Quality of Interaction Between Very Preterm Infants and Their Mother in the First Year of Life Predicts General Development and Autism Features at 18 Months

Background: Previous research has indicated that preterm born children have an increased risk for impairments across different domains (e.g., cognition, language) and for neurodevelopmental disorders such as Autism Spectrum Disorder (ASD; e.g., Dudova et al., 2014). Apart from this biological vulnerability, environmental factors such as early parent-child interactions (PCI) also seem to be important to understand differences in developmental outcome associated with ASD (e.g., Wai Wan et al., 2012). It is surprising that, although these early PCI can have a profound impact on the development of preterm infants (PI), to date still little prospective research has been conducted on these interactions and their relationship to later outcome in infants at risk for ASD.

Objectives: This study examined whether 5- and 10-month PCI in PI differ from PCI in full-term infants (FI) and whether characteristics of such early interactions can predict general development and ASD features at 18 months.

Methods: As part of a longitudinal follow-up study, global aspects of PCI were assessed at 5 and at 10 months of age during unstructured play interactions in 68 PI (<30 gestational weeks) and 37 FI and coded with the Coding Interactive Behaviour rating scales (Feldman, 1998). At 18 months, measures of developmental level (BSID-II; Van der Meulen et al., 2004) and language (N-CDI; Zink & Lejaegere, 2003) were included and ASD features were observed with the ADOS-T (Lord et al., 2012).

Results : At 5 months of age, no significant differences were found in the quality of PCI between the PI and FI. In contrast, at the age of 10 months results showed that PI were less involved (p<0.001), and their parents exhibited lower sensitive responding (p=0.01). Moreover, the dyadic patterns between PI and their mothers were less reciprocal (p<0.001) and more negatively charged (p<0.001).

Preliminary analyses with a subset of the preterm sample, showed that parent sensitivity at 5 months is positively related to language comprehension at 18 months and that parent sensitivity at 10 months is positively related to the developmental level and both language comprehension and production at 18 months. We also found significant associations between infant involvement, dyadic reciprocity, dyadic negative state at 5 months and parent sensitivity at 10 months, with social affect scores as well as with the repetitive behaviour and interest scores on the ADOS-T at 18 months. More detailed analyses of the entire sample will be provided at the meeting.

Conclusions : Our findings indicate that PCI in high risk PI and FI are very similar at 5 months but once the infants grow older, the mother-preterm infant dyads experience more interactional difficulties compared to full-term dyads. This prospective study also provides information on the association between the quality of PCI and different aspects of development in preterm children, an area that has been analysed in only a few studies. In the PI-group, different characteristics of the quality of PCI were significantly associated with later general development and ASD features. This finding may stress the importance of supporting the early social-communicative skills during PCI in PI.