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Teaching is a demanding profession with teachers of very young children reporting high rates of stress and exhaustion. We tested the effects of a relationship-focused professional development intervention designed to enhance teachers' use of mindfulness-based strategies to support coping on trajectories of teachers' stress, exhaustion (emotional, physical, and mental), and coping. Infant and toddler teachers ( N = 81) from Early Head Start (EHS) or EHS childcare partnerships (CCP) were randomized to the intervention or usual care control condition. Using ecological momentary assessment, teachers completed twice-weekly reports of stress, exhaustion, coping, and coping strategy effectiveness via smartphones for 40 weeks. Multilevel linear regression modeling, accounting for within-person repeated measures, showed no intervention effects on stress and exhaustion trajectories. Teachers in the intervention reported increased use of mindfulness-based strategies for coping over time as compared to the control group, although frequency of use peaked and then declined. While perceptions of stress and exhaustion did not change, teachers' increased use of mindfulness-based strategies suggests improvements in how teachers managed stress and exhaustion; however, the decline in use of coping suggests the need for ongoing support within the workplace., Competing Interests: Conflict of interest The authors have no competing interests to disclose that are relevant to the content of this article.

Little work has examined longitudinal associations between parental reflective functioning (PRF) and mind-mindedness (MM), limiting the understanding of separate or bidirectional trajectories of these related but distinct forms of mentalization. We examined cross-lagged associations between PRF, assessed via interview, and MM, coded from play interactions, over 12 months among 90 parents (86% female; 57% White, 43% Black) of infants ( M age = 10.56 months, SD = 8.20) who were participating in The Michigan Model of Infant Mental Health Home Visiting. Data were collected at study enrollment Time 1 (T1) and at 6-month Time 2 (T2) and 12-month Time 3 (T3) postenrollment. Mind-minded comments were coded as appropriate, reflecting accurate interpretation of mental states or nonattuned, characterizing inaccurate interpretations. PRF and appropriate MM each remained stable over time. PRF at the T1 positively predicted appropriate MM at T2. No other cross-lagged associations between PRF and appropriate MM were significant. Concurrent correlations between appropriate MM and PRF were significant only at T3. Nonattuned MM showed stability from T1 to T2 but nonattuned MM at the T2 did not predict nonattuned MM at T3. Greater PRF at T1 predicted less nonattuned MM at T2. No other cross-lagged associations between PRF and nonattuned MM were significant. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Consistent, sensitive caregiving across home and childcare contexts supports optimal development. In this paper, we share the story of the development of Hearts and Minds on Babies (HMB) for Early Head Start (EHS) administrators, teachers, and parents. HMB was designed to support caregiver reflective functioning and sensitivity and reduce caregiver stress. This paper describes a series of Plan-Do-Study-Act cycles used to adapt an existing parenting intervention into the HMB programming for EHS. Throughout the paper, we present HMB concepts and learning objectives and share teachers' and parents' feedback and adaptations to content and delivery options that support implementation by EHS programs. Feedback from the final cycle suggests that HMB supports EHS administrators, teachers, and parents in their roles and improves relationships. The paper highlights the importance of research-practice partnerships in developing programming that meets the needs of EHS., (© The Author(s), under exclusive licence to Springer Nature B.V. 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Decreased consumption of nicotine and other drugs during pregnancy appears to be a cross-species phenomenon from which mechanism(s) capable of interrupting addictive processes could be elucidated. Whether pregnancy influences smoking behaviour independent of women's knowledge of the pregnancy, however, has not been considered. Using repeated measures analysis of variance (ANOVA), we estimated within-person change in mean cigarettes/day smoked across the estimated date of conception but prior to individually reported dates of pregnancy recognition using longitudinal smoking data from two independent observational cohorts, the Growing Up Healthy (GUH, n = 271) and Midwest Infant Development Studies (MIDS, n = 145). Participants smoked an average of half a pack/day in the month immediately before conception (M (SD) = 12(8.1) and 9.5(6.7) cigarettes/day in GUH and MIDS, respectively). We observed within-person declines in smoking after conception, both before (M GUH  = -0.9; 95% CI -1.6, -0.2; p = 0.01; M MIDS  = -1.1; 95% CI -1.9, -0.3; p = 0.01) and after (M GUH  = -4.8; 95% CI -5.5, -4.1; p < 0.001; M MIDS  = -3.3; 95% CI -4.4, -2.5; p < 0.001) women were aware of having conceived, even when women who had quit and women who were planning to conceive were excluded from analyses. Pregnancy may interrupt smoking-related processes via mechanisms not previously considered. Plausible candidates and directions for future research are discussed., (© 2022 Society for the Study of Addiction.)

