Tag Archives: environment

How to engage a baby

When you share a laugh with your baby, it can be one the warmest feelings as a parent. But is this a genuine mutual exchange, and how does it come about?

This is a video of what is now a classic experiment in developmental psychology. It shows a mother happily engaging face-to-face with an equally happy baby. The mother then ceases all facial engagement – the “still face” – to which the baby reacts by trying, with all its might, to reestablish the happy interactions. It’s quite a marked and powerful effect:

A historical review of the experiment quotes the researchers who first documented the effect:

“the infant first “orients toward the mother” and “greets her expectantly.” But then, when the mother “fails to respond appropriately,” the infant …

… rapidly sobers and grows wary. He makes repeated attempts to get the interaction into its usual reciprocal pattern. When these attempts fail, the infant withdraws [and] orients his face and body away from his mother with a withdrawn, hopeless facial expression.”

The experiment, in this form, was first presented at a scientific conference in 1975, but it wasn’t the first to document what happened when infants are exposed to varying social interactions. It was, however, the first to use “then-novel videotape technology” on the conference hall’s big screen. Adamson and Frick, in their historical review, suggest that the  immediate and dramatic illustration of the phenomenon contributed to the broad interest this experiment gained. An early lesson in the power of ‘modern’ technology for effective science communication and to maximise research impact.

This may all seem a little obvious to some parents. You may feel that you don’t need a psychologist with a video camera to tell you that a baby is happiest when you are engaging them face-to-face. But there are a number of reasons why the methodical description of this effect has had profound and lasting influence.  

What this experiment first showed, by deliberately manipulating the parent’s engagement, was that the baby is an active player in this exchange. The infant’s social behaviours can influence the parent’s level of engagement, just as the parent can influence the baby, and it can subtly alter these depending on the context. It’s not simply the parent reacting to the baby’s randomly generated cues. It has even been detected in babies as young as a few weeks old.

As Jason Goldman at The Thoughtful Animal says:

“The still face experiment demonstrated that very young infants already have several basic building blocks of social cognition in place. It suggested that they have some sense of the relationship between facial expression and emotion, that they have some primitive social understanding, and that they are able to regulate their own affect and attention to some extent. The infants’ attempts to re-engage with their caregivers also suggest that they are able to plan and execute simple goal-directed behaviors.”

But one reason why this experiment has been so important and enduring is that it provided a standard and reproducible way of measuring children’s social emotional development.

By using the same set-up time-and-time again, it has shown how a child’s social and emotional development becomes richer as they grow older. The response becomes increasingly complex with age, and can include deftly timed facial cues, dampened smiles, sideways glances at their parent and yawns. Adamson and Frick cite a lovely example for the original set of experiments in which a five-month old boy, upon encountering a still face, stopped being wary and…

“…looked at the mother and laughed briefly. After this brief tense laugh, he paused, looked at her soberly, and then laughed again, loud and long, throwing his head back as he did so. At this point, the mother became unable to maintain an unresponsive still face.”

An experience I’m sure many a parent can relate to when – armed with a stern face – they try earnestly to tell off their child, only to be met with a cheeky grin or giggle!

The experiment has also allowed researchers to deconstruct these parent-baby social interactions into visual, auditory and tactile components. Vision and hearing, it seems, is especially important as children get older, but touch can be enough to, at least partially, lessen an infant’s anxiety when confronted with a still face.

Nevertheless, a still face is usually enough to produce the basic negative reaction in a child, even if it’s in response to their mother, father, a stranger or someone on television. Children make a distinction, however, for inanimate objects, even if they appear quite human-like, demonstrating their ability to form genuine social relationships.

This experimental set-up has also revealed possible negative consequences of a parent’s still face. According to Adamson and Frick, children actually show a more dramatic reaction to a still face than to a brief period of separation or to situations in which the parent interrupts interactions to talk to a researcher. Babies assimilate and react to a negative social cue, rather than simply becoming distressed at the lack of stimulation.

