Quality of Interaction between Very Preterm Infants and Their Mothers and Its Relationship with General Development and Autism Features

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 the 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 with later outcome in infants at risk for ASD.

Objectives: This study aimed to compare the early PCI of PI with the PCI of their term born counterparts (TI) and to investigate if the developmental trajectories of PCI are similar in both groups. Among PI, this study also examined whether characteristics of such early interactions can predict the emergence of ASD symptomatology and general development at 36 months.

Methods: Drawing on the model of prospective studies of infant siblings, a longitudinal follow-up study was set up to identify early developmental trajectories. Global aspects of PCI were assessed at 5, 10, 18, 24 and 36 months of age during unstructured play interactions in 67 PI (<30 gestational weeks) and 38 TI and coded with the Coding Interactive Behaviour rating scales (Feldman, 1998). At 36 months, measures of developmental level (MSEL) and language (RDLS) were included and ASD features were observed with the ADOS-2.

Results: Results showed that PI were less involved in the interaction at 10 and 36 months, and their parents exhibited lower sensitive responding at 10 months. Moreover, the dyadic patterns between PI and their mothers were less reciprocal at 10, 24 and 36 months. Preliminary analyses showed that different maternal, child and dyadic factors of PCI in the first two years of life are related to developmental level at 36 months. Maternal sensitivity and intrusiveness at respectively 10 and 18 months and child involvement at 24 months were associated with language comprehension and production at 36 months. We also found significant associations between two child domains of interaction at 10 and 18 months and social affect scores on the ADOS-2 at 36 months. More detailed analyses will be provided at the meeting.

Conclusions: These results indicate that mother-preterm dyads experience more interactional difficulties than mother-full term dyads in the first years of life. This study also provides information on the association between the quality of PCI and different aspects of development in PI, 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 different aspects of the early PCI in PI because it may lead to better general development and less severe ASD symptomatology later in life.