Few studies have examined whether maternal caregiving representations are associated with maternal reflective functioning (MRF), especially when MRF is evaluated longitudinally beginning in pregnancy. This study addresses this gap by evaluating whether prenatal and postnatal MRF are associated with mothers' caregiving representations assessed at 7 months postpartum, and by exploring theoretically unexpected MRF scores in each of the representational categories. Forty-seven mothers were recruited during their last trimester of pregnancy from an obstetrics clinic at a university hospital located in a large mid-western city in the United States. During pregnancy, mothers completed the Pregnancy Interview, and at 7 months postpartum they completed the Parent Development Interview (PDI) and the Working Model of the Child Interview. Results indicate that higher prenatal and postnatal MRF increased the odds of being classified as balanced versus disengaged. At 7 months, MRF also increased the odds of being balanced vs. distorted. Ten mothers who were classified as balanced or distorted had unexpected prenatal MRF scores, and six mothers had unexpected MRF scores when representations were assessed concurrently. Mothers classified as balanced with low MRF scores tended to have a low level of education, whereas mothers classified as distorted with high MRF scores had responses that were hostile, helpless, and role-reversed., (© 2021 Michigan Association for Infant Mental Health.)

This study examined changes in parental reflective functioning (PRF) among mothers enrolled in Infant Mental Health-Home Visiting (IMH-HV) and explored whether parental risk, treatment dosage or therapist experience predicted change in PRF. Participants included 75 mothers and their children who were enrolled in IMH-HV delivered by Community Mental Health therapists. Results indicated significant improvements in PRF from baseline to 12-months. Maternal demographic and psychosocial risk, therapist experience and treatment dosage were not directly associated with changes in PRF. However, Mothers who received more treatment sessions from therapists with six or more years of experience demonstrated the greatest improvements in PRF, while mothers who received more treatment sessions from therapists who had been practicing IMH for less than 15 months showed a decline in PRF. Therapists working with very high-risk families may need specific training and ongoing reflective supervision over a period of years to promote improvement in PRF.

Background: The present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting (IMH-HV) infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental "co-regulation" of infant emotion as a pathway to young children's capacity for self-regulation. The synchrony of parent-infant interaction begins to shape the infant's own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant-parent relationship may help buffer the effect of parental risk on child outcomes., Methods: Participants were 58 mother-infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age (<24 months at enrollment) and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences (ACEs) parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder (PTSD) symptoms, as well as their toddler's socioemotional development (e.g., empathy, prosocial skills, aggression, anxiety, prolonged tantrums)., Results: Maternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment., Conclusion: Results indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ribaudo, Lawler, Jester, Riggs, Erickson, Stacks, Brophy-Herb, Muzik and Rosenblum.)

Background: Evaluations of infant-toddler court teams suggest improvements related to permanency, service provision, and parenting. However, findings regarding permanency are limited in that they do not capture children who remain in care for long periods. Less is known about how court teams impact child development., Objective: The first two objectives are to describe baseline development for a small group of infants and toddlers participating in a pilot court team project and to explore changes in their development and behavior. The third objective is to describe permanency outcomes., Participants and Setting: Infants and toddlers (n = 25) under court jurisdiction for substantiated maltreatment and their parents participated in pre-and posttest evaluation of a pilot court team project. All dyads were referred to a parenting intervention, Infant Mental Health Home Visiting. Infant development was assessed using the Bayley-III and behavior was assessed in the Crowell parent-child interaction task. Court records were reviewed for permanency outcomes., Results: Thirty-five percent of children had a developmental delay at program entry and showed significant improvements in expressive language development (p < .01). Increases in prosocial behavior were seen in domains of positive affect (p < .05) and enthusiasm (p < .02) and significant reductions child withdrawal (p < .06). More than two-thirds of children were reunified with their parent(s) and they spent an average of 18.7 months in out-of- home care., Conclusions: These preliminary findings add to the limited literature on the potential impact that infant-toddler court teams can have on permanency and well-being., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Implementation research suggests that fidelity to a therapeutic model is important for enhancing outcomes, yet can be difficult to achieve in community practice settings. Furthermore, few published studies have reported on characteristics of treatment fidelity. The present study examined fidelity to the Infant Mental Health Home Visiting (IMH-HV) model among 51 therapists with a range of experience practicing in community settings across the state of Michigan. IMH therapists completed fidelity checklists after every session with participating families to track use of 15 treatment strategies central to the IMH-HV model across the 12-month study period. Results indicated that the most commonly endorsed components utilized in home visits were developmental guidance and infant-parent psychotherapy, followed by the provision of emotional support. Use of IMH-HV components did not vary over time for the entire sample; however, patterns of strategies used showed somewhat more variability among more experienced therapists and when serving higher risk families. Findings demonstrate that IMH-HV therapists report a range of adherence to the model in community settings, with greatest fidelity to several model core components. Ongoing training in the flexible use of all core strategies may further enhance fidelity and contribute to positive outcomes for caregivers and their children receiving IMH-HV services., (© 2020 Michigan Association for Infant Mental Health.)

