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Research at TRI

INTERVENTION STUDIES

 


Brazelton demonstrations

Field, T., Dempsey, J., Hallock, N., & Shuman, H. H. (1978). The mother's assessment of the behavior of her infant. Infant Behavior and Development, 1, 156-167.

• There were no differences between mothers’ and testers’ assessments except that testers assigned more optimal interactive process scores. Normal term infants received more optimal scores from both mothers and testers. Mothers assigned more optimal ratings at one month than at birth.


Widmayer, S., & Field, T. (1980). Effects of Brazelton demonstrations on early interactions of preterm infants and their teenage mothers. Infant Behavior and Development, 3, 79-89.

• Brazelton demonstrations and Mother’s Assessment of the Behavior of her Infant (MABI) were provided to lower class teenage mothers of preterm infants during the neonatal period. Both the Brazelton/MABI group and the MABI group showed more optimal Brazelton interactive process scores, feeding and face-to-face interaction ratings at one month than did preterm and term infant control groups.


Widmayer, S., & Field, T. (1981). Effects of brazelton demonstrations for mothers on the development of preterm infants. Pediatrics, 67, 711-714.

• Results of the first and fourth month assessments showed that the experimental groups preformed more optimally on the Brazelton scale interactive process items, showed superior ratings on the video-tape feeding and face-to-face play sequences, and had better fine motor-adaptive skills.


Carrying position

Field, T., Malphurs, J., Carraway, K., & Pelaez-Nogueras, M. (1996). Carrying position influences infant behavior. Early Child Development and Care, 121, 49-54.

• Results indicate that when the infants were carried facing-in in a soft infant carrier, they spent more time sleeping and were rarely actively awake and looking at the environment. In contrast, the infants were more active in the facing-out position including more time moving their arms, head-turning, kicking, and looking at their environment.


Interactions

Field, T., Healy, B., Goldstein, S., & Guthertz, M. (1990). Behavior state matching and synchrony in mother infant interactions of nondepressed versus depressed dyads. Developmental Psychology, 26, 7-14.

• The depressed mothers and their infants matched negative behavior states more often and positive behavior states less often than did the nondepressed dyads. The total percentage time spent in matching behavior states was less for the depressed than for the nondepressed dyads.


 Interaction coaching

Pickens, J.N. & Field, T. (1993). Attention-getting vs. imitation effects on depressed mother-infant interactions. Infant Mental Health Journal, 14, 171-181.

• Data suggest that the attention-getting condition was the most effective “intervention” for eliciting positive behavior in the depressed mother-infant dyads. Mothers generally rated as showing more positive facial expressions and more game playing (particularly the depressed mothers) during the attention-getting versus the imitation sessions. The infants received more optimal physical activity and facial expression ratings during attention-getting, and the infants of depressed mothers, in particular, showed more positive facial expressivity and more joy expressions. In the imitation condition, mothers showed more imitative behavior, contingent responsivity, and silence during gaze aversion. Infants generally showed more disinterest and self-comfort behaviors, and the infants of depressed mothers, in particular, showed more anger expressions, fussiness, and squirming during the imitation condition.


Nonnutritive sucking

Ignatoff, E., & Field, T. (1982). Effects of nonnutritive sucking during tube feedings on the behavior and clinical course of ICU preterm neonates. Infant Behavior and Development, 107-115.

• Infants provided with nonnutritive sucking stimulation during tube feedings were ready for bottle feeding three days earlier following fewer tube feedings and greater daily weight gain than the control group. They were also discharged earlier with a lower average hospital cost.


Field, T., Ignatoff, E., Stringer, S., Brennan, J., Greenberg, R., Widmayer, S., & Anderson, G. (1982). Nonnutritive sucking during tube feedings: Effects on preterm neonates in an Intensive Care Unit. Pediatrics, 70, 381-384.

• The infants provided with pacifiers averages 27 fewer tube feedings, started bottle feeding three days earlier, averaged a greater weight gain per day, and were discharged eight days earlier for an average hospital cost savings of approximately $3,500.00.