The “still face” experiment has shown its use in further understanding various developmental disorders, such as Down’s syndrome, deafness and autism, as well the effects of environmental conditions like infants exposed to cocaine prenatally or to depressed mothers.

The still face experiment has been used to ask questions about how early social and emotional engagement may affect later behaviour. The strength of an infant’s still face effect has been linked to their mother’s normal sensitivity and interactive style, and it may predict the degree of later infant attachment, depression or anxiety, and even behavioural problems.

Clearly, parents who may have a lower level of engagement, such as those experiencing postpartum depression, should not be guilt-tripped, especially as this could have an exacerbating effect. But the still face experiment has shown that simple procedures can help in these situations – depressed mothers who are encouraged to provide more touch stimulation are often able to offset the lack of visual or auditory engagement to bring about more positive social interations.

As Ed Tronick – one of the original researchers of the “still face” experiment – says on his website:

“An infant’s exposure to “good, bad, and ugly” interactions with the mother, as repeatedly communicated by her facial expressions or lack of expression (i.e., a still-face) has long-term consequences for the infant’s confidence and curiosity, or social emotional development, with which to experience and engage the world.

Though let’s not forget the role of fathers, or other partners, either.

[Thanks to mum-in-law Jenny (once again) for the video and @matthewcobb for the Adamson and Frick article]

Telly addicts: alarm over kids’ TV viewing habits

There was a flutter of activity across Twitter and blogs the other day, in response to some reports that suggested kids’ increasing TV viewing was having a detrimental effect on mental health. According to the reports, TV viewing should be limited for children even into their teens and banned altogether for under-threes. The issues highlighted here will be familiar to detractors of Bad Science and Bad Reporting, but I wanted to record some thoughts for posterity.

I first saw the story in The Guardian and it was also picked up by BBC News, The Independent, The Telegraph, Daily Mail, Metro and many other outlets. Whilst it’s an interesting and worthwhile area of study, the paper published in the journal Archives Of Disease In Childhood and the subsequent press statements, had a few problems that undermine the stark headlines.

The paper was not an original research paper, but an opinion piece that looked back at some previous research. The chief agitator in this is Aric Sigman, a psychologist whose method of ‘cherry-picking’ evidence Ben Goldacre has had much to say about in the past. ‘Cherry-picking’ is essentially picking the bits of evidence that support a particular claim, whilst ignoring other evidence that doesn’t. As Goldacre points out, a better way to analyse previous research is to perform a ‘systematic review‘. These reviews say exactly how the literature was searched and compiled, which means it is more free from bias and allows others to reproduce it.

As for this specific case, Pete Etchells at SciLogs does a good job at highlighting the problems with the selective nature of the analysis and why it’s important to understand the cause of something before issuing guidance on fixes. I worry that many developmental outcomes – such as empathy, attention, educational performance – are lumped in under the banner of ‘mental health’, but that is probably for someone more qualified to comment on. Professor Dorothy Bishop‘s remarks in the Guardian article are salient too – if Sigman’s concerns are to do with kids just sitting for long periods, you shouldn’t advocate reading books for too long.

My first thought on reading the reports was that the conclusions seem to be based entirely on correlative studies, so it’s hard to determine cause-and-effect. What if children who watch more TV are also more likely to have inattentive parents? You may still see an association between more TV watching and developmental problems if these are both caused in some way by inattentive parenting, but enforcing a reduction in TV time wouldn’t do anything – getting parents to interact more at other times would have the most effect. (For the record, this is just an example of ‘correlation does not imply causation’ and I’m not suggesting this is supported by the evidence!)

On a more general but related point, there is a real problem with defining ‘screen time’, because you’re essentially describing a medium and not an activity. The Mind Hacks blog (written by KCL psychologist Vaughan Bell and Sheffield University psychology lecturer Tom Stafford) has written about this in relation to internet use. Bell has also written about how there have been worries throughout modern history over new technology. Even ‘education’ was once considered a risk to mental health.

