Kevin MacDonald, Ph.D.
CSULB, Department of Psychology
Psychology 361
PREMATURITY
Definitions: Prematurity: Born prior to 38 weeks after conception, i.e., 38 weeks gestational age.
Prematurity is distinct from from SMALL FOR GESTATIONAL AGE (SGA); SGA = Born in the bottom 10% of weight for babies of a particular gestational age. I.e., a baby could be born at 38 weeks'the normal period of pregnancy'but still be SGA because it is in the bottom 10% by weight for babies born at that age. It could also be premature, say born at 7 months of age but be normal for babies of that age, or it could be SGA'in the bottom 10% of babies born at that age.
PREMATURITY IS ASSOCIATED WITH LOWER SOCIAL CLASS, AGE OF MOTHER (<17; >34), ETHNICITY blacks > whites> Latinos), STRESS, MANY PREGNANCIES, DRUG USE, POOR HEALTH (HYPERTENSION, ANEMIA)
1/14 OF U. S. BABIES WEIGH LESS THAN 5.5 LB.;
1/100 WEIGH LESS THAN 3.3 LB (10-20% HAVE MAJOR DISABILITY
SUCH AS CEREBRAL PALSY); OFTEN PASSIVE, "FOLLOWERS";
40% HOSPITALIZED AT LEAST TWICE IN FIRST YEAR
TECHNOLOGY IMPROVES SURVIVAL:
1977: 20-40% IF <1000g (2.2 lb)
1987: 75-80%
1995: > 90%
But at any level of technological sophistication, the babies at the low end of the weight distribution are more likely to have problems. The biggest problem is respiration. There is no way for the child to live without breathing. Many of these children have damaged lungs because their immature lungs are forced to breathe oxygen, which is highly reactive. Prematures are more likely to have asthma and other respiratory diseases when they get older.
Prematurity is associated with IATROGENIC EFFECTS, i.e., effects resulting from the treatments they are exposed to. For example, OXYGEN IN RESPIRATOR AFFECTS LUNGS and EYES; NOISE AFFECTS HEARING
The effects of prematurity on IQ are difficult to disentangle from other variables, and they depend on how premature the babies are.
ONE STUDY: X = 98.7 FOR PREMIES
X= 109.3 FOR FULL-TERM SIBS
This study controls for social class and genetic differences because they are sibs reared in the same family.
CONTINUUM OF REPRODUCTIVE CASUALTY (MEDICAL MODEL):
ENVIRONMENTAL INSULT AFFECTS BRAIN PERINATALLY
(AROUND THE TIME OF BIRTH) WITH LONG LASTING
EFFECTS ON THE BRAIN.
INSULT ----> BRAIN -----> LATER DEVELOPMENT
CONTINUUM OF CARETAKING CASUALTY (TRANSACTIONAL
MODEL): ENVIRONMENTAL INSULT AFFECTS BRAIN
PERINATALLY, BUT THE LONG TERN EFFECT RESULTS
MAINLY FROM TRANSACTIONS WITH POSTNATAL
ENVIRONMENTS
INSULT --> BRAIN --> CHILD'S BEHAVIOR --> CARETAKER'S BEHAVIOR-->
CHILD'S BEHAVIOR --> CARETAKER'S BEHAVIOR
ETC.
PERSONAL CHARACTERISTICS (PERSONALITY, KNOWLEDGE, FINANCIAL RESOURCES, ETC.) AFFECT CAREGIVER'S BEHAVIOR. \
OBVIOSLY, THE TRANSACTIONAL MODEL IS A PSYCHOLOGICAL MODEL; IT INCORPORATES WHAT HAPPENS AFTER THE CHILD COMES HOME FROM THE HOSPITAL, NOT JUST THE EFFECT OF PREMATURITY ON THE BRAIN.
EVIDENCE FOR THE TRANSACTIONAL MODEL: Socio-economic status (SES) os associated with outcome. In other words, children from homes with more resources do better after they come home from the hospital even though they have the same injury to start with. This means that it is not just the injury. However, in many cases, the early injury completely compromises the child, so that no matter what home environment he or she experiences, there are long term problems. This situation is better analysed with the Continuun of Caretaking Casualty (the medical model).
1.) PARENTS FEEL GUILTY, INADEQUATE, WORRIED
2.) DIFFERENT APPEARANCE; premature babies look sickly. Parents respond much better to healthy, normal babies than sickly premature babies. This may be part of our evolutionary psychology.
3.) DELAYED SMILING; NORMAL SMILE AT 6-8 WEEKS; PREMATURES SMILE 6-8 WEEKS POSTTERM; i.e., prematures smile 6-8 weeks after they should have been born, so if they were born 1 month premature, they would begin smiling at 10-12 weeks. This delay in smiling makes it more difficult to interact with the premature baby, because the baby's smile is very reinforcing.
4.) CRYING: There is less crying at first because the baby is weak and sickly, but when the baby does cry it has an irritating pitch. Premature babies' cries are very stressful to adults.
