Measuring Maternal Behaviors in the Neonatal Intensive Care Unit.
Kimberley D Lakes, Yuqing Guo, Candice Taylor Lucas and 1 others
PMID 29720787WHAT IT FOUND
In 24 NICU mother-preterm infant interactions, raters agreed on mothers' sensitivity and child negative mood.
Maternal sensitivity and positive regard scores varied as expected. Infant behaviors were often not observable. This is about measurement, not infant outcomes.
Key findings
01Rater agreement was moderate for flatness of affect and strong for sensitivity to distress and child negative mood.
02Maternal sensitivity, positive regard, and flatness of affect scores were normally distributed, while intrusiveness, detachment, negative regard, and child ratings were positively skewed.
03Raters agreed on infant states, and quiet sleep was the most common state in 12 of 24 infants.
STILL TO COME
How it was doneWhat they found
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What it does not show
The sample had only 24 dyads, so it cannot establish broad validity for all NICU populations. The measure was originally designed for older infants and children, and this study tested it only in preterm infants in the NICU. The study tested rater agreement and score distributions, but it did not show whether these ratings predict later development or agree with other established measures. Infant behaviors were often marked as no opportunity to observe, so this study cannot say much about infant ratings. Ratings were based on a single 10-minute recorded interaction in the NICU. The dyads came from an intervention study with specific birth age, discharge timing, weight, and exclusion criteria. Generalizability analyses and information about the number of raters or occasions needed were not reported.
The easy way to misread this
Do not read the reliable ratings as proof that the NICU exercise program improves infant development. The study tested rater agreement and score distributions in 24 dyads, not clinical outcomes. It also did not show that these scores can guide individual patient care.