As for TV, there are clearly different types of programmes kids can watch – some are aimed at learning and education, some are musical and participatory, some are interactive, and so on. And there are also different contexts in which to watch TV – alone, with parents talking things through, in the background whilst doing other things, etc. Understanding whether different types of TV interaction have different effects or whether other factors in the child’s environment tend to lead to a particular sort of behaviour, are critical in getting to the root of the issue.

The evidence just isn’t strong or reliable enough to make the sort of alarmist claims Sigman has made. And this is why it is again so disappointing to see the same blanket coverage across much of the press, with little in the way of a proper critique (Prof Bishop’s comments aside). It was once again left to bloggers and commentators on social media to provide a more discerning look at the issues.

I want to emphasise that I’m not dismissing these issues, and there may well be problems caused by excessive use – however that’s defined – of certain types of ‘screen time’ (as Etchells notes too). But it’s important to know what you’re measuring and understand the nuances. It is also crucial to have proper evidence before issuing supposed evidence-based guidance.

The influence of early eating habits in children

Our little one, who is now 10 months old, seems to have got his eating sorted after a stubborn start. We started weaning around the World Health Organization’s recommended 6-month mark, using a mix of spoon feeding and baby-led weaning (more on that in later post). Since then, it has seemed apparent that some things have gone down better than others: scrambled eggs, yoghurt, cheese, toast, chicken, bananas and strawberries were all early hits, while broccoli, tomatoes and beef were swiftly rejected.

He seems to have developed an appetite for some foods after a unsure start, such as cucumber, carrot and apple. And this brought to mind a Naked Scientists podcast from a few months ago, which featured an interview with Marion Hetherington, Professor of Biopsychology at the University of Leeds, on children’s appetite and eating behaviour.

The full transcript is available here and the audio is available here. I’ve made a few summary points below, but do check out the full interview.

  • A developing foetus can encounter tastes and odours derived from the mother’s diet and toxins from the environment, and this may affect later food preference.
  • Babies fed with breast milk are exposed to a greater variety of flavours than are formula-fed babies, and this can mean they are more willing to try new tastes.
  • Babies are primed to accept sweet tastes from birth, whereas bitter tastes are rejected. This means that we have to learn to like bitter foods but not sugary foods.
  • Parents may need to try their baby 8-10 times with a new flavour before the child will accept it, so parents shouldn’t give up after the usual 2-3 times. Also, there may be a sensitive period between 6-9 months in which to introduce new flavours and textures, after which it becomes harder for the child to accept a new food.
  • If a child of school age is fussy about trying new foods, then using rewards and social praise is an effective way of persuading them to test new tastes.
  • Setting healthy eating preferences early on is best to keep healthy eating going into childhood. Even if eating habits go awry in teenage years, many return to their early healthy eating habits as adults.

I thought this raised some interesting points, such as the persistance needed to introduce new tastes during a sensitive time window, and was worth highlighting.

It’d be interesting to know how these environmental factors interact with genetically influenced preferences, such as whether early exposure to broccoli, sprouts or cabbage can moderate the repulsion certain people have towards a compound in those foods. It has been suggested that ageing, smoking or illness may modify this genetically based food preference, and so it would be intriguing to know whether child eating behaviour did so too.

On the social environment

I was brought to thinking about child development and the influence of early parental nurturing after watching a lively exchange on BBC’s Newsnight between the clinical psychologist, Oliver James, and Dr Ellie Lee, a lecturer in social policy at the University of Kent.*

From what I could see, the intense antagonism (aside from James’ unwavering dogmatism) was partly the result of a difference between a purely clinical look at child development, by which controlled scientific studies are held up to encourage the need for early intervention, and the sociological implementation of these ideas, which can introduce many variables to successful intervention.