Field, T., & Goldson, E. (1984). Pacifying effects of nonnutritive sucking on term and preterm neonates during heelstick procedures. Pediatrics, 74, 1012-1015.

• Term neonates and preterm neonates, in minimal care or intensive care participated in the study. The treated infants (preterm, minimal care neonates) who were given pacifiers spent less time during and following the heelstick procedure.


Parent training

Field, T., Widmayer, S., Greenberg, R., & Stoller, S. (1982). Effects of parent training on teenage mothers and their infants. Pediatrics, 69, 703-707.

• Growth and development during the first two years were superior for the infants whose mothers received training, particularly those who received paid parent training as teachers aide’s in the infant nursery. Repeat pregnancies were lower and return to work/school rates were higher for the infant nursery mothers.


Review

Field, T. (1980). Supplemental stimulation of preterm neonates. Early Human Development, 4, 301 314.

• The present work is a review of supplemental stimulations of preterm infants treated in intensive care nurseries which suggest benefits for stimulated infants. The types, degree, and duration of benefit, however, vary across studies.


Field, T. (1981). Intervention for high risk infants and their parents. Educational Evaluation and Policy Analysis, 3, 69-78.

• Different studies suggest a number of general implications for social policy on early interventions for high-risk infants. Any form of early intervention must be heavily researched to ensure there are no undesirable side effects. Also, long term assessments must be provided for the subjects, demonstrating long-term effects and cost effectiveness. Generalizability of findings on particular interventions with particular infants should also be evaluated because studies may not always relate to the same group of people. Lastly, the parent should be involved in the interventions as trainee and trainer, they can then become more knowledgeable and skillful.


Field, T. (1986). Interventions for premature infants. Journal of Pediatrics, 109, 183-191.

• Compensating influences of early interventions for premature infants include supplemental stimulation, nonnutritive sucking during tube feedings and heelsticks, tactile and/or kinesthetic stimulation, and parent training.


Field, T. (1988). Stimulation of preterm infants. Pediatrics in Review, 10, 149-154.

• Three of the most popular forms of stimulation for preterm infants in the NICU are described, as well as their effects. They are nonnutritive sucking, kangaroo care, and massage therapy. Results suggest that preterm neonates not only benefit from soothing, calming properties of these forms of stimulations, but they conserve energy, can be pacified during painful procedures, and can demonstrate growth gains following this stimulation.


Field, T. (1990). Alleviating stress in newborn infants in the intensive care unit. Perinatology, 17,1-9.

• Natural care-giving stimulation such as gentle stroking and self-comforting stimulation such as sucking appeared to attenuate distress behavior and physiology during stressful intensive care procedures. These interventions not only soothe the infant, but enable increased weight gain and shorter hospital stay.


Field, T. (1992). Interventions in early infancy. Infant Mental Health Journal, 13, 329-336.

• To facilitate attachment to and from their caregivers three interventions and their affects are described. They include; giving high-risk pregnant women video feedback during prenatal ultrasound, providing preterm neonates nonnutritive sucking opportunities to reduce stress during heelstick and gavage feedings, and providing preterm neonates and preterm cocaine-exposed neonates massage therapy.


Field, T. (1994). Caregiving environments for infants. Children's Environments, 11, 147-154.

• Two of the infants’ most vital caregiving needs are an interesting, organized physical environment and a responsive human environment. Studies suggest that an infant’s physical environment must pay special attention to the following attributes; adequate caregiver and infant ratio, infant group schedule, and environmental organization and stimulation. The human environment, on the other hand, requires the caregiver to be sensitive to the infant’s biological rhythms and social behaviors and to be contingently responsive.


Rooming-in

Prodromidis, M., Field, T., Arendt, R., Singer, L., Yando, R., & Bendell, D. (1995). Mothers touching newborns: A comparison of rooming-in versus minimal contact. Birth, 22, 196-200.

