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FACE-TO-FACE INTERACTION BETWEEN PRETERM INFANTS AND MOTIIERS:USE OF THE STILL FACE PROCEDURE

Regina M. Cusson & Tao Yin

University of Maryland School of Nursing, 5 15 W. Lombard St, Baltimore, MD 2 120 1

One of the main developmental tasks of the first year of life is the establishment of a successful and positive relationship between infant and mother. Factors influencing that relationship are salient, particularly with regards to the impact of infant risk, such as prematurity. The influence of both maternal and infant individual contributions can giive insight into the dynamics of establishing the relationship. While it has been well- established that mothers lead the interaction, the infant also makes a valuable contribution to the dyad. Examining more closely the specific interaction strategies used by each partner may provide additional insights into this dynamic process, with the potential for intervention to assist in establishing a positive interactive relationship.

The purpose of this project was to examine interaction in 35 mother-preterm infant pairs at six months chronological age during face-to-face interaction, using the still-face paradigm. The still-face procedure used consisted of five minutes of face-to-face interaction where the mother has several toys available to use in play, three minutes where the mother maintains an ai&ctively neutral face and does not interact with the infant, followed by five minutes of fkwto-face interaction without the use of toys. This process was videotaped and maternal and infant interaction coded. Infant’s responses were coded in three distinct dimensions: gaze, affect, and state. Merging gaze direction with positive and negative affect variables yielded two additional measures: social engagement (gaze directed at mother with positive affect) and social protest (gaze directed at mother with negative affect). Maternal variables included maternal positive and negative affect.

Mothers displayed primarily positive affect during the interaction, with few instances of negative affect. Maternal affect in initial play and recovery play was highly correlated, with consistency of afIkct across both play phases. Infant affect was also consistent across both play phases. In addition, infant positive affect was associated with less distress and disorganization during the still-face phase. Both maternal age and infant age were associated with more optimal interaction strategies, indicating a maturation &ect for favorable dyadic behavior. The still-face effect was present, with infant neutral (43.5%) and negative (40.9%) affect dominating the phase. Interestingly there was more positive and negative affect displayed than reported previously for fullterm infants during the still-face phase. While social protest occurred at about the same rate as that reported for tullterms (10.2% vs. 9.8%), social engagement was approximately twice as long (8.2% vs. 4.5%). Since mothers of preterms have often been described as intrusive in their attempts to engage their infants, it is hypothesized that preterms may increase their interactive behavior when the mother withdraws from the interaction. Removing the mother’s attempts at interaction may free the preterm infant to take the lead in social engagement. These results suggest that preterm infants may demonstrate a different pattern of behavior during the still-face procedure. This pattern may offer opportunities for teaching mothers more sensitive interaction strategies.