For instance, showing that supportive parenting behaviours can lead to improved mental and language abilities in infants is one thing (as James would point out), but how you successfully communicate that to parents and change behaviour, is another (as Lee might counter). To lay down a hard-and-fast prescription for parents to follow, without layering burden upon burden, is not always straightforward. A more nuanced approach is required, as appreciated in the Early Intervention report featured in the Newsnight item.

Oliver James, in particular, seems very disposed to attach blame to a parent for any perceived character flaw in their child, and guilt-tripping parents in this way seems an overly blunt approach. And this is the point that Dr Lee may have wished to explain more explicitly.

It seems to me, albeit speculatively, that the parent’s well-being is an important consideration when encouraging them to follow particular regimens. The current consensus of the scientific community may be that a child should be doing X, Y and Z, but it may also be the case that to achieve this, one or both of the parents would end up dangerously sleep deprived, mentally exhausted and with a strain on their relationship. This would be differentially affected by a person’s physiology, underlying immunity, predisposition to mental illness, and so on. It would also depend fairly heavily on a person’s life – their age, whether they’re a single parent, in proximity to close family, in a high pressured job, etc. All of these considerations temper any absolute assertion of an intervention based on clinical data.

The field of psychosocial research, which seeks to understand the interplay between one’s psychology and their social environment, is an important factor to consider when establishing any health initiative. It would be great to see whether there is any direct evidence related to this in the context of early intervention programmes for parents. A recent special issue in the journal Science, lays out some of the issues facing educational intervention initiatives, including the obstacles faced when moving from scientific research to public policy. The need for a holistic approach is summarised in the introduction:

Early childhood education remains peppered with both opportunities and debate. Continued progress will require new research that bridges traditional disciplines of neuroscience, psychology, sociology, economics, public policy, health, and education.

So whilst the clinical research may show that a particular intervention leads to the absolute best outcomes, it may be that a parent ends up finding a middle ground that still provides a beneficial environment for their child, but also a satisfactory outcome for themselves (a sort of cost-benefit assessment, if you like). It would be no good hectoring parents into following a specific course of action, with no amount of flexibility, if it leads to a significant worsening of their own physical or mental health, especially if the knock-on effect is a deterioration in family relationships. It seems highly unlikely that this would allow people to be good parents nor provide a decent environment for the child (a brief look at the scientific literature suggests this assumption isn’t entirely unreasonable, e.g. this, this and this).

I should emphasise that I do not wish to appear as though I am justifying or accepting of ‘bad behaviour’ of parents. There are clearly things we should all strive to do, things that are a struggle, and this will involve a series of adaptations, compromises and sacrifices.

Why, say, do one in five British adults smoke when we know categorically that is causes lung cancer, heart disease and increased risk of stroke? Worse, why do so many adults still smoke in the presence of children or during pregnancy, when passive smoking can cause the same health problems in children (and more) and parental smoking increases the chances that a child will smoke as an adult? A look at how mothers from disadvantaged backgrounds respond to tobacco control initiatives gives some clues – in short, increasing stigmatisation can be counter-productive.

I would like to think, though, that most, if not all, parents are happy to put their very best efforts in and would never be wilfully neglectful. But the point which seems to emerge is that the results of clinical research should be considered against a backdrop of social and population variances. In the case of early intervention, labelling a child as ‘at risk’ or categorically predicting their development, could be helpful in targeting the right guidance and support to the right people, but should not lead to undue and counter-productive stigmatisation.

So, appreciating that each baby, each parent, each family’s circumstance is different, is very valuable. It is critical, as always, to be guided by the scientific evidence available and make this the basis of any initiative to improve child development, but it may not be possible to then arrive at a ‘one-size-fits-all’ formula, a point similar to that made by Dr Luisa Dillner regarding sleep routine.

In short, it’s complicated. Plus ça change…

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* Better quality video embedded (05/10/2011) – thanks to Denys Andrianjafy.