• Data revealed that the rooming-in mothers looked at, talked to, and touched their infants more, watched less television, and talked less on the telephone than mothers with minimal contact with their infants.


Tactile/Kinesthetic stimulation

Field, T., Schanberg, S.M., Scafidi, F., Bauer, C.R., Vega-Lehr, N., Garcia, R., Nystrom, J. & Kuhn, C. M. (1986). Tactile/Kinesthetic stimulation effects on preterm neonates. Pediatrics, 77, 654-658.

• Tactile/kinesthetic stimulation was given to 20 preterm neonates (mean gestational age, 31 weeks; mean birth weight, 1,280 g; mean time in neonatal intensive care unit, 20 days) during transitional ("grower") nursery care, and their growth, sleep-wake behavior, and Brazelton scale performance was compared with a group of 20 control neonates. The tactile/kinesthetic stimulation consisted of body stroking and passive movements of the limbs for three, 15-minute periods per day for 10 days. The stimulated neonates averaged a 47% greater weight gain per day (mean 25 g v 17 g), were more active and alert during sleep/wake behavior observations, and showed more mature habituation, orientation, motor, and range of state behavior on the Brazelton scale than control infants. Finally, their hospital stay was 6 days shorter, yielding a cost savings of approximately $3,000 per infant. These data suggest that tactile/kinesthetic stimulation may be a cost effective way of facilitating growth and behavioral organization even in very small preterm neonates.


Field, T. (1987). Alleviating stress in ICU neonates. Journal of the American Osteopathic Association, 87, 646-650.

• Forty preterm infants were assigned to a control or treatment group. The treatment group received tactile/kinesthetic stimulation for three 15-minute periods during three consecutive hours per day for 10 days. Data suggested that the stimulated infants had a 47% greater weight gain than the control group, were more awake and active a greater percentage of the observation time, received better scores on the Brazelton habituation, orientation, motor activity, and range of state behaviors, and the stimulated infants were hospitalized for 6 days less than the control infants, which saved the hospital approximately $3,000 per infant.


Teenage mothers

Field, T., Widmayer, S., Stringer, S., & Ignatoff, E. (1980). Teenage, lower class, Black mothers and their preterm infants: An intervention and developmental follow up. Child Development, 51, 426-436.

• Lower-class, black teenage mothers were provided a home-based, parent training intervention, and their development was then compared with that of nonintervention controls, of term infants of teenage mothers, and of term and preterm infants of adult mothers. The preterm infants of teenage mothers who received intervention showed more optimal growth, Denver scores, and face-to-face interactions.


Field, T., Widmayer, S., Ignatoff, E., & Stringer, S. (1982). Developmental effects of an intervention for preterm infants of teenage mothers. Infant Mental Health Journal, 3, 11-18.

• Compared to preterm infants without intervention and of teenage mothers, term infants of teenage mothers, and term and preterm infants of adult mothers, the intervention infants of teenage mothers showed more optimal growth, cognitive development, temperament and play behaviors during interactions with their mothers across their first year of development.


Field, T., Widmayer, S., Adler, S., & Decubas, M. (1990). Teenage parenting in different cultures, family constellations and caregiving environments: Effects on infant development. Infant Mental Health Journal, 11, 158-174.

• Teenage parenting was investigated in Cuban and American Black ethnic groups; single parent, nuclear, and extended families; and primary caregiving arrangements- mother versus other. Being a Cuban mother, living in a nuclear family, and being a secondary caregiver were each associated independently with stronger social support systems and more positive child-rearing attitudes and mother-infant play interactions.


Ultrasound feedback

Field, T., Sandberg, D., Quetel, T. A., Garcia, R., & Rosario , M. (1985). Effects of ultrasound feedback on pregnancy anxiety, fetal activity and neonatal outcome. Obstetrics and Gynecology, 66, 525-528.

• The feedback reduced pregnancy anxiety and fetal activity, particularly for the primiparous women. These women experienced fewer obstetrics complications and gave birth to neonates who were greater weight, more appropriate weight-for-length, and less active and irritable.