awake and a significant increase (p $<$.05) in the time spent in quiet sleep rather than active sleep occurred with the earmuff cap on. Findings suggest that noise reduction may be a viable means of increasing respiratory efficiency and the amount and quality of sleep in premature infants in neonatal intensive care.

A comparison of breathing patterns of normal full term infants in supine versus right side-lying during quiet and active behavioral sleep states

This study investigated the effect of sleep position on breathing patterns of normal full term infants during quiet and active behavioral sleep states. Tidal volume, percent contribution of rib cage to tidal volume, and respiration rate were measured via respiratory inductive plethysmography (RIP) and pneumotachograph (PNT) in ten infants sleeping in supine versus right side-lying. Data was collected immediately following two consecutive feedings. Paired t tests and ANOVA comparisons showed no significant differences between the two postures (p $<$.05) in mean tidal volume (supine, M = 19.16, right side, M = 22.45), percent contribution of rib cage to tidal volume (supine, M = 30.55, right side M = 33.20), or respiration rate (supine, M = 49.13, right side, M = 49.37) during quiet sleep. Comparisons also showed no significant differences between the two postures (p $<$.05) in mean tidal volume (supine, M = 18.89, right side, M = 20.12), percent contribution of rib cage to tidal volume (supine, M = 6.43, right side, M = 6.97) or respiration rate (supine, M = 62.18, right side, M = 61.04) during active sleep. Therefore, no differences were found in the three respiratory variables measured between the supine and right side-lying positions. These findings suggest that infants may be positioned in either sleep position without detriment to respiratory function. This information may benefit occupational therapists and other health professionals involved in the education of parents on infant positioning and their respective advantages. ^

A validation study of the construct "jealousy" in eleven- to fourteen-month-old infants: Evidence for its divergence from "fear" and "anger"

There has been increasing interest in expanding the scope of the study of the "basic" emotions and their development in infancy to include more of the so-called "complex" emotions like jealousy. This dissertation investigated evidence for the divergence of jealousy in infants from both fear and anger, two of the basic emotions said to be precursors and contributors to the emergence of jealousy in the later part of the first year of life. Participants judged how well eight emotion-denoting terms (including jealousy, anger and fear) described infants' emotionality in fear-, anger-, and jealousy-provoking situations in which the social context of the emotion episodes was either included or excluded. Differences within and between participants' judgments of the eight terms in the two context conditions were examined across the three emotion-provoking conditions. Results suggested that infants' emotional behavior denoting jealousy was not judged differently from behavior denoting anger or fear in the absence of contextual information and, that when contextual information was provided, attributions of infant jealousy, anger, and fear were made "correctly" for their respective target emotion conditions. ^

Infants' selective attention to faces and prosody of speech: The roles of intersensory redundancy and exploratory time

One of the overarching questions in the field of infant perceptual and cognitive development concerns how selective attention is organized during early development to facilitate learning. The following study examined how infants' selective attention to properties of social events (i.e., prosody of speech and facial identity) changes in real time as a function of intersensory redundancy (redundant audiovisual, nonredundant unimodal visual) and exploratory time. Intersensory redundancy refers to the spatially coordinated and temporally synchronous occurrence of information across multiple senses. Real time macro- and micro-structural change in infants' scanning patterns of dynamic faces was also examined. ^ According to the Intersensory Redundancy Hypothesis, information presented redundantly and in temporal synchrony across two or more senses recruits infants' selective attention and facilitates perceptual learning of highly salient amodal properties (properties that can be perceived across several sensory modalities such as the prosody of speech) at the expense of less salient modality specific properties. Conversely, information presented to only one sense facilitates infants' learning of modality specific properties (properties that are specific to a particular sensory modality such as facial features) at the expense of amodal properties (Bahrick & Lickliter, 2000, 2002). ^ Infants' selective attention and discrimination of prosody of speech and facial configuration was assessed in a modified visual paired comparison paradigm. In redundant audiovisual stimulation, it was predicted infants would show discrimination of prosody of speech in the early phases of exploration and facial configuration in the later phases of exploration. Conversely, in nonredundant unimodal visual stimulation, it was predicted infants would show discrimination of facial identity in the early phases of exploration and prosody of speech in the later phases of exploration. Results provided support for the first prediction and indicated that following redundant audiovisual exposure, infants showed discrimination of prosody of speech earlier in processing time than discrimination of facial identity. Data from the nonredundant unimodal visual condition provided partial support for the second prediction and indicated that infants showed discrimination of facial identity, but not prosody of speech. The dissertation study contributes to the understanding of the nature of infants' selective attention and processing of social events across exploratory time.^

Defining Fluid Restriction in the Management of Infants Following Cardiac Surgery and Understanding the Subsequent Impact on Nutrient Delivery and Growth Outcomes