This study describes maternal and infant contributions to dyadic affective exchanges during the Still-Face Paradigm (SFP) in an understudied mostly low-income sample. One hundred eleven mothers and their 7-month-old infants were videotaped during the SFP to analyze how a social stressor affects mother-infant positive and negative affective exchanges during interaction. The SFP includes 3 episodes: baseline, maternal still-face, and reunion. Maternal and infant positive and negative affect were scored by masked reliable coders. Data were analyzed using the Actor-Partner Interdependence Model to test the hypotheses that each partner's affectivity during the baseline episode would predict their own affectivity during the reunion episode (actor effects). We also expected that each partner's affectivity during the baseline episode would influence the other partner's affectivity during the reunion episodes (partner effects). After controlling for infant sex and maternal education, results provided evidence for actor effects for maternal and infant positive affect, and for partner effects for maternal baseline positive affect to infant positive affect during the reunion. One significant partner effect was observed for negative affect: Infant negativity during baseline predicted greater maternal negativity during reunion. Findings confirm that both mothers and infants contribute to dyadic affective processes during the SFP but specific findings vary depending on the affective valence in question. Clinical implications and future research are discussed., (Copyright © 2019 Elsevier Inc. All rights reserved.)

This article describes an infant-toddler court team in Michigan, the community-based participatory research approach to the implementation evaluation, and the resulting changes in parenting. Like other court teams, Michigan's Baby Court is led by a science-informed jurist, and all service providers are knowledgeable about the developmental needs of young children and engage in collaborative communication throughout the case. Relationship-based treatment in the form of infant mental health home-visiting was provided to families. Sixteen parents participated in pre- and posttest evaluation visits to assess changes in parents' reflective functioning and interactions with their child. Findings suggest improvements in parents' responsiveness, positive affect, and reflective functioning, with moderate effects. Higher risk parents demonstrated significant changes in reflective functioning, as compared to those at lower risk. These findings add to and support the limited literature on the effectiveness of infant-toddler court teams, which include relationship-based and trauma-informed services., (© 2019 Michigan Association for Infant Mental Health.)

Functional circuits of the human brain emerge and change dramatically over the second half of gestation. It is possible that variation in neural functional system connectivity in utero predicts individual differences in infant behavioral development, but this possibility has yet to be examined. The current study examines the association between fetal sensorimotor brain system functional connectivity and infant postnatal motor ability. Resting-state functional connectivity data was obtained in 96 healthy human fetuses during the second and third trimesters of pregnancy. Infant motor ability was measured 7 months after birth using the Bayley Scales of Infant Development. Increased connectivity between the emerging motor network and regions of the prefrontal cortex, temporal lobes, posterior cingulate, and supplementary motor regions was observed in infants that showed more mature motor functions. In addition, females demonstrated stronger fetal-brain to infant-behavior associations. These observations extend prior longitudinal research back into prenatal brain development and raise exciting new ideas about the advent of risk and the ontogeny of early sex differences.

There is growing evidence that "secure-base scripts" are an important part of the cognitive underpinnings of internal working models of attachment. Recent research in middle class samples has shown that secure-base scripts are linked to maternal attachment-oriented behavior and child outcomes. However, little is known about the correlates of secure base scripts in higher-risk samples. Participants in the current study included 115 mothers who were oversampled for childhood maltreatment and their infants. Results revealed that a higher level of secure base scriptedness was significantly related to more positive and less negative maternal parenting in both unstructured free play and structured teaching contexts, and to higher reflective functioning scores on the Parent Development Interview-Revised Short Form. Associations with parent-child secure base scripts, specifically, indicate some level of relationship-specificity in attachment scripts. Many, but not all, significant associations remained after controlling for family income and maternal age. Findings suggest that assessing secure base scripts among mothers known to be at risk for parenting difficulties may be important for interventions aimed at altering problematic parental representations and caregiving behavior.

This study examined relationships among maternal reflective functioning, parenting, infant attachment, and demographic risk in a relatively large (N = 83) socioeconomically diverse sample of women with and without a history of childhood maltreatment and their infants. Most prior research on parental reflective functioning has utilized small homogenous samples. Reflective functioning was assessed with the Parent Development Interview, parenting was coded from videotaped mother-child interactions, and infant attachment was evaluated in Ainsworth's Strange Situation by independent teams of reliable coders masked to maternal history. Reflective functioning was associated with parenting sensitivity and secure attachment, and inversely associated with demographic risk and parenting negativity; however, it was not associated with maternal maltreatment history or PTSD. Parenting sensitivity mediated the relationship between reflective functioning and infant attachment, controlling for demographic risk. Findings are discussed in the context of prior research on reflective functioning and the importance of targeting reflective functioning in interventions.