After a few weeks, premature babies cry more than normals, and their cry is very irritating to adults. They are also very irritable'quick to cry and become upset.
5.) ALTERNESS AND RESPONSIVENESS: Premature babies have low scores on the Brazelton Neonatal Behavior Assessment Scale (BNBAS). This means they are less alert and responsive to stimulation.
6.) PARENTS STIMULATE PREMATURES LESS UNTIL ABOUT 4 MONTHS
7.) AFTER 4 MONTHS:
PARENTS STIMULATE PREMIES MORE -- more tactile and vocal stimulation.
But, the interactions are more negative. There is less smiling, less affectionate touching, less face-to-face interaction, more gaze aversion during face-to-face interaction. The relationship is more one-sided. They parent is more intrusive,
There are also cognitive, motor, and language deficits through the first year, even for premature babies weighing more than 3.3 lbs.
Premature babies are highly irritable. This means they will avert their gaze more often during social interactions. Normal babies have a sort of sine-wave style of arousal when interacting in face-to-face interactions with their mothers. They gradually get more and more excited and positive, but at the peak of the interaction they look away, and their arousal goes back down to neutral. They then re-engage the mother so that they again become aroused and happy. But premature babies are hypersensitive to stimulation. They turn their gaze away earlier in the sequence, and they are more easily overaroused -- they more easily and quickly become negative in their emotional response. This makes interaction with premature babies very difficult and is probably why so many premature babies are abused.
HIGH POSITIVE
AFFECT
NEUTRAL _____________________________________________________
TIME
HIGH NEGATIVE
AFFECT
Tiffany Field
In MacDonald, K. B. (Ed.). (1993). Parent-child Play: Descriptions and Implications. Albany, NY: State University of New York Press.
Studied low SES mother-infant interaction in three Miami cultures; all mothers are teenagers
*Southern Blacks
*Second generation Haitian immigrants
*Second generation Cuban immigrants
The sample is therefore controlled for social class and age of mother and infant.
Question: Are their ethnic differences in mother-infant interaction in the second generation among immigrant-derived groups?
Overall descriptions:
Blacks:
1) Infants are doted on; much attention to food and clothes.
2) But 'most black women believe the children are easily spoiled by too much attention including being held, carried, and praised.'
3) Infants are often left unattended for long periods of time. Black infants forced to be autonomous earlier than other groups.
4) Teenage pregnancy is tolerated but mother soon becomes disinterested in baby and grandmother takes over most of the care.
5) High levels of physical discipline, including 'shaking and spanking, often with belts and switches.'
Cuban-Americans
1) Teenage pregnancy not sanctioned. High rate of abortions.
2) Infants are the center of attention of entire extended household.
3) Infants are carried everywhere and rocked a great deal, are scolded infrequently, and are seldom physically punished.
Study: Comparison of Black and Cuban-American teenage mothers' interaction with infants during developmental assessments at 12, 18, and 24 months;
N=112 blacks; N=52 Cuban-Americans; mothers in both groups were low SES, lived in same neighborhoods and went to the same schools.
Results for teenage mothers replicate similar results with adult mothers from the same cultures.
Field attributes differences to 'cultural differences', but she can't control for genetic differences; suggests greater fussiness of Cuban infants was due to overstimulation by their mothers.
Concludes: Cuban mother in U.S. or Cuba spoils child and overstimulates it; Black mothers concerned about spoiling their children and understimulate them.
Table: Mother-Infant Play Interactions (In Percent Time Behavior Observed)
Blacks (N= 112) Cubans (N= 52)
Mother-Touching 17.9 38.1
Looking 71.9 95.0
Talking 70.2 82.0
Smiling 13.2 34.1
Laughing 6.5 12.0
Playing 56.2 81.0
Demonstrating Toys 15.8 48.6
Reading 1.3 4.8
Directing 52.2 25.6
Ignoring 6.1 .9
Infant- Looking 31.6 47.3
Vocalizing 16.4 34.1
Smiling 6.6 14.7
Laughing 2.6 12.8
Examining Toys 22.5 38.8
Fussing 10.2 23.9
*Standard deviations can be obtained from the authors.
Haitian-derived group:
1) There are ethnic and cultural differences between this group and native American blacks; Haitians come from a French-speaking culture that was predominantly black.
2) Both Southen Blacks and Haitians are poor, but Haitians not eligible for AFDC; Haitians out-compete blacks in unskilled job market.
3) Study: Father-absent, low SES, extended family situation; income from unskilled laborer jobs. Based on videotaped interactions at 4-months of age during feeding and play session.
4) Mother-infant face-to-face interaction during bottle feeding:
* mother infant dyads rated positive, but high level of 'failure-to-thrive' (i.e., infants
do not gain weight even though they are not sick)
* mothers do not cradle infants; infant positioned upright and facing away from mother;
mother does not look at infant.
* mothers interacted positively with infants in presence of researchers, but when
researchers absent they did not interact and faced the infants away from themselves.
*Mothers tried to act acculturated by bottle feeding but were awkward at it and did
not monitor infant's sucking well
FILM: BRAIN DEVELOPMENT
Three states of brain development:
1. PRODUCTION (PROLIFERATION) OF NEURONS: CELL PRODUCTION OCCURS FROM BETWEEN 10 AND 26 WEEKS AND THEN NO MORE CELLS ARE PRODUCED; CELLS ARE PRODUCED AT ~ 250,000/MINUTE;
IN GENERAL, THERE IS A PROCESS OF OVERPRODUCTION OF NEURONS FOLLOWED BY SELECTIVE RETENTION (50%);
E. G., THE MOUSE WHISKER STUDY IN THE FILM: NEURONS THAT WERE NOT BEING USED DIED OFF. THIS ALSO OCCURS IN OTHER PERCEPTUAL SYSTEMS. FOR EXAMPLE, IF CATS REARED IN A VERTICAL ENVIRONMENT WITH NO HORIZONTAL SURFACES, THE CELLS THAT ARE SPECIALIZED TO SEE HORIZONTAL SURFACES DIE OFF.
2. MIGRATION OF NEURONS: NEURONS MIGRATE TO OTHER PARTS OF THE BRAIN. THIS PROCESS IS COMPLETED BY ABOUT 7 MONTHS
GESTATIONAL AGE; BOTH RADIATION AND ALCOHOL INTERFERE WITH MIGRATION, BUT IN DIFFERENT WAYS.
3. ELABORATION OF NEURONS: AXONS AND DENDRITES FORM SYNAPSES WITH OTHER CELLS. (YOU SHOULD KNOW WHAT ALL THESE WORKDS MEAN; SEE THE TEXT, P. 178.)
ELABORATION CONTINUES THROUGHOUT LIFE BUT AT A MUCH SLOWER RATE. THERE ARE SENSITIVE PERIODS FOR SOME PHENOMENA, SUCH AS RECOGNITION OF LANGUAGE SOUNDS.
IN THE MOVIE THERE WAS AN ELEGANT DEMONSTRATION THAT 8-MONTH-OLD INFANTS CAN DISCRIMINATE LANGUAGE SOUNDS FROM ANY LANGUAGE, BUT BY 1-YEAR OF AGE, THEY CAN'T DISCRIMINATE SOME SOUNDS FROM FOREIGN LANGUAGES. THIS IS ANALOGOUS TO THE EXAMPLE ON MUSIC PERCEPTION IN THE TEXTBOOK, PP. 206-207.
FLEXIBILITY (OPEN TO ENVIRONMENTAL INFLUENCE) VERSUS
COMMITMENT (GAINS EFFICIENCY AND STABILITY): The brain becomes more committed and stable with age. The mouse whisker manipulation would have no effect on an adult mouse. And if you isolated an adult cat in a room without horizontal surfaces, the cells sensitive to horizontal surfaces would not die off. This is also why we as adults can get drunk once in awhile and not ruin our brains, but alcohol has a devastating effect on fetal brains.
ASSOCIATION BETWEEN RAPID CHANGE AND PLASTICITY: In general, systems are more open to environmental influence when they are changing rapidly. That's why teratogens are far more devastating during the early stages of organ formation (2-8 weeks after conception). During this period, the organs are developing very rapidly.
FETAL ALCOHOL SYNDROME EFFECTS: HYPERACTIVITY, POOR ATTENTION, IMPULSIVITY, LACK OF INHIBITORY CONTROL; note the devastating effects of alcohol on the morphology of the brain.
KAGAN ON BRAIN DEVELOPMENT
INTRINSIC MOTIVATION: "BUILT TO SEEK INFORMATION" (SEAGULL ANALOGY)--very Piagetian.
UNIVERSAL ENVIRONMENT IDEA: ANY ENVIRONMENT WITH POTS
AND PANS, STICKS AND STONES IS SUFFICIENT FOR NORMAL DEVELOPMENT. THIS IS ALSO A VERY PIAGETIAN IDEA.
STAGE SHIFTS IN BRAIN DEVELOPMENT:
3-MONTHS: SMILE OF RECOGNITION
18-24 MONTHS: INTENTIONALITY, SENSE OF SELF, MORAL SENSE, SOCIAL EMOTIONS (E. G., GUILT, SHAME, PRIDE)
6-7 YEARS: RESPONSIBILITY CONFERRED, ABSTRACT FEARS
13 YEARS: PUBERTY; SEXUAL COMPETENCE, ADULT RESPONSIBILITIES, ADULT EMOTIONS?
THESE SHIFTS COINCIDE BASICALLY WITH THE PIAGETIAN STAGE SHIFTS. KAGAN IS SAYING THAT CHANGES IN THE BRAIN CAUSE CHANGES IN COGNITION AND EMOTION.
BRAIN CHANGES ---> COGNITIVE CHANGES ---> CHANGES IN EMOTION