Adequacy of nutritional intake during the postoperative period, as measured by a change in weight-for-age z-scores from surgery to the time of discharge, was evaluated in infants (n = 58) diagnosed with a congenital heart defect and admitted for surgical intervention at Miami Children’s Hospital using a prospective observational study design. Parental consent was obtained for all infants who participated in the study. Forty patients had a weight available at hospital discharge. The mean preoperative weight-for-age z-score was -1.3 ±1.43 and the mean weight-for-age z-score at hospital discharge was -1.89 ±1.35 with a mean difference of 0.58 ±0.5 (P Nutritional intake during the postoperative period was inadequate based on a decrease in weight-for-age z-scores from the time of surgery until discharged home. Our findings suggested that limited fluid volume for nutrition likely contributes to suboptimal nutritional delivery during the postoperative period; however, inadequate nutrition prescription may also be an important contributing factor. Development of a nutrition protocol for initiation and advancement of nutrition support may reduce the delay in achieving patient’s nutritional goals and may attenuate the observed decrease in z-scores during the postoperative period.

Infants' detection of synchrony between sounds and pauses in the movement of an object

The present study investigated the development of sensitivity to temporal synchrony between sounds of impact and pauses in the movement of an object by infants of 2 1/2, 4 and 6 months of age. Ninety infants were tested across four experiments with side-by-side videos of a red and white square and a blue and yellow triangle along with a centralized soundtrack which was synchronized with only one of the films. This preference phase was then followed by a search phase, where the two films were accompanied by intermittent bursts of the soundtrack from each object. Twomonth- olds showed no evidence of matching films and soundtracks on the basis of synchrony, however 4-month-olds looked more on the second block of trials to the object which paused when the sound occurred and directed more first looks during the preference phase to the matching object. Six-month-olds demonstrated significantly more first looks to the mismatched object during the search phase only. These results suggest that infants relate impact sounds with synchronous pauses in continuous motion by the age of four months.

Factors affecting BMI and hemoglobin levels of mothers and infants in Kuwait

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Mother-Infant Reciprocity and the Development of Joint Attention in 12 Month Old Infants

Social contingency is the ability to connect social stimuli, such as those behaviors performed by oneself and those performed by others. Detecting social contingencies occurs by means of reciprocity through shared experiences with others. Reciprocity denotes a circumstance in which two individuals participate in a collaborative exchange, and is distinguished from an event in which two individuals engage in separate, unrelated activities. Specifically, reciprocity incorporates joint attention (JA), which occurs when two individuals simultaneously and visually attend to the same item. JA is facilitated by gazing and pointing, whereby one individual initiates the action and the second individual follows suit by, for example, gaze-following. However, little is known about the role the mother may play in the development of JA. The purpose of our study was to investigate social contingency between mothers and infants engaging in dyadic interactions. Thirty-three 12-month-old typically developing infants (M = 12.2, SD = .19; N = 19 males) were filmed for 10 minutes during free play with their mothers and toys provided by an experimenter. Reciprocity was measured by coding mother-infant interactions when a precise chain of events occurred: (1) mother initiated a bid by introducing a toy/activity or request to the infant, (2) infant accepted the bid/request by engaging in play with the given toy/activity, and (3) mother persisted by continuing to engage in play with said toy/activity. We computed a Pearson Correlation to assess the relation between the mothers’ initiations of JA and their infants’ responses to JA. We found a moderately positive correlation between the two variables (r= 0.37, p<.05). Our findings suggest that reciprocity, an important component of social relationships, during parent-infant dyads may serve as a scaffold for joint attention abilities, which have been linked to social and language development.

Defining fluid restriction in the management of infants following cardiac surgery and understanding the subsequent impact on nutrient delivery and growth outcomes

Adequacy of nutritional intake during the postoperative period, as measured by a change in weight-for-age z-scores from surgery to the time of discharge, was evaluated in infants (n = 58) diagnosed with a congenital heart defect and admitted for surgical intervention at Miami Children’s Hospital using a prospective observational study design. Parental consent was obtained for all infants who participated in the study. ^ Forty patients had a weight available at hospital discharge. The mean preoperative weight-for-age z-score was -1.3 ±1.43 and the mean weight-for-age z-score at hospital discharge was -1.89 ±1.35 with a mean difference of 0.58 ±0.5 (P = 0.2).^ Nutritional intake during the postoperative period was inadequate based on a decrease in weight-for-age z-scores from the time of surgery until discharged home. Our findings suggested that limited fluid volume for nutrition likely contributes to suboptimal nutritional delivery during the postoperative period; however, inadequate nutrition prescription may also be an important contributing factor. Development of a nutrition protocol for initiation and advancement of nutrition support may reduce the delay in achieving patient’s nutritional goals and may attenuate the observed decrease in z-scores during the postoperative period.^