Despite a plethora of research on parenting and infant attachment, much less is known about the contributions of parenting to preschool attachment, particularly within different racial groups. This study seeks to build on the extant literature by evaluating whether similar associations between parenting and attachment can be observed in African American and Caucasian families, and whether race moderates them. Seventy-four primary caregivers and their preschool children (51% African American, 49% Caucasian, 46% male) from similar urban, low-income backgrounds participated in two visits 4 weeks apart when children were between 4 and 5 years of age. Attachment was scored from videotapes of the Strange Situation paradigm using the preschool classification system developed by Cassidy, Marvin, and the MacArthur Working Group. Parenting was assessed using a multimethod, multicontext approach: in the child's home, in the laboratory, and via parent-report. Seventy-three percent of the children were classified as securely attached. Warm, responsive parenting behavior (but not race) predicted attachment. Although parents of African American and Caucasian children demonstrated some significant differences in parenting behaviors, race did not moderate the relationship between parenting and child attachment. These findings highlight the direct role that parenting plays over and above race in determining attachment security during the preschool period., (© 2013 American Psychological Association)

This study presents preliminary outcomes for a problem-solving court improvement model, the Miami Child Well-Being Court (Miami-CWBC), which makes evidence-based clinical intervention and integration of the treating clinician's ongoing assessment and perspective central in the dependency court process. Records were reviewed for children adjudicated for maltreatment that completed treatment. Several promising findings suggest that this approach can help jurisdictions improve the lives of young children and their families' capacity to care for them.

This study describes the developmental trajectories of language skills in infants with substantiated maltreatment histories over a 5-year period and evaluates the effect of three different custodial placements on their language trajectories over time: in-home (remaining in the care of the biological parent/parents), nonkin foster care, and nonparental kinship care. Participants included 963 infants reported to child protective services prior to their first birthday and whose maltreatment was substantiated. Results from covariate-controlled growth modeling revealed no significant placement effects. Across all groups, children's auditory and expressive communication scores decreased significantly from Wave 1 (intake) in the infants' first year to Wave 4, when children were about 3.5 years of age, then improved to baseline levels by Wave 5, when children were about 6 years old. Despite these fluctuations, children's average language scores in each placement group remained below the population mean at each wave of the study.

Using data from the National Survey of Child and Adolescent Well-Being, this study examines differences between kinship and foster placements for infants placed in out-of-home care prior to their first birthday. The differences examined include developmental status at time of placement, differences in the home and neighborhood environments, and the duration of time in placement. Participants included 457 infants placed in either kinship or foster care and their caregivers. Findings suggest that infants placed with kin had fewer developmental concerns 2 to 6 months after the initial Child Protective Services investigation and spent significantly less time in placement. The quality of foster and kinship homes and neighborhoods also differed: Foster homes were generally of better quality and located in safer neighborhoods. Overall, for both kin and foster care, the data suggest that even after passage of the Adoption and Safe Families Act of 1997 (ASFA, Public Law 105-89), infants remain in care for a long time: Approximately one third of infants are still in out-of-home care 3 years after the initial investigation., (Copyright © 2011 Michigan Association for Infant Mental Health.)

Clinicians understand the importance of their clients' past relationships on current functioning. The notion of attachment disorganization is especially salient to many clinicians because based on the traditional model of attachment it is the category in which clients with a history of relational trauma are most likely to fall. Unfortunately, lumping together what so many clinicians feel is clinically important may not inform clinical practice and the process by which attachment is assessed is beyond the reach of many clinicians. A different model of attachment, the Dynamic Maturational Model of Attachment and Adaptation offers a new lens through which to view relational trauma and to understand the ways in which danger is processed. This article describes the similarities and differences in the two models of attachment.

The relationships among social skills, dysregulation of symbolic representations of attachment, and school readiness were examined. Participants were 74 preschool children from low-income families in Midwest America. Attachment representations and dysregulation of symbolic representations of attachment were assessed using a story completion task (George & Solomon, 2000) and teachers completed a survey of child behavior, which was used to assess social skills and school readiness skills. Dysregulated content in children's narratives and social skills were significant negative correlates of school readiness. There was also a marginally significant negative association between defensive dysregulation and school readiness skills for children classified as disorganized. Furthermore, a specific marker of dysregulation, controlling behavior toward the administrator, was negatively associated with school readiness, but only for children classified as disorganized. Results from this study suggest that a breakdown in the strategies of insecure/organized children may be a risk factor for low levels of school readiness and that different forms of disorganization may be associated with different types of risk. It may be useful for future studies to account for different forms of disorganization and evidence of a breakdown